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1,Central Line/Dressing Standards of Care: Nursing Standards of Care:         Rationale: 2, . Pt getting ready to...

1,Central Line/Dressing Standards of Care:

Nursing Standards of Care:        

Rationale:

2, . Pt getting ready to get intubated . Which orders do you implement first, and give a rationale why

1,Ventilator settings: CMV/AC rate 12, TV 550 mL, PEEP +5, FiO2 100%.

2,0.9% NS IV infusion 100 mL hour

3,Insert urinary catheter

4,Fentanyl IV infusion 10-125 mcg/hour. RASS goal -3 (Mod. Sedation)

5,Dexmedetomidine IV infusion 0.2-1 mcg/kg/hour. RASS goal - 3 (Mod. Sedation)

6,Norepinephrine IV infusion (0.5-30 mcg/min) to maintain MAP >65.

7,Vasopressin 0.04 IV infusion

Solutions

Expert Solution

Answer q 1

Dressing is a strile pad,compress or a piece of material that is applied directly over a wound to promote healing. For dressing a central line can use gauze or transparent dressing.Before doing the procedure should wash hands with soap and water , and use a clean gloves .The central line dressing should be changed every 5-7 days if using a transparent dressing. inspect the central line for any soiled , if the dressing is soiled remove the dressing and replace a new sterile dressing

Rationale----Maintaining the central line dressing help to reduce the risk of catheter based infection. The prolonged hospitalization , or a continous use of antibiotics through a central line may leads to infection ,absess,cellulitis and bacteremia.inorder to avoid these complications should check the dressing site and change dressing when ever needed.

Answer q2

1 )Ventilator setting:CMV/AC rate 12TV550ml ,peep +5 ,FiO2 100%

Rationale---vetilator should be kept ready before the procedure to provide direct ventilation to the lungs. most of the intubated patients are mechanically ventilated.

3) Insert urinary catheter

Rationale---- it is important to put urinary catheter before the intubation of the patient to monitor the urine out put. and to reduce changes in patient who are terminally ill or cannot care for themselves.

4) fentanyl IVinfusion 10-125mcg/hr

Rationale--fentanyl can be given as a prior medication to reduce pain and reduce the increased blood pressure.

Nightingale answered 2 years ago
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