The nurse is called to the intubated patient’s room by the patient's child who reports a large gush of red-tinged fluid from a transverse abdominal wound after the patient coughed. While calling for help, the nurse ensures the patients bed is set to which degree angle?

30°. The patient has experienced a wound dehiscence. Therefore, the nurse places the patient into the low Fowler’s position (15°-30°) to decrease intra abdominal pressure. However, because the patient is intubated and care must be taken to prevent ventilator-associated pneumonia, the patient’s head of bed (HOB) should be set to 30°. Setting the angle at 45° increases the patient’s intra abdominal pressure and should be avoided after a dehiscence. A flat head of bed increases intra abdominal pressure and increases the risk for VAP.

The nurse is called to the intubated patient’s room by the ...

Category: Physiological Adaptation
Difficulty: 8

Topics: Communication & Documentation Disease Prevention Gastrointestinal Respiratory

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