Wednesday, January 20, 2010

Nursing Care for Patients with MODS

Prevention and Treatment of Infection

Prevention and treatment of infections important in MODS.
Minimize risks of nosocomial infections.
Early surgery to remove necrotic tissue that may provide a medium for bacterial growth.
Once a specific organism is identified, therapy should be modified.
Aggressive pulmonary management is indicated to avoid respiratory infections.
Strict asepsis is indicated for all patients with MODS.

Maintenance of Tissue Oxygenation

Maintaining adequate oxygenation is important.
Interventions that decrease O2 demand and increase O2 delivery are essential.
Sedation, mechanical ventilation, analgesia, paralysis, and rest decrease O2 need.

Appropriate Support of Individual Failing Organs

The patient with ARDS needs aggressive oxygen herapy and mechanical ventilation.

Nutritional and Metabolic Support

Providing adequate nutrition is important.
The total energy expenditure is 1.5 to 2 times normal and protein calorie malnutrition is common
Enteral nutrition is preferred because of a decreased risk of bacterial translocation
TPN is indicated if the enteral route is unavailable or insufficient.

(Lewis, et. al 2007 pg 1795-1796)

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