Clinical meaning
Mechanical ventilation delivers positive pressure breaths to support gas exchange when the patient cannot maintain adequate ventilation or oxygenation independently. Positive pressure reverses normal physiologic negative-pressure breathing, which impacts hemodynamics (decreased venous return, potential hypotension) and requires vigilant monitoring. The nurse must understand ventilator settings (mode, rate, FiO2, PEEP, tidal volume), alarm parameters, and how to rapidly assess and intervene when alarms activate.
Exam relevance
Risk factors: - ARDS or acute respiratory failure - Post-operative respiratory support - Neuromuscular disease (GBS, myasthenia crisis) - Drug overdose with respiratory depression - Spinal cord injury above C5 - Severe pneumonia or sepsis
Diagnostics: - Verify ventilator settings match the order at the beginning of each shift and after any changes - Monitor and document ventilator settings every 2-4 hours (mode, RR, Vt, FiO2, PEEP, peak pressure, plateau pressure) - Assess patient-ventilator synchrony - Monitor ABGs as ordered (30-60 minutes after setting changes) - Monitor continuous SpO2 and EtCO2 if available - Assess readiness for weaning using SBT criteria