A physician is using a pressure support protocol to wean a patient off ventilatory support. The patient is now at a 5 cm H2O pressure level and has a spontaneous respiratory rate of 21/min
Other cardiovascular and respiratory signs indicate that the patient remains stable. Which of the following actions would you recommend at this point?
a. Switch the patient to 5 cm H2O continu-ous positive airway pressure (CPAP) through the endotracheal tube.
b. Extubate the patient and provide supple-mental O2.
c. Switch the patient to intermittent manda-tory ventilation at a rate of 2/min.
d. Decrease the pressure support level to 3 cm H2O.
ANS: B
In general, patients who can spontaneously breathe comfortably at this level of pressure support can be extubated without problems.
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In this situation, what is the most appropriate action for the LPN to take?
ACTION ONE Wait until he is alone with the receptionists and then ask if they were aware that a patient was listening to their conversation. ACTION TWO Since Will is not the receptionists’ supervisor, Will should keep doing his work because he does not have the authority to say anything. ACTION THREE Will should go to the receptionists and quietly point out that there is a patient listening.