Author Question: A 65-year-old male is intubated and placed on a mechanical ventilator after a motor vehicle ... (Read 23 times)

casperchen82 · **on:** Jul 16, 2018

A 65-year-old male is intubated and placed on a mechanical ventilator after a motor vehicle ac-cident.

Thirty-six hours later he develops infiltrates on the chest radiograph. Which of the following ac-tions may have been able to prevent this from occurring?
1. Elevation of the head of the bed 20 to 30 degrees
2. Aspiration of subglottic secretions
3. Changing ventilator circuit every 24 hours
4. Stress ulcer prophylaxis
5. Avoid the use of sedatives
a. 1 only c. 1, 2, 4, and 5
b. 1, 3, and 5 d. 1, 2, 3, 4, and 5

Question 2

A home care patient is being instructed on the use of a hand-held nebulizer. Which of the fol-lowing would be the recommended method of disinfection for the nebulizer?

a. Alkaline glutaraldehyde
b. One part household vinegar and three parts water
c. Pasteurization
d. Autoclave

bbburns21 · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: C
The information indicates that the patient has ventilator-associated pneumonia; ventila-tor-associated pneumonia must be suspected anytime intubation develops shortly after endotra-cheal intubation. There are many actions that can be taken to prevent its development. Current standards state that the ventilator circuit should be changed only when it is grossly contaminated.

Answer to Question 2

ANS: B
Acetic acid is the agent of choice to disinfect home care equipment due to its low cost and effec-tiveness. Alkaline glutaraldehyde requires a use of a hood for protection from fumes. Pasteuriza-tion and autoclave both require specialized equipment.