care Of The Ventilator Patient Quiz

You are the ICU nurse caring for a ventilator patient, post op 40 hours for abdominal surgery with a history of COPD, vital signs are normal, ventilator settings check ok, and no endotracheal secretions are noted.  First write out the steps, using the Institute of Healthcare Improvement (IHI) Ventilator care bundle (VCB), of how you would care for that patient. It is now eight hours into your shift, you go into assess your patient and notice the patient has a temperature of 102.6, copious secretions in the endotracheal tube, and ventilator alarms increased respiratory rate, decreased tidal volume, and increased minute ventilation, and oxygen saturation of 86%.  With that in mind, what occurred with the patient and write out what you would do to care for that patient using the IHI VCB and why. 

Identify three symptoms of VAP:

• A.

  Fever, purulent tracheobronchial secretions, leukocytosis, increased respiratory rate, decreased tidal volume, increased minute ventilation, and decreased oxygenation.

• B.

  Fever, leukocytosis, decreased tidal volume, decreased oxygenation, and increased blood pressure.

• C.

  Decreased oxygen, increased minute ventilation, increased tracheobronchial secretions, and decreased respiratory rate.

• D.

  Fever, increased tracheobronchial secretions, increased respiratory rate, and increased tidal volume.

True or False, ventilator-associated pneumonia is a type of Hospital acquired pneumonia that develops more than 48 to 72 hours after endotracheal intubation? 

• A.

  True

• B.

  False

The key components of the Institute for Healthcare Improvement Ventilator Bundle are:

The risk factors of ventilator associated pneumonia are:

• A.

  Preexisting conditions, such as immunosuppression, chronic obstructive lung disease, and acute respiratory distress syndrome

• B.

  Patients’ body positioning

• C.

  Level of consciousness

• D.

  Medications, including sedative agents and antibiotics