A patient receiving mechanical ventilatory support accidentally ...

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A patient receiving mechanical ventilatory support accidentally displaces the endotracheal tube out of the trachea. What would be the most appropriate action at this time?
 
  a. Remove the tube and provide manual ven-tilation or oxygenation as necessary.
  b. Push the tube back into the trachea by moving the patient's neck up and down.
  c. Suction the oropharynx with a Yankauer (tonsillar) suction tip.
  d. Apply manual ventilation or oxygenation directly through the endotracheal tube.

Question 2

What does a positive cuff leak test indicate?
 
  a. The patient has significant upper airway edema.
  b. The patient's neuromuscular function is adequate to protect the lower airway.
  c. The patient is at minimal risk for upper airway obstruction.
  d. The patient's muscle strength will provide an effective cough.

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Answer to Question 1

ANS: A
In these cases, completely remove the tube and provide ventilatory support as needed until the patient can be reintubated or the tracheostomy tube reinserted.

Answer to Question 2

ANS: C
The presence of a peritubular leak during spontaneous breathing indicates no encroachment of airway (a positive test).

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TYSM

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