In which patient would continued use of an artificial airway be ...

[kamilo84]

In which patient would continued use of an artificial airway be necessary?
 
  a. A patient with upper airway burns and no peritubular leak
  b. A patient who tests positive for a perit-ubular leak
  c. A patient with bronchospasm and supple-mental oxygen requirements
  d. A patient with a strong cough who ex-pectorates moderate amounts of sputum

Question 2

A recently extubated patient develops a partial upper airway obstruction, which causes stridor. What action can the respiratory therapist take to improve the patient's condition?
 
  a. Aerosolize 11.25 mg (2.25 solution) of racemic epinephrine.
  b. Put a nonrebreather mask on the patient.
  c. Place the patient on NPPV.
  d. Suggest the use of lorazepam (Ativan).

[popopong]

Answer to Question 1

ANS: A
A patient with upper airway burns may have upper airway inflammation that could obstruct the upper airways. The fact that the patient does not have a peritubular leak means that the airway caliber is not adequate. Extubation of this patient at this time would not be successful.

Answer to Question 2

ANS: A
This patient has developed postextubation glottic edema and should be treated immediately with aerosolized racemic epinephrine. The patient also could be given steroids. A nonrebreather mask would not address the upper airway obstruction unless the mask is powered by heliox. This would allow time for the medical treatment to take effect. Use of an antianxiety drug is not in-dicated in this situation, because it would decrease the patient's drive to breathe. Putting the pa-tient on NPPV would not address the patient's immediate problem.

[kamilo84]

Thanks for the timely response, appreciate it

[ryhom]

Excellent