A 78-Year-Old Woman Is Admitted to the Intensive Care Unit

question 56

Multiple Choice

A 78-year-old woman is admitted to the intensive care unit (ICU) with confusion, fever, hypotension, and tachypnea.  She is intubated and started on antibiotics for septic shock caused by a urinary tract infection.  Norepinephrine infusion is started via an internal jugular venous catheter.  The ventilator is set on continuous mandatory ventilation (CMV) mode and the patient is sedated with midazolam and fentanyl infusions.  Chest x-ray shows mild subsegmental atelectasis and appropriate positioning of endotracheal and orogastric tubes.
Which of the following is likely to decrease this patient's length of stay in the ICU and reduce the number of days she requires mechanical ventilation?

• A)Daily interruption of sedation
• B)Early tracheostomy
• C)Low tidal volume ventilation with higher positive end-expiratory pressure levels
• D)Neuromuscular blockade
• E)Synchronized intermittent mandatory ventilation

---

Definitions:

Impression Formation Theory

Theory that explains how you develop perceptions about people and how you maintain and use those perceptions to interpret their behaviors.

Correspondence Inference Theory

A psychological theory that explains how and why people draw inferences about the dispositional attributes of others based on observed behavior and its consequences.

Self-Serving Bias

Tendency to perceive our own behavior as more positive than others’ behavior.

Fundamental Attribution Error

Error that arises from attributing another person’s behavior to internal, controllable causes rather than to external, uncontrollable causes.