You are caring for an adult patient with a tracheostomy who is on a mechanical ventilator. His pulse oximetry reading of 85%, heart rate is 113, and respiratory rate is 30. The patient is very restless
His respirations are labored, and you hear gurgling sounds. You auscultate crackles and rhonchi in both lungs. What is the most appropriate action to take?
1) Call the respiratory therapist to check the ventilator settings.
2) Provide endotracheal suctioning.
3) Provide tracheostomy care.
4) Notify the physician of signs of fluid overload.
ANS: 2
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