Page 21 - Critical Care Notes

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Ventilator Complications—cont’d

Complication Signs & Symptoms/Interventions
Decreased venous return → Hypotension
decreased cardiac output from Decreased CVP, RAP, and preload
increased intrathoracic pressure Monitor vital signs and hemodynamics.
Stress ulcer and GI bleeding Blood in nasogastric drainage
Hematemesis and/or melena
Hematest nasogastric drainage, emesis,
feces.
Administer proton pump inhibitors or
histamine H 2 -receptor antagonists.
Gastric distention Auscultate bowel sounds. Consider NG
placement.
Paralytic ileus Absence of diminished bowel sounds
Provide nasogastric drainage with inter-
mittent suction.
Turn and position patient frequently.
Inadequate nutrition, loss of Refer to section on nutrition.
protein Start enteral feedings if appropriate.
Start total parenteral nutrition if GI tract
nonfunctional or contraindicated.
Increased intracranial pressure Changes in level of consciousness
Inability to follow commands
Assess neurological status frequently.
Fluid retention from increased Assess for edema.
humidification from ventilator, Administer diuretics.
increased pressure to Drain ventilator tubing frequently.
baroreceptors causing release
of ADH
Immobility Turn and position patient frequently.
Skin breakdown Assess skin for breakdown.
Assist patient out of bed to chair unless
contraindicated.
Keep skin clean and dry, sheets
wrinkle-free.
Continued

BASICS