| Course | NR 341 Complex Adult Health |
|---|---|
| Week | 5 |
| Paper type | Ventilated patient write-up |
| Length | About 1,100 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 341 Week 5
Ventilated Patient Write-Up: Day 3 of ARDS After Aspiration in a 47-Year-Old Man, Machine Settings Beside What He Achieved
Student Name
College of Nursing, Chamberlain University
NR 341: Complex Adult Health
Instructor Name
Month Day, Year
Ventilated Patient Write-Up: Day 3 of ARDS After Aspiration in a 47-Year-Old Man, Machine Settings Beside What He Achieved
The Patient
Mr. G. is 47, 175 centimeters tall, admitted three days ago after a seizure at home during which he aspirated; he developed acute respiratory distress syndrome and was intubated on the first night. This record covers my 12-hour day shift in the intensive care unit on day 3 of ventilation. Details are composite. His predicted body weight, calculated from his height and sex, is 70.6 kilograms, which is the weight all of his ventilator settings are based on.
Two other facts shape the record. His lungs were healthy before Sunday, so the damage on his chest film is new and may recover well, and his seizure medicine, levetiracetam, is given through his feeding tube twice a day, so a missed dose while the tube is paused would put him at risk of another seizure. His tube feeding runs at 50 mL an hour, his goal rate, and is paused only when he is laid flat. His wife visits each afternoon and is kept informed by the team at the bedside.
Settings Beside Achieved Values
Table 1 pairs what the ventilator is set to deliver with what Mr. G. actually achieved, at 1000.
Table 1
Ventilator Settings and Achieved Values, Day 3, 1000
| Measure | Set | Achieved | What it means |
|---|---|---|---|
| Mode | Volume assist-control | Triggering 2 breaths a minute above the set rate | He is making some effort of his own |
| Tidal volume | 420 mL (about 6 mL/kg predicted body weight) | Exhaled 410 to 430 mL | Delivered as set |
| Rate | 24 | 26 total | Mild extra drive, fits his acidosis |
| PEEP | 12 cm H2O | 12 | Holding the lungs open between breaths |
| FiO2 | 0.55 | Saturation 92 to 94% | Within the ordered target of 88 to 95% |
| Plateau pressure | Goal 30 or below | 27 cm H2O | Lung stretch within the protective limit |
| Arterial gas at 0600 | pH 7.33, PaCO2 49, PaO2 72 | Ratio of PaO2 to FiO2 about 131: moderate ARDS; carbon dioxide allowed to rise to protect the lungs |
Note. Plateau pressure measured with a half-second inspiratory hold by the respiratory therapist.
The settings follow the lung-protective approach tested by the ARDS Network, whose trial compared small breaths, about 6 mL for each kilogram of predicted weight with the plateau held at 30 or lower, against the traditional 12 mL per kilogram; deaths fell to 31.0% in the small-breath group against 39.8% (Acute Respiratory Distress Syndrome Network, 2000). The rising carbon dioxide and mild acidosis are the accepted price of smaller breaths, and they are recorded as expected findings, not problems.
Alarms during the shift. The high-pressure alarm sounded three times between 0800 and 1100, each time while he coughed on secretions; each settled after suctioning. The low minute-volume alarm sounded once at 1330, when the circuit was disconnected for an in-line catheter change, and settled within 10 seconds.
The Assessment a Tube Puts at Risk
Lungs. Coarse crackles at both bases, louder on the right, where he aspirated. Secretions thick and tan, moderate in amount, needing suction about every two hours.
Mouth. The tube holder had left a 1 centimeter reddened area on the left corner of his lower lip. The tube was moved to the right side at 0800 and is now moved every 2 hours with the respiratory therapist, with the depth confirmed at 23 centimeters at the lip each time. His teeth were brushed at 0800 and 2000 and his mouth moistened every 2 hours.
Skin. No pressure areas on the sacrum or heels. The skin behind his ears under the tube tie is intact; foam protectors are in place.
Eyes. His lids close fully. Lubricating ointment is applied every 4 hours because a sedated patient blinks less and the cornea can dry.
Care Written With Its Disturbance
Every piece of care has a cost to the ventilated patient, and the record says what it was. Suctioning at 0930 dropped his saturation to 86% for about a minute and raised his heart rate from 96 to 118, both settling within 2 minutes; he was given 100% oxygen for 1 minute before the next suction. Turning at 1200 triggered the high-pressure alarm as he coughed, and his saturation fell to 89% before recovering in 3 minutes. The bed bath was split into two parts, at 1000 and 1400, because doing it all at once had dropped his saturation to the mid-80s yesterday.
Where the Sedation Is Held
He is receiving propofol at 30 micrograms per kilogram per minute and fentanyl at 50 micrograms an hour. The ordered target on the Richmond Agitation-Sedation Scale is -1 to 0: drowsy but opening his eyes to voice for 10 seconds or more, or alert and calm. At 1000 he was at -1, opening his eyes to his name and following a command to squeeze my hand. The current pain, agitation and delirium guideline suggests light rather than deep sedation for adults on ventilators (Devlin et al., 2018). What light sedation secures is that he can show pain, follow commands and be assessed for delirium, which was negative on the confusion assessment at 1000. What it conceals is little, but it does mean he sometimes coughs against the ventilator, which is where the high-pressure alarms came from.
The Angle of the Bed
The head of his bed is kept at 30 to 45 degrees, checked each hour and recorded, because lying flat raises the risk of stomach contents reaching his lungs, the same event that brought him here. It was lowered only for the turn at 1200, for less than 2 minutes.
What He Is Moving Toward
His FiO2 came down from 0.60 yesterday to 0.55 today, and his PEEP may come down if his oxygen holds. The team plans a daily sedation interruption paired with a spontaneous breathing trial once his FiO2 is 0.50 or below and his PEEP 8 or below, which could be tomorrow. For the nurse, that means keeping him light, keeping him moving in bed, and watching his secretions, since thick secretions are one of the reasons a trial fails. His wife asked today when he could talk again; the honest answer was that the tube may come out within days if his lungs keep improving, and that this record will show her the numbers the team is waiting for.
References
Acute Respiratory Distress Syndrome Network. (2000). Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. New England Journal of Medicine, 342(18), 1301-1308. https://doi.org/10.1056/NEJM200005043421801
Devlin, J. W., Skrobik, Y., Gélinas, C., Needham, D. M., Slooter, A. J. C., Pandharipande, P. P., Watson, P. L., Weinhouse, G. L., Nunnally, M. E., Rochwerg, B., Balas, M. C., van den Boogaard, M., Bosma, K. J., Brummel, N. E., Chanques, G., Denehy, L., Drouot, X., Fraser, G. L., Harris, J. E., . . . Alhazzani, W. (2018). Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical Care Medicine, 46(9), e825-e873. https://doi.org/10.1097/CCM.0000000000003299
What the NR 341 Week 5 assignment asks for
The Week 5 assignment asks you to document the care of a patient receiving mechanical ventilation. Instructors generally want a patient background, ventilator settings and their meaning, a respiratory and systems assessment, sedation and comfort management, measures to prevent complications, and evidence in APA. Pair each setting with what the patient actually achieved. Record alarms with their cause and how they settled. Assess the areas a tube puts at risk, such as the mouth, lips and eyes. Write each piece of care with the disturbance it caused and how long it lasted. Compare sedation with the ordered target. Record head-of-bed angle and say why it matters for this patient.
How this NR 341 Week 5 example is built
The first section introduces Mr. G., his height, the seizure and the aspiration, and notes that his lungs were healthy before Sunday. Table 1 places settings beside achieved values at 1000, including a set tidal volume of 420 mL, about 6 mL per kilogram of predicted weight, and a plateau pressure measured with an inspiratory hold. The ARDS Network trial explains the small breaths. Alarms are listed with their causes, such as coughing on secretions. The assessment covers crackles louder on the right, the reddened lip, the skin under the tube tie and eye care. Care is described with its cost, such as suctioning that dropped saturation to 86%. Sedation, bed angle and the path toward a breathing trial complete the paper.
NR 341 Week 5 rubric: what full points look like
Ventilated patient rubrics generally score accurate documentation of ventilator settings, interpretation of the patient's response, a systems assessment, sedation and comfort, prevention of complications, evidence and APA. Most of the NR 341 Week 5 points ride on interpretation, so every setting here is paired with the achieved value and what it means. Assessment earns points for covering the areas the tube puts at risk, including the lip injury. Complication prevention scores through bed angle, tube repositioning and eye care with reasons. Sedation is credited when the actual score is compared with the target, as Devlin and colleagues recommend. Writing each care activity with its disturbance shows the attention graders reward. The ARDS Network trial supports the settings row.
NR 341 Week 5 help from the desk
The worst version of this write-up copies the ventilator screen into a table without saying what the patient achieved. A close second is reporting sedation as "comfortable" with no score or target. Students also leave out the mouth, lips and eyes, which a tube and sedation put at risk, or list prevention measures without reasons tied to this patient. Alarms recorded without causes look like noise rather than assessment. Overloading the paper with ventilator physics leaves little room for nursing. Bed angle should be checked and recorded, not simply assumed. If your patient has a different diagnosis or mode, send the settings and an NR 341 write-up can pair them with what your patient achieved.
Get a NR 341 Week 5 example written to your instructions
Send the Week 5 instructions, the template your classroom issues and the case you were given, and a custom example comes back written to them inside 24 to 48 hours, the first at no charge. One limit worth stating plainly: we work from the scenario your section supplies, never from a patient you looked after, and nothing a clinical instructor signs is ours to produce.
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NR 341 Week 5 questions, answered
How much ventilator detail is expected at this level?
Enough to say what the machine is delivering, what the patient is doing with it, and which signs would tell you it had failed. Sections rarely want the physics. They want the nursing consequence: which alarm you would act on first, what you would check with your own hands before believing a number, and what you would report.
Should the write-up include the family?
Where your template has a field for it, yes, and it is worth more than students expect. A sedated patient cannot report pain, orientation or fear, so what the family notices becomes part of the assessment. Record what they observed and what they were told, and keep it as concrete as the rest of the document rather than reducing it to a line about support.
What if the scenario gives no sedation scale reading?
State the scale your section uses, give the target you are working to and say what you are observing to place the patient against it. An invented score is worse than an honest description. Markers accept a written account of responsiveness far more readily than a number that the case never supplied and nobody could check.
Where can I find a free NR 341 Week 5 sample paper?
The complete Week 5 ventilated patient write-up for Mr. G., including the settings table, alarms, the at-risk assessment, sedation, bed angle, the weaning plan and its references, is on this page.
What tidal volume does the NR 341 Week 5 patient receive, and why?
420 mL, about 6 mL per kilogram of his predicted weight, following the lung-protective approach the ARDS Network trial tested, with the plateau pressure held at 30 or lower.