Which of the following problems are associated with premature withdrawal from mechanical ventilation and untimely extubation? I. hypokalemic metabolic alkalosis II. cardiovascular stress III. muscle overload and fatigue IV. loss of airway protection
A. I, II only
B. II, IV only
C. III, IV only
D. II, III, IV only
ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: The ventilation discontinuation process must be done with proper caution and monitoring because premature withdrawal is associated with the following problems:
• ? Loss of airway protection
• ? Cardiovascular stress
• ? Suboptimal gas exchange
• ? Muscle overload and fatigue
Muscle overload and fatigue may require 24 hours or more of muscle rest. Muscle rest may demand reintubation and high levels of mechanical support to recover from fatigue and overload.
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