Which of the following conditions are complications of ...

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Which of the following conditions are complications of endotracheal suctioning? I. low vacuum pressures II. elevated intracranial pressure III. derecruitment IV. loss of mentation
 
  A. I, III only
  B. II, III only
  C. II, IV only
  D. II, III, IV only

Question 2

The therapist has been asked to attempt to suction a patient's left mainstem bronchus. How should the therapist try to accomplish this task?
 
  A. Simply insert the suction catheter as usual with the hope of entering the left mainstem bronchus.
  B. Insert the suction catheter, and twirl it leftward while advancing the catheter downward.
  C. Use a closed-circuit suction catheter system because this type suction system favors left mainstem bronchus suctioning.
  D. Turn the patient's head to the right while advancing the suction catheter into the airway.

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Answer to Question 1

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Complications of ET suctioning include: (1) hypoxemia, (2) airway trauma, (3) cardiac dysrhythmias, (4) derecruitment, (5) bronchospasm, (6) airway contamination, (9) elevated intracranial pressure, and coughing. Some patients experience alveolar collapse during suctioning, especially when the vacuum pressure is applied too long. To minimize the occurrence of derecruitment, the therapist needs to apply vacuum pressure only during withdrawal of the suction catheter, and limit the procedure to 10 to 15 seconds.
A low vacuum pressure is not a complication of ET suctioning. Suctioning does not cause the patient to loose the ability to think.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.

Answer to Question 2

ANS: D
A. Incorrect response: Despite the chance of successfully entering the left mainstem bronchus with a suction catheter by employing the routine suction maneuver, the therapist must make a special attempt to accomplish this order, and not rely on chance.
B. Incorrect response: Inserting the suction catheter, and twirling it leftward while advancing the catheter downward will not accomplish the task of left mainstem bronchus entry any more than the maneuver performed in response A.
C. Incorrect response: A closed-circuit suction system has no more chance of performing left mainstem bronchus suctioning than does standard open suctioning.
D. Correct response: By turning the patient's head to the right, the angle of bifurcation at the carina for the left mainstem bronchus becomes somewhat less acute, thereby improving the likelihood of entering the left mainstem bronchus with a suction catheter.