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 why the 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: C
Feedback:
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.
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