Delayed discontinuation from mechanical ventilatory support ...

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Delayed discontinuation from mechanical ventilatory support exposes the patient to which of the following unnecessary risks? I. stretch injury II. infection III. airway trauma IV. community acquired pneumonia
 
  A. III, IV only
  B. I, II, III only
  C. I, II, IV only
  D. II, III, IV only

Question 2

Which of the following problems are associated with premature withdrawal from mechanical ventilation and untimely extubation? I. hypokalemic metabolic alkalosis II. cardiovascular stress III. muscle overload and fatigue IV. loss of airway protection
 
  A. I, II only
  B. II, IV only
  C. III, IV only
  D. II, III, IV only

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Answer to Question 1

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Ventilator management should be aimed at getting the patient liberated from mechanical ventilation as rapidly as possible. Delayed discontinuation from mechanical ventilatory support exposes the patient to unnecessary risks of:
  Infection
  Stretch injury
  Sedation needs
  Airway trauma
  Increased costs
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.

Answer to Question 2

ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: The ventilation discontinuation process must be done with proper caution and monitoring because premature withdrawal is associated with the following problems:
  Loss of airway protection
  Cardiovascular stress
  Suboptimal gas exchange
  Muscle overload and fatigue
Muscle overload and fatigue may require 24 hours or more of muscle rest. Muscle rest may demand reintubation and high levels of mechanical support to recover from fatigue and overload.