Mechanical Ventilation Nursing Care for the NCLEX

Common Ventilator Modes

• AC (Assist-Control): Delivers set rate and volume; client can trigger additional breaths (each gets full volume)
• SIMV: Set rate with full volume; client's extra breaths are own effort (lower volume)
• CPAP: Continuous positive pressure - used for weaning, client breathes independently
• Pressure Support (PS): Augments client's inspiratory effort - used for weaning

Key Settings

• FiO2: Fraction of inspired oxygen (21-100%). Keep ≤60% to prevent O2 toxicity
• PEEP: Positive end-expiratory pressure (prevents alveolar collapse). Typical: 5 cmH2O
• Tidal volume: 6-8 mL/kg ideal body weight

Alarm Troubleshooting

• High pressure alarm: Obstruction - suction, kink in tubing, biting, coughing, bronchospasm
• Low pressure alarm: Disconnection - check all connections, assess client
• NEVER silence alarms without investigating

Nursing Care

• HOB elevated 30-45° (prevent VAP)
• Oral care with chlorhexidine every 2-4 hours
• Assess breath sounds, SpO2, ABGs
• Communication: provide writing materials or picture board
• Sedation assessment (RASS scale)

Study at Respiratory Disorders cheat sheet and Respiratory Nursing deep dive.