Practice Quiz

Respiratory Therapist

Category - Initiation and Modification of Interventions

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Upon intubation, the respiratory therapist notes breath sounds on the right side, but is unable to detect breath sounds bilaterally. What has most likely occurred during the intubation process?
  1. The cuff has not be inflated on the endotracheal tube.
  2. The endotracheal tube is in the esophagus.
  3. The Ambu bag is not secured to the artificial airway.
  4. The endotracheal tube is in either the left or the mainstem bronchus.
Explanation
Answer: D-If breath sounds are not present on both sides, the endotracheal tube is in either the left or right mainstem bronchus.

The cuff can be deflated and the tube pulled back slightly to correct this. A chest x-ray should be performed to assure proper positioning.

If the cuff is not properly inflated, breath sounds would be absent or bilaterally present but not adequately ventilating patient but would not cause one sided breath sounds to be detected. If the endotracheal tube was in the esophagus no breath sounds would be detected. A sign of esophageal intubation is a distended abdomen. Breath sounds would not be present on either side of the chest if the Ambu bag is not secured to the artificial airway.
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