Thursday, August 1, 2019

Mechanically Ventilated Patient Requiring Sedation Essay

A care plan for a mechanically ventilated patient requiring sedation has to be cautiously planned out with the help of a multidisciplinary team of medical professionals. It is very important for a nurse taking care of a patient on a ventilator to deliver high quality care using evidence-base nursing practices. The nurse need to make sure that he/she has a clear understanding of assessment skills and how to perform safety checks on vital life-saving equipment, having this knowledge base will assist the nurse in planning interventions that best fit the patient needs and desires (Alasad, 2005). The most crucial intervention that I would focus on is the patient’s airway due to if the airway is blocked this would increase the patient’s risk of not breathing and possibly coding by going into respiratory distress, to help decrease the risk of the patient having these airway problems I would focus my attention on doing an assessment of the airway at least once every hour or sooner. The next intervention that I would focus on is the pain level because this is problematic due to the inability of a mechanically ventilated patient to verbalize due to the invasive endotracheal intubation. Therefore I would use tools to measure a patient’s pain that are appropriate for that individual such as a pain picture board or paper with the numeric pain scale on it for the patient to the point to (Ackley, 2011). The following intervention that I would focus on is mouth care and comfort measures in the ventilated patient due to the patient cannot perform oral care on themselves so that puts the patient at an increased risk for an infection setting up in their mouth. Therefore mouth care with a soft brush should be performed every two hours. In addition to this comfort measure are important so the patient must be turned q2hours as a result this will keep the patient comfortable and decrease the risk of the patient’s skin from breaking down due to immobilized. Along with this, a bed bath would be performed everyday so that the nurse can assess the skin for any break downs that may be forming. Another important intervention to perform on a mechanically ventilated patient who is sedated is eye care. It is important for the nurse to maintain eye integrity due to these patients is susceptible to corneal dehydration, abrasions, and even infection. Therefore it is important to instill eye drops to keep the eyes moist and to use the antibiotic eye ointment as prescribed. The last intervention that I would include in this care plan in conjunction with the respiratory department in the hospital is sedation vacation. Doing this method would assist the patient in being weaned off the vent and for the nurse to gather further assessment data without the patient being heavily sedated (Ackley, 2011). In conclusion the nurse’s goal in providing care to a mechanically ventilated patient on sedation is to provide relief while minimizing the development of drug dependency and oversedation. Careful monitoring with a bedside scoring system, the appropriate use of medications, and a strategy of daily interruption can lead to diminished time on the ventilator and in the ICU (Urden, 2012). Reference Ackley, B. J., & Ladwig, G. B. (2011). Nursing diagnosis handbook: An evidence-based guide to planning care (9th ed.). St. Louis, MO: Mosby Elsevier Alasad J, Ahmad M. Communication with critically ill patients. Adv Nurs 2005;50(4) Urden, L. (2012). Priorities in critical care. (6th ed.). St. Louis, MO: Elsevier

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