FACULTY OF NURSING

LESSON PLAN ON:

CARE OF BABIES IN
VENTILATORS

SUBMITTER BY: SUBMITTED TO:

MISS SHREYA SHARMA MRS. JASMI MANU (PROF.)
M. SC. NURSING 1ST YEAR PRINCIPAL
FACULTY OF NURSING FACULTY OF NURSING
RAMA UNIVERSITY RAMA UNIVERSITY
 GENERAL DESCRIPTION

NAME: Miss Shreya Sharma

COURSE: M. Sc. Nursing 1st year

BATCH: 2021-2022

TOPIC: Care of babies in Ventilators

DATE: 25/11/22

TIME: 45 Minutes

VENUE: M. Sc. Nursing 1st-year class

METHOD OF TEACHING: Lecture cum discussion

AV AIDS: Whiteboard, Leaflets, Pamphlets, Images, Chart

NAME OF THE SUPERVISOR:

PREVIOUS KNOWLEDGE OF THE GROUP: The group has basic knowledge about the Partogram as they have learned about it
during their graduation
 GENERAL OBJECTIVES

At the end of the session, the group will learn about the Partogram and will be able to apply the knowledge in clinical life or day-
to-day life.

SPECIFIC OBJECTIVES

At the end of the session, the group will be able to:

 describe clinical evaluations when the baby is on the ventilator.

 explain the assessment of blood gas exchange.
 elaborate on radiological assessment and imaging.
 discuss assessment of pulmonary functions.
 elucidate on monitoring/ screening for complications.
 explicate the assessment of the needs of the adjunctive therapies.
 S. TIME SPECIFIC CONTENT ACTIVITIES AV EVALUATION
NO OBJECTIVES AIDS
. TEACHING LEARNING
1. 5 INTRODUCTION: Babies requiring mechanical ventilation The teacher The listeners
minutes need close monitoring to assess underlying lung pathology, is are actively
response to treatment, and screening for complications that introducing listening.
are usually associated with mechanical ventilation. Such the topic to
babies often have multi-system involvement and their care the group.
requires prompt identification and correction of all factors
that have the potential to impede their recovery or cause
complications. It should also be realized that respiratory
distress syndrome (RDS), particularly in newborns, is a
dynamic process and is influenced by many factors. These
include different stages of lung development, changing
status of underlying lung disease, secondary complications, a
unique interaction of the heart and lungs, and the
relationship between central control of respiratory drive and
respiratory muscles.

S. TIME SPECIFIC CONTENT ACTIVITIES AV EVALUATION

NO OBJECTIVES TEACHING LEARNING AIDS
.
2. 5 describe CLINICAL EVALUATIONS: This starts with a careful The teacher The listeners L What clinical
minutes clinical history of current and preceding problems, observations of is describing are actively E evaluations are
evaluations general physical condition, and an orderly review of all clinical listening. A done when the
when the baby systems, keeping in mind that babies requiring ventilation evaluations F baby is on the
is on the often have multi-system failure. Clinical examination of the when the L ventilator?
ventilator cardio-respiratory system includes observation for general baby is on E
physical signs including chest wall movement, equality of the T
air entry (by auscultation of both axillae), and the presence ventilator. S
of adventitious sounds such as rhonchi, crepitations.
 S. TIME SPECIFIC CONTENT ACTIVITIES AV EVALUATION
NO OBJECTIVES AIDS
. TEACHING LEARNING
3. 5 explain the ASSESSMENT OF BLOOD GAS EXCHANGES: Analysis The teacher The listeners C What are the
assessment of
minutes of blood gases and acid-base balance on its own conveys is explaining are making H components that
blood gas
exchange relatively little information and should ideally be interpreted the notes. A are needed to be
in a clinical context. When interpreting blood gas results, a assessment R examined during
number of factors must be assessed simultaneously including of the blood T blood gas
the infant’s work of breathing, whether a recent change in gas assessments?
blood gas values represents an acute or chronic deterioration exchange.
and what stage of illness the infant is in.
 S. TIME SPECIFIC CONTENT ACTIVITIES AV EVALUATION
NO OBJECTIVES AIDS
. TEACHING LEARNING
4. 5 elaborate on RADIOLOGICAL ASSESSMENT AND IMAGING: Chest The teacher The listeners W What are the
minutes radiological radiography is one of the most commonly used is elaborating are actively H radiological and
assessment and investigations in neonatal intensive care units, both for the on listening. I imaging done
imaging. purpose of diagnosis and to follow the course of the disease. radiological T when the baby is
However, the specificity of chest radiographs is poor and assessment E on the ventilator?
should always be interpreted in context with clinical and imaging B
information. The findings on chest radiographs are mostly O
suggestive and not always diagnostic. The frequency of A
chest radiography depends on an individual's clinical needs. R
D
 S. TIME SPECIFIC CONTENT ACTIVITIES AV EVALUATION
NO OBJECTIVES AIDS
. TEACHING LEARNING
5. 10 discuss ASSESSMENT OF PULMONARY FUNCTIONS: Real- The teacher The listeners P What will uh
minutes assessment of time graphic analysis of pulmonary mechanics in infants is discussing are actively A assess in
pulmonary receiving assisted ventilation has emerged as a valuable tool the taking part in P pulmonary
functions to aid clinical decision-making. Working knowledge of assessment the H function?
pulmonary mechanics also improves understanding of of pulmonary discussion. L
pulmonary physiology and pathophysiology. Pulmonary functions. E
mechanics monitoring consists of measurements of several T
variables which define different aspects of lung function. S
Specifically, one is interested in the pressure necessary to
cause a flow of gas to enter the airway.
 S. TIME SPECIFIC CONTENT ACTIVITIES AV EVALUATION
NO OBJECTIVES AIDS
. TEACHING LEARNING
6. 5 elucidate on MONITORING/ SCREENING FOR COMPLICATIONS: The teacher is The listeners W What are the
minutes monitoring/ Although life-saving, mechanical ventilation is associated elucidating are listening H complications
screening for with a number of complications which are mostly on carefully I that may occur?
complications iatrogenic. These complications can be broadly divided into monitoring/ T
two groups: (1) injuries to the lungs and airways, and (2) screening for E
other systems. complications B
O
As they are related to mechanical ventilation, it is hoped that A
the extent and frequency of these complications can be R
reduced, even if not completely eliminated, by optimal use D
of ventilatory strategies.
 S. TIME SPECIFIC CONTENT ACTIVITIES AV EVALUATION
NO OBJECTIVES AIDS
. TEACHING LEARNING
7. 10 explicate the ADJUNCTIVE THERAPIES: Infants receiving mechanical The teacher The listeners I What are the
minutes assessment of ventilation are at risk of developing nutritional deficiencies is explicating are listening M adjunctive
the need for for a variety of reasons including inadequate nutritional the carefully A therapies given
adjunctive intake, higher energy requirement, altered nutritional assessment G when the baby is
therapies requirement, intolerance to enteral feeding, and development of the need E on the ventilator?
of feeding disorders. In addition, a significant number of for
such infants develop chronic lung disease with associated adjunctive
nutritional disorders and are likely to have a major adverse therapies.
effect on their subsequent growth and development.
 RECAPITULATION

 What clinical evaluations are done when the baby is on the ventilator?
 What are the components that are needed to be examined during blood gas assessments?
 What are the radiological and imaging done when the baby is on the ventilator?
 What will uh assess in pulmonary function?
 What are the complications that may occur?
 What are the adjunctive therapies given when the baby is on the ventilator?

ASSIGNMENT
Explain the nursing care when the baby is on the ventilator.

DATE OF SUBMISSION: 26/11/22

 SUMMARY

In the session, we discussed the need for care when the baby is on the ventilator, clinical evaluations that are to be done when the
baby is on the ventilator, different components that are to be examined during the blood gas assessment, radiological and imaging
performed when the baby is on the ventilator, assessment of the pulmonary functions, complications that may occur in the babies, and
the adjunctive therapies that are given to the babies on ventilators.

CONCLUSION
Infants receiving mechanical ventilation are often very sick with multi-organ failure and require close monitoring of all systems.
Most complications arising in ventilated infants can be described as iatrogenic. Their incidence and severity can be reduced by good
understanding of the underlying pathophysiology, and appropriate use of ventilatory techniques and adjunctive therapies such as
methylxanthines. A number of advances have occurred in the way mechanical ventilation.
 BIBLIOGRAPHY
 STUDENT HUNT, MEDICINE, child care on ventilator. Available at: https://estudhut.com/ventilator/.
 Care of child on a ventilator. (2022, June 14). In Wikipedia. https://en.wikipedia.org/wiki/care.of.child.on.ventilator
 Konar Hiralal; DC Dutta’s Textbook of Obstetrics; Jaypee Bother’s Medical Publications; 8th Edition; care of a ventilated baby,
page no. 208.
 Arora Sakshi; Self-Assessment & review Obstetrics; Jaypee Health Science Publisher; 9th Edition; baby on ventilator, page no.
552.