At 1030 the Respiratory Therapist Is Called to the Bedside

question 6

Multiple Choice

At 1030 the respiratory therapist is called to the bedside of a patient being mechanically ventilated with VC-IMV.The patient is a 55-kg female who has been intubated with a size 8 endotracheal tube.Currently,the ET tube is located 20 cm at the gum line.During spontaneous breathing,the patient shows lack of coordinated chest wall movement,and the respiratory therapist notes some retraction of the intercostal spaces.The respiratory therapist performs a system check.The current and past few patient-ventilator system checks reveal the following information:
$\begin{array} { | l | l | l | l | l | } \hline \text { Time } & 0430 & 0640 & 0835 & 1030 \\\hline P I P \left( \mathrm {~cm} \mathrm { H } _ { \mathbf { 2 } } \mathrm { O } \right) & 28 & 31 & 34 & 41 \\\hline \mathrm { P } _ { \mathrm { qht.nu } } \left( \mathrm { cm } \mathrm {} \mathrm { H } _ { 2 } \mathrm { O } \right) & 18 & 21 & 19 & 20 \\\hline\end{array}$
The most appropriate action to take in this situation is which of the following?

• A) Deflate the cuff and reposition the endotracheal tube.
• B) Request that the patient receive haloperidol and midazolam.
• C) Administer albuterol via an in-line metered-dose inhaler.
• D) Switch the mode to PC-IMV and increase the rate.

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