Which of the following statements apply to VAP and respiratory ...

[sjones]

Which of the following statements apply to VAP and respiratory therapy equipment? I. Patients are more likely to develop VAP from secretions aspirated past the ETT cuff than through the ETT. II. HMEs and heated tubing have no difference in VAP rates. III. Drugs aerosolized in-line may become contaminated by reflux of tubing condensate. IV. Closed suction systems reduce the incidence of VAP compared with open system suction catheters.
 
  A. I, III only
  B. I, II, III only
  C. I, III, IV only
  D. I, II, III, IV

Question 2

Which of the following factors facilitate aspiration? I. using muscle relaxants II. assuming a semirecumbent position III. applying endotracheal tube cuff pressures greater than 25 cm H2O IV. using small diameter feeding tubes
 
  A. I only
  B. I, IV only
  C. I, II, III only
  D. II, III, IV only

[gstein359]

Answer to Question 1

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Ventilator tubing, humidifiers, in-line medication nebulizers, and suction catheters play a role in the development of VAP. Patients are more likely to develop VAP from secretions aspirated past the ETT cuff than through the ETT. No difference exists between heated tubing and HMEs in terms of risk of developing VAP. In-line medication nebulizers may become contaminated by reflux of tubing condensate. Closed system and open system suction catheters have the same rate of incidence of VAP.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B

Answer to Question 2

ANS: A
A. Correct response: The endotracheal tube increases the risk of developing pneumonia. Despite the cuff of the endotracheal tube, aspiration has been detected in 20 to 77 of intubated patients. Factors that facilitate aspiration are the supine position, low endotracheal tube cuff pressure (>20 to 25 cm H2O), heavy sedation, large size feeding tubes, and muscle relaxants.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A

[sjones]

Excellent

[amandanbreshears]

TYSM