Page 276 - Clinical Application of Mechanical Ventilation

242 Chapter 9

Key Terms

anion gap hypoxia
cerebral perfusion pressure (CPP) intrapulmonary shunting
diffusion defect oliguria
dyshemoglobins pulse oximeter
end-tidal carbon dioxide monitoring transcutaneous PCO (PtcCO )
2
2
hypoventilation transcutaneous PO (PtcO )
2
2
hypoxemia ventilation/perfusion (V/Q) mismatch

Learning Objectives

After studying this chapter and completing the review questions, the learner
should be able to:

Name 4 vital signs and list their clinical application.
Describe the findings of normal and abnormal chest movement, breath
sounds, and chest imaging.

Evaluate fluid balance and anion gap.
Describe the application and limitations of blood gases, oximetry, and CO-
oximetry.
Describe the application and limitations of capnography.
Describe the application of transcutaneous blood gas monitoring.
Calculate cerebral perfusion pressure and explain why a minimal pressure
is required for critically ill patients.

INTRODUCTION

Monitoring a patient’s clinical condition during mechanical ventilation is vital be-
cause clinical status often changes rapidly and unpredictably. A patient’s clinical
status may be affected by the underlying illness, medications, organ failure, and
even the settings on the ventilator.

There are four reasons for monitoring a patient on a continuous basis: (1) baseline
measurements can be used to establish the initial treatment plan and serve as a refer-
ence point for future measurements; (2) a trend can be established to document the
progress or regression of a patient’s condition; (3) treatment plans can be added,
altered, or discontinued according to the measurements obtained; and (4) high-limit
and low-limit alarms can be set on most monitors to safeguard a patient’s safety.
This chapter provides an overview of monitoring techniques pertinent to
mechanical ventilation.

Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.