Nurse Nacole ◂ Nursing Resources

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 15 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
Positive-pressure mechanical ventilatory support is an essential component in the life support of patients with respiratory failure. However, it is important to note that this technology is supportive, not therapeutic, and it cannot cure lung injury.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 14 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
Mechanically ventilated patients are at an increased risk of pulmonary infections. One reason is that the ICU environment, with its heavy antibiotic use and sick patients, heightens the risk for infections, often from antibiotic-resistant organisms.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 13 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
Mechanically ventilated patients are at an increased risk of pulmonary infections. One reason is that the endotracheal tube impairs the cough reflex and in itself serves as a potential portal for pathogens to enter the lungs.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 12 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
Mechanically ventilated patients are at an increased risk of pulmonary infections. The natural protective mechanism of glottic closure is compromised, permitting continuous low-grade seepage of oropharyngeal material into the airways.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 11 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
In mechanical ventilation, managing dyssynchronies can be challenging. Careful adjustments of flow magnitude, timing and patterns (especially the use of pressure-targeted, variable-flow breaths) may help optimize flow and cycle synchrony.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 10 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
In mechanical ventilation, subtle dyssynchronies are of little clinical relevance. However, significant dyssynchronies that produce severe patient discomfort are frequently cited as indications for sedation administration in intensive care units.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 09 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
In mechanical ventilation, cycle dyssynchrony occurs when the breath cycling is inappropriately short or long for the duration of effort. Dyssynchronous patients will have unnecessary loads placed on their respiratory muscles.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 08 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
In mechanical ventilation, flow dyssynchrony occurs when the ventilator’s flow delivery algorithm is not well matched to the patient's effort and is more likely to occur during fixed-flow breaths (flow targeted).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 07 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
In mechanical ventilation, premature triggering (double triggering) may be derived from circuit motion artifacts, premature breath cycling or the recently described “reverse” triggering observed during controlled breaths.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 06 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
Patients can interact with all three phases of an assisted breath: (1) trigger, (2) flow delivery and (3) cycle. Triggering dyssynchronies can be attributed to insensitive or unresponsive triggering mechanisms or intrinsic PEEP.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 05 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
Dyspnea, anxiety and discomfort from inadequate ventilatory support can lead to stress-related catecholamine release with subsequent increases in myocardial O2 demands and risk of dysrhythmias.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 04 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
Volume repletion can be used, if appropriate, to maintain cardiac output in the setting of high intrathoracic pressure. Lung distention can increase the right ventricular afterload, further compromising cardiac output.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 03 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
In addition to affecting ventilation, intrathoracic pressure changes resulting from positive-pressure ventilation can affect cardiovascular function. In general, as the mean intrathoracic pressure is increased, the right ventricular filling is decreased.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 02 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
Ventilator-induced lung injury is often a regional phenomenon that occurs when low-resistance/high-compliance units receive a disproportionately high regional tidal volume or when collapsed lung regions are repeatedly opened and closed.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 01 Sep 2026 12:00:00 +0000

Category: Critical Care Nursing
Excessive alveolar stretch (i.e., beyond physiologic limits) can produce significant lung injury even without frank alveolar rupture (ventilator-induced lung injury). Excessive stretching is induced by excessive stress (transpulmonary pressure).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 31 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Other positive-pressure ventilation regional injuries include: Pericardium (pneumopericardium), subcutaneous tissue (subcutaneous emphysema), pleura (pneumothorax) and vasculature (air emboli).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 30 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
The lung can be injured when it is stretched excessively by positive-pressure ventilation. Historically, the most well-recognized injury was alveolar rupture, presenting as extraalveolar air in the mediastinum (pneumomediastinum).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 29 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Because diseased lung units require higher pressures to open than to keep open, additional recruitment can sometimes be provided by the use of recruitment maneuvers that apply pressures in excess of the tidal values.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 28 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Another potential detrimental effect of PEEP is that it raises mean intrathoracic pressure, with the potential in susceptible patients to impede venous return and compromise cardiac filling.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 27 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Because parenchymal lung injury is often heterogeneous, appropriate PEEP in one region may be suboptimal in another. Optimizing PEEP is a balance between recruiting diseased regions without overdistending healthier regions of alveoli.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 26 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
PEEP can be detrimental. Because the tidal breath is delivered on top of the PEEP, end-inspiratory pressures are usually raised by the application of PEEP (although this increase may be less than the actual added PEEP because of compliance).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 25 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Alveoli prevented from collapsing, or “derecruiting,” by PEEP receive several potential benefits. First, alveolar recruitment improves matching and gas exchange throughout the ventilatory cycle.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 24 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
Because of alveolar flooding, exudate and collapse, lung injury usually leads to mismatching and intrapulmonary shunt. In many disease processes, many collapsed alveoli can be recruited during a positive-pressure ventilatory cycle.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 23 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
A patient's effort affects ventilation distribution. A passive positive-pressure breath without diaphragmatic contraction distributes to more nondependent regions. In contrast, an active diaphragm facilitates gas distribution to more dependent zones.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 22 Aug 2026 12:00:00 +0000

Category: Critical Care Nursing
The flow pattern in mechanical ventilation influences distribution. For example, in obstructive inhomogeneities, slow and constant flows tend to distribute gas more evenly (although consequent shorter expiratory times may worsen air trapping).