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34.A patient in the ICU has had an endotracheal tube in place for 3 weeks. The physician has ordered that a tracheostomy tube be placed. The patient's family wants to know whythe endotracheal tube cannot be left in place. What would be the nurse's best response?A)“The physician may feel that mechanical ventilation will have to be used long-term.”B)“Long-term use of an endotracheal tube diminishes the normal breathing reflex.”C)“When an endotracheal tube is left in too long it can damage the lining of the windpipe.”D)“It is much harder to breathe through an endotracheal tube than a tracheostomy.”Ans:CFeedback:Endotracheal intubation may be used for no longer than 2 to 3 weeks, by which time a tracheostomy must be considered to decrease irritation of and, trauma to, the tracheal lining, to reduce the incidence of vocal cord paralysis (secondary to laryngeal nerve damage), and to decrease the work of breathing. The need for long-term ventilation would not be the primary rationale for this change in treatment. Endotracheal tubes do not diminish the breathing reflex.35.The home care nurse is planning to begin breathing retraining exercises with a client Page 12
newly admitted to the home health service. The home care nurse knows that breathing retraining is especially indicated if the patient has what diagnosis?36.The nurse is performing nasotracheal suctioning on a medical patient and obtains copious amounts of secretions from the patient's airway, even after inserting and withdrawing the catheter several times. How should the nurse proceed?