A patient receiving mechanical ventilation has increased peak inspiratory pressures, coarse rhonchi, and a fever. What should the respiratory therapist recommend?
- Sputum culture and gram stain
- Increase the tidal volume
- Chest physiotherapy
- Spontaneous breathing trial
Explanations
- 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.
- Incorrect. Increasing the tidal volume will not address the patient’s increased peak airway pressures, airway secretions, and fever.
- Incorrect. Chest physiotherapy may help if there is difficulty removing secretions. However, secretions alone are not an indication to begin chest physiotherapy.
- Incorrect. There is no evidence from the information given in the question that a spontaneous breathing trial is indicated.