Problem:
M. R. owns a shrimping boat and lives outside of Charleston, SC. M. R. has a 60 pack/yr smoking history. His only additional history includes a laceration of his leg which required 20 stitches in 1988. M. R. was shrimping 3 days ago. Upon arriving at the dock, he was trying to untangle his shrimp nets that were 25 feet off the ground. When his leg got caught in a net, it caused him to fall 25 feet, landing on his chest. He was able to get up, refused emergency medical attention, and went home. Today he presented to the emergency department with shortness of breath, pulse oximetry 89% on RA, and sinus tachycardia with frequent PVCs. M. R.'s oxygen saturation continued to drop to 82% on 100% NRBM. He was intubated in the emergency department. Etomidate 20 mg IV and Anectine 100 mg IV were given prior to intubation 30 min ago. M. R. currently has a 7.5 cm ETT at 22 cm at teeth, right side of mouth. Vent settings are TV 550, assist control 10, FiO2 55%. ABGs were done prior to transfer to ICU (15 min ago). A chest x-ray was also done after intubation. BMP and CBC results are pending. M. R.'s daughter is at the bedside.
Identify items and their purpose in the care of a client with ARDS requiring mechanical ventilation
- Oropharyngeal or nasopharyngeal airway
- Manual resuscitation bag and face mask with 100% oxygen
- Magic slate, magnetic board with plastic letters, pictures, alphabet boards, flash cards
- Yankauer suction catheter
- Wall mount or gomco suction unit
- Inline suction catheter
- Oral care swabs, toothbrush, mouth rinse, mouth moisturizer, and pharyngeal suction catheter
- Pulse oximetry