Patient/client monitoring at UPV/SŠ (nurse)

Clinical surveillance

  • Chest movements:
    • Symmetry of movements - do both sides of the chest rise the same during inhalation?
    • Synchronization with the respiratory cycle of the ventilator - does the curve recorded on the monitor agree with the respiratory manifestations of P/K?
  • Skin Color:
  • Listening phenomena:
    • Wheezing, wheezing, "bubbling" – bronchospasm, development of pulmonary edema .
    • Administration of breathing mixture in case of balloon leakage - foamy sputum from the mouth.
  • Engagement of accessory respiratory muscles indicates P/K difficulties with ventilation.
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Monitoring gas exchange

  • Pulse oximetry, oxygen saturation:
    • Beware of CO or cyanide intoxications → increase oxygen saturation values.
    • Methemoglobinemia - the saturation value is recorded lower than it actually is.
    • Attention to the reduction of peripheral circulation caused by P/K cold, administration of catecholamines or e.g. during fever etc.
  • Capnometry and capnography
    • EtCO 2 values ​​are given in different units – kPa, %, mmHg.
    • The capnograph should display a waveform similar to that recorded by the ventilator.
  • Investigation according to ASTRUP :
    • Sampling of arterial, capillary, venous blood → the results can be compared, the oxygen consumption of the periphery can be evaluated.

Monitoring physiological functions

  • EKG :
    • Tachycardia occurs during difficulties.
    • Rhythm disorders.
  • Blood pressure , hemodynamic invasive monitoring:
    • Increase in blood pressure during exercise, after rehabilitation, etc.
  • Breathing frequency:
  • Body temperature:
    • TT increases during exertion, tachypnea, hyperventilation occurs during fevers.
  • State of consciousness :
    • The depth of relaxation, the quality and quantity of consciousness - evaluation of the condition according to the requirements for the ventilation mode.

echnology monitoring

  • Recording the values ​​shown by the fan, the monitor.
  • Fan synchronization monitoring - P/K.

References

  • DOSTÁL, Pavel, et al. Fundamentals of artificial lung ventilation. 2nd, expanded edition. Prague: Maxdorf Jessenius, 2005.  ISBN 80-7345-059-3 Category :high school Nurse Nursing