A patient receiving mechanical ventilation for 2 days ...

[a0266361136]

A patient receiving mechanical ventilation for 2 days demonstrates the following clinical features:   Purulent respiratory secretions   Body temperature 35.5 C   Leukopenia   Pao2 65 mm Hg What should the therapist suggest at this time?
 
  A. blood culture
  B. culture and sensitivity
  C. bronchoscopy
  D. chest radiograph

Question 2

Which of the following microorganisms is the most common gram-negative bacillus to cause VAP?
 
  A. Staphylococcus aureus
  B. Candida albicans
  C. Pseudomonas aeruginosa
  D. Haemophilus influenzae

[tdewitt]

Answer to Question 1

ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: VAP should be suspected if two or more of the following clinical features are present:
  Purulent respiratory secretions
  Body temperature 35.5 C (>38 C and <36 c)
  Leukopenia
  Pao2 65 mm Hg (hypoxemia)
Once VAP is suspected, radiologic studies need to be done. If a newer or persistent chest radiographic abnormality is found, bacteriologic studies need to be performed, and empiric therapy should be started. The presence of a cavity by radiography or positive blood culture with the same pathogen isolated from the respiratory secretions confirms the diagnosis.

Answer to Question 2

ANS: C
A. Incorrect response: Staphylococcus aureus is a facultative anaerobe and an opportunistic pathogen.
B. Incorrect response: Candida albicans is a fungus.
C. Correct response: The most common gram-negative pathogen responsible for the development of VAP is the gram-negative bacillus Pseudomonas aeruginosa.
D. Incorrect response: Haemophilus influenzae is a gram-negative bacillus