Respiratory Therapist

Category - Initiation and Modification of Interventions

A noncompliant patient with end-stage COPD has been hospitalized numerous times over the past year for respiratory failure, and is very difficult to wean from ventilator.

What can the respiratory therapist recommend as a change during his next respiratory failure?
  1. Nontracheal intubation
  2. Endotracheal intubation
  3. Tracheostomy tube
  4. Laryngeal tube
Explanation
Answer: C-A noncompliant, end stage COPD patient who has had multiple respiratory failures and intubations over the past year would benefit from the insertion of a tracheostomy tube during next hospitalization.

A tracheostomy would lessen airway trauma, be easier to maintain, and be helpful during the weaning process. After the patient is weaned from mechanical ventilation, a trach button can be placed on the tube for easy access at next respiratory failure.
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