Medical Surgical Ventilator Settings & Mechanical Ventilation #5

Question

A client was intubated for placement on a mechanical ventilator. Which intervention by the nurse to check for proper placement of the endotracheal tube is priority?

Answers

  1. Ordering a chest X-ray.
    • Rationale:

      This answer is not correct because although a chest X-ray is good, capnography is the priority and most reliable way to confirm that the endotrachial tube has been properly placed.

  2. Checking the client's oxygen saturation
    • Rationale:

      This answer is not correct because although it is important to maintain correct oxygen saturation, this method is not the most definitive way to confirm that the endotrachial tube has been properly placed.

  3. Capnography.
    • Rationale:

      This answer is correct because capnography is the priority and most reliable way to confirm that the endotrachial tube has been properly placed. Capnography is a monitoring device which actually measures the amount of carbon dioxide in air that is exhaled and exhibits a waveform tracing and a numerical readout.

  4. Lung auscultation.
    • Rationale:

      This answer is not correct because although the nurse should auscultate the client’s lungs sounds, capnography is the priority and most reliable way to confirm that the endotrachial tube has been properly placed.

Overview

Capnography is the priority and most reliable way to confirm that the endotrachial tube has been properly placed. Capnography is a monitoring device which actually measures the amount of carbon dioxide in air that is exhaled and exhibits a waveform tracing and a numerical readout.

Explanation

Learning Outcomes

When a client is intubated to be placed on mechanical ventilation, the nursing priority is to ensure the endotracheal tube is correctly placed. The most reliable way to confirm placement of the endotrachial tube is through capnography. Other ways of determining correct tube placement include a sudden increase in the client’s heart rate, sufficient chest wall movements, and by direct laryngoscopy.

Test Taking Tip

Remember that with endotracheal intubation, capnography is the priority and most reliable way to confirm that the endotrachial tube has been properly placed.

Video Rationale