While monitoring a patient during a T tube weaning trial, you notice the following: increased patient agitation; increased heart rate (from 90 to 118/min); increased respiratory rate (from 17 to 33/min with some paradoxical motion); and premature ventricular contractions (PVCs) increasing to an average of 5/min. Which of the following actions would be appropriate at this time?
A) Reconnect the patient to the ventilator with prior settings.
B) Encourage the patient to relax, and continue careful monitoring.
C) Request that the patient be given a stat (immediate) bolus of lidocaine.
D) Request that the patient be given a strong sedative or hypnotic.

Question

Quizplus · Accepted Answer

The patient is showing signs of respiratory distress and cardiac compromise, with an increase in heart rate and respiratory rate, as well as PVCs. These symptoms may indicate that the patient is not ready for T tube weaning and needs to be reconnected to the ventilator with prior settings to support their breathing and prevent further complications. Encouraging the patient to relax and careful monitoring may not be enough to address the worsening symptoms. Requesting a bolus of lidocaine or strong sedative/hypnotic is not appropriate without further assessment and consultation with a physician.

While Monitoring a Patient During a T Tube Weaning Trial