Mechanical Ventilator Management for NCLEX: Modes, Alarms & Nursing Care
NCLEX review of mechanical ventilation. Learn ventilator modes, alarm troubleshooting, ABG interpretation, and critical nursing interventions.
Mechanical Ventilator Management for NCLEX
Mechanical ventilation questions on the NCLEX test your ability to manage complex respiratory care. Understanding ventilator modes, alarm management, and nursing interventions is essential for safe patient care.
Common Ventilator Modes
Assist-Control (AC) delivers a set tidal volume and rate, but allows the patient to trigger additional breaths at the set volume. Every breath is a full mechanical breath. Synchronized Intermittent Mandatory Ventilation (SIMV) delivers a set number of mechanical breaths synchronized with the patient effort, allowing spontaneous breaths between mandatory breaths. Pressure Support Ventilation (PSV) augments the patient spontaneous breathing effort with a set pressure. It is used for weaning and requires the patient to initiate all breaths. CPAP provides continuous positive airway pressure during spontaneous breathing and is commonly used as a weaning mode.
Ventilator Alarms and Troubleshooting
High pressure alarm: Check for kinking in the tubing, mucus plugging (suction the patient), biting on the tube, bronchospasm, or pneumothorax. Low pressure alarm: Check for disconnection from the ventilator, cuff leak or deflation, or tubing disconnection. Always assess the patient first, then the equipment. If unable to resolve the alarm, disconnect the patient from the ventilator and manually ventilate with an Ambu bag while calling for assistance.
Nursing Care for Ventilated Patients
Maintain the head of bed at 30-45 degrees to prevent ventilator-associated pneumonia (VAP). Perform oral care every 2-4 hours with chlorhexidine. Assess respiratory status and breath sounds every 2 hours. Monitor ABG results and report abnormalities. Provide DVT prophylaxis and stress ulcer prophylaxis. Assess sedation level using the Richmond Agitation-Sedation Scale (RASS). Ensure the endotracheal tube cuff pressure is maintained at 20-30 cm H2O.
Weaning Criteria
Patients may be ready for weaning when the underlying condition is improving, FiO2 is 40% or less, PEEP is 5-8 cm H2O or less, adequate spontaneous tidal volume and respiratory rate exist, and the patient can protect their airway. Conduct spontaneous breathing trials and monitor for fatigue or distress. Explore our clinical nursing flashcards and practice ventilator management questions.