A patient receiving mechanical ventilation has increased peak inspiratory pressures, coarse rhonchi, and a fever. What should the respiratory therapist recommend?​

  1. Sputum culture and gram stain
  2. Increase the tidal volume​
  3. Chest physiotherapy
  4. Spontaneous breathing trial

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1. Sputum culture and gram stain

Explanations

  1. Correct. The patient’s fever and coarse rhonchi may indicate the presence of an infection. A sputum gram stain will identify if there is gram positive, or gram negative bacteria present in the sputum.
  2. Incorrect. Increasing the tidal volume will not address the patient’s increased peak airway pressures, airway secretions, and fever.
  3. Incorrect. Chest physiotherapy may help if there is difficulty removing secretions. However, secretions alone are not an indication to begin chest physiotherapy.
  4. Incorrect. There is no evidence from the information given in the question that a spontaneous breathing trial is indicated.

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