The nurse notes premature ventricular contractions (PVCs) while ...

[RODY.ELKHALIL]

The nurse notes premature ventricular contractions (PVCs) while suctioning a patient's endotracheal tube. Which action by the nurse is a priority?
 
  a. Decrease the suction pressure to 80 mm Hg.
  b. Document the dysrhythmia in the patient's chart.
  c. Stop and ventilate the patient with 100 oxygen.
  d. Give antidysrhythmic medications per protocol.

Question 2

To verify the correct placement of an oral endotracheal tube (ET) after insertion, the best initial action by the nurse is to
 
  a. auscultate for the presence of bilateral breath sounds.
  b. obtain a portable chest x-ray to check tube placement.
  c. observe the chest for symmetric chest movement with ventilation.
  d. use an end-tidal CO2 monitor to check for placement in the trachea.

[TheNamesImani]

Answer to Question 1

ANS: C
Dysrhythmias during suctioning may indicate hypoxemia or sympathetic nervous system stimulation. The nurse should stop suctioning and ventilate the patient with 100 oxygen. Lowering the suction pressure will decrease the effectiveness of suctioning without improving the hypoxemia. Because the PVCs occurred during suctioning, there is no need for antidysrhythmic medications (which may have adverse effects) unless they recur when the suctioning is stopped and patient is well oxygenated.

Answer to Question 2

ANS: D
End-tidal CO2 monitors are currently recommended for rapid verification of ET placement. Auscultation for bilateral breath sounds and checking chest expansion are also used, but they are not as accurate as end-tidal CO2 monitoring. A chest x-ray confirms the placement but is done after the tube is secured.