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TMC study

Troubleshooting Changes in Vital Signs

QuestionAnswer
Hypotension Decreased venous return (caused by positive pressure) Evaluate fluid balance and possible need for filling of vascular bed
Hypertension Anxiety response to decreased PaO2, decreased PaCO2 Reassure, alleviate fear Check patient-ventilator system; If not easily corrected obtain and evaluate ABG value
Respiratory swing of blood pressure Decreased venous return (caused by positive pressure) systolic/diastolic pressures indicate inadequate perfusion, evaluate fluid balance; consider filling vascular bed
New arrhythmias Anxiety Decreased PaO2 Decreased PaCO2 Increased PaCO2 Decreased venous return Reassure, alleviate fear
Large swings in CVP or PCWP Decreased venous return Check other hemodynamics parameters for adequacy of perfusion
Decreased urinary output Decreased renal perfusion Increased ADH Evaluate other hemodynamics parameters for adequacy of perfusion
Fever infection Atelectasis Increased metabolic rate caused by fighting the ventilator Overheated humidifier Treat infection/review precautions Check for mucous plugs, ET position Check sensitivity and patient triggering effort settings Check temp
Changes in respiratory rate Altered settings Change in metabolic needs Anxiety Sleep Check patient-ventilator settings Evaluate patient's metabolic rate Reassure, alleviate fears Normal observation
Accessory muscle use/paradoxical breathing Increased work of breathing Patient-ventilator dyssynchrony auto-PEEP Increase support level Provide pressure support ventilation Increase insp flow or sensitivity Eliminate auto-PEEP
Created by: VivianP