JIPMER Nursing Officer-2024
Medical Surgical Nursing
Hard
A patient with airway obstruction suddenly becomes unresponsive. What should be the next immediate step?
Appeared in: JIPMER Nursing Officer-2024
Explanation
- When a patient with an airway obstruction becomes unresponsive, the protocol immediately shifts from anti-choking maneuvers (like abdominal thrusts) to CPR.
- The first step of CPR in this scenario is to begin high-quality chest compressions.
- Chest compressions serve a dual purpose: they circulate blood to vital organs and can generate enough pressure to dislodge the foreign object.
- This approach follows the American Heart Association (AHA) guidelines for Basic Life Support (BLS), emphasizing the C-A-B (Compressions, Airway, Breathing) sequence.
Why Other Options Were Wrong
- Option B: Back blows are the recommended intervention for a responsive choking infant (under 1 year of age), not for an unresponsive adult or child.
- Option C: Abdominal thrusts (Heimlich maneuver) are performed only on responsive choking adults and children. They are ineffective and should be stopped once the patient loses consciousness.
- Option D: While CPR is the correct intervention, it must begin with chest compressions, not rescue breaths. Attempting to give breaths first is futile because the airway is blocked, and this delays vital chest compressions.
Related Visual
- Visual 1: Flowchart: Algorithm for managing a choking adult, clearly distinguishing the steps for a responsive victim (abdominal thrusts) versus an unresponsive victim (start CPR with compressions).
- Visual 2: Illustration: Depicting the correct hand placement on the lower half of the sternum for performing chest compressions on an adult.
Clinical Relevance
- Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Management of Foreign Body Airway Obstruction (FBAO) in an Unresponsive Patient in acute care settings.
- Nurses must be able to instantly recognize when a choking patient becomes unresponsive and immediately switch from performing abdominal thrusts to initiating CPR with chest compressions.
- This rapid assessment and change in action are critical determinants of patient survival and neurological outcome.
- Patient Safety: A crucial nursing intervention is to look for the foreign object before giving breaths but to never perform a blind finger sweep, which risks pushing the object deeper and worsening the obstruction.
How to Approach the Question
- First, identify the key elements of the clinical scenario: the patient has an 'airway obstruction' and has 'suddenly become unresponsive'.
- Recognize that 'unresponsive' is the critical change in condition that alters the standard protocol.
- Recall the emergency procedures for choking. Differentiate the steps for a responsive victim versus an unresponsive victim.
- For an unresponsive victim, the procedure is to start CPR.
- Remember the C-A-B sequence (Compressions, Airway, Breathing) for CPR. The first and most immediate action is to start chest compressions.
- Evaluate the options based on this protocol. Eliminate options for responsive victims (Back blows, Abdominal thrusts) and the option that starts CPR incorrectly (Rescue breathing first).
Concept Tested & Keywords
- Concept Tested: Management of Foreign Body Airway Obstruction (FBAO) in an Unresponsive Patient
- Stem keywords: airway obstruction, unresponsive, immediate step
- Lead-in keywords: next immediate step
- Clinical cues: The patient's change in status from (presumably) responsive choking to unresponsive is the critical cue that dictates a change in emergency protocol.
Question ID
Q_cxN9U5d01tfU57weIapk
Practise the full JIPMER Nursing Officer-2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Critical Care Nursing Questions
- What is the procedure shown in the image?
- A nurse at ICU setting is doing suctioning for a client to remove excessive secretions from the mouth. She should know that the maximum time for suct…
- In ATLS algorithm E stands for?
- Most common late complication of central venous line or PICC?
- The low-pressure alarm sounds on the ventilator. The nurse checks the client and then attempts to determine the cause of the alarm but is unsuccessfu…
- Selective digestive decontamination is used to prevent?
- While giving ET tube suctioning, the patient suddenly goes on tachycardia. What will the nurse do?
- An unconscious patient admitted in ICU, what is the first priority for this patient?
- A client with chest tube drainage system. During the morning rounds, the on-duty nurse observes that there is no oscillation in the drainage system.…
- A nurse is doing endotracheal suctioning. During the procedure, the nurse notes decreasing heart rate on the monitor. What should be the first priori…
More JIPMER Nursing Officer-2024 Questions
- Which word cannot be formed from the letters of the word "dummarment"?
- Identify the grammatically correct sentence:
- Correct the following sentence into passive voice: "Teacher is teaching book to students."
- How many times do the hour and minute hands of a clock coincide in a 24-hour period?
- Panchayat Samiti is at which level of the Panchayati Raj system in India?
- What should come in place of "?" in the given series? 18 39 67 102 144 ?
- What sum (in ₹) will earn a simple interest of ₹480 in 3 years at 20% per year rate of interest?
- An example of an organism that takes nutrition from dead and decaying matter is known as
- Turner's sign is?
- Which of the following is the most important initial care when chemical burn is suspected?