The therapist receives an order to administer an inhaled corticosteroid to a patient with status asthmaticus who is receiving mechanical ventilation. What should the therapist do at this time?
A. Attach a spacer near the elbow of the ventilator breathing circuit.
B. Actuate the MDI directly down the ETT.
C. Use a small-volume nebulizer to aerosolize the drug.
D. Inform the physician that inhaled corticosteroids are ineffective for acute asthma episodes.
?ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: Patients who experience an asthmatic attack while being mechanically ventilated should receive systemic IV corticosteroids. Generally, inhaled corticosteroids are not indicated for patients receiving mechanical ventilation. However, asthma patients who are not having an acute episode, but are maintained on inhaled corticosteroids, may be an exception.
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