Which of the following precautions can be implemented to minimize ...

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Which of the following precautions can be implemented to minimize the risk of developing VAP? I. employing the minimal leak technique for cuff care II. instituting noninvasive positive pressure ventilation when indicated III. avoiding placing the patient in the supine position IV. suctioning the patient only PRN
 
  A. I, II only
  B. II, III only
  C. II, III, IV only
  D. I, III, IV only

Question 2

Which of the following VAP preventive measures fall into the IA classification? I. Do not routinely change ventilator circuits unless soiled. II. Clean and sterilize certain equipment. III. Staff education and involvement in infection control. IV. Use sterile water for nebulization.
 
  A. I, IV only
  B. I, III only
  C. II, IV only
  D. I, II, III, IV

[Smiles0805]

Answer to Question 1

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Despite the recommendation to avoid placing the patient in the supine position, and to apply using the semirecumbent position, clinicians often maintain patients in the supine position during mechanical ventilation. Noninvasive positive pressure ventilation should be considered in all eligible patients with no contraindications because it has been shown to reduce the need for intubation, prevent VAP, and improve outcome. Also, unnecessary blood transfusions need to be avoided. Lung-protective mechanical ventilation strategies need to be implemented along with timely weaning and extubation practices.
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 Centers for Disease Control and Prevention published guidelines in 2004 providing an evidence-based recommendation for the prevention of VAP. The recommendations have five categories and are delineated on pages 277 and 278 in the textbook. The components of Category IA are strongly recommended for implementation and are strongly supported by experimental, clinical, or epidemiologic studies. The components of Category IA include:
  Do not routinely change ventilator circuits unless soiled.
  Clean and sterilize certain equipment.
  Staff education and involvement in infection control.
  Use sterile water for nebulization.

[Coya19@aol.com]

Excellent

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