While monitoring a patient during a T tube weaning trial, you ...

[OSWALD]

While monitoring a patient during a T tube weaning trial, you notice the following: increased pa-tient agitation; increased heart rate (from 90 to 118/min);
 
  increased respiratory rate (from 17 to 33/min with some paradoxical motion); and premature ven-tricular contractions (PVCs) increasing to an average of 5/min. Which of the following actions would be appropriate at this time?
  a. Reconnect the patient to the ventilator with prior settings.
  b. Encourage the patient to relax, and con-tinue careful monitoring.
  c. Request that the patient be given a stat (immediate) bolus of lidocaine.
  d. Request that the patient be given a strong sedative or hypnotic.

Question 2

While monitoring a patient during a T tube weaning trial, you notice the following: an increase in heart rate from 86 to 100/min; an increase in respiratory rate from 12 to 23/min;
 
  an increase in PaCO2 from 39 to 45 mm Hg; and a decrease in PaO2 from 82 to 73 mm Hg. Which of the following actions would be appropriate at this time?
  a. Reconnect the patient to the ventilator with prior settings.
  b. Request that the patient be administered a mild sedative.
  c. Suction the patient after manual hyperin-flation or oxygenation.
  d. Encourage the patient to relax, and con-tinue careful monitoring.

[Ashley I]

Answer to Question 1

ANS: A

Answer to Question 2

ANS: D