A patient receiving mechanical ventilation is experiencing bronchospasm. The physician has ordered 5 mg of albuterol every 20 minutes for three doses. Which of the following forms of medication delivery should the therapist select?

A. metered-dose inhaler
B. small-volume nebulizer
C. dry powder inhaler
D. direct instillation

?ANS: B
A. Incorrect response: Under routine conditions, an MDI is the preferred method of bronchodilator administration during mechanical ventilation.
B. Correct response: A small-volume nebulizer is the preferred mode of delivery of a bronchodilator to a patient receiving mechanical ventilation when the drug dose is either high or when continuous delivery has been ordered.
C. Incorrect response: A dry powder inhaler is an ineffective method of drug delivery to a mechanically ventilated patient.
D. Incorrect response: Bronchodilator medications are not available for direct installation into endotracheal tubes.