The nurse is providing care to a child who is intubated and the child's condition is deteriorating. Which of the following would the nurse do first?
A) Check if the tracheal tube is obstructed
B) Assess for displacement of the tracheal tube
C) Look for signs of a possible pneumothorax
D) Check the equipment for malfunction
B
Feedback:
The PALS mnemonic "DOPE" is useful for troubleshooting when the status of a child who is intubated deteriorates: D = Displacement: the tracheal tube is displaced from the trachea; O = Obstruction: the tracheal tube is obstructed (e.g., with a mucus plug); P = Pneumothorax: usually a pneumothorax results in a sudden change in the child's assessment manifested by decreased breath sounds and decreased chest expansion on the side of the pneumothorax, possible subcutaneous emphysema over the chest (with a tension pneumothorax, there may be a sudden drop in heart rate and blood pressure); E = Equipment failure: relatively simple problems such as a disconnected oxygen supply, leaks in the ventilator circuit, and loss of power can cause the child to deteriorate.
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