BHU NO-2019
Medical & Surgical Nursing
Easy
What is the recommended position for ventilated patients to prevent Ventilator Associated Pneumonia?
Appeared in: BHU NO-2019
Explanation
- The semi-recumbent position, with the head of the bed elevated 30 to 45 degrees, is the standard of care for preventing Ventilator-Associated Pneumonia (VAP).
- This position utilizes gravity to help prevent the aspiration of oropharyngeal and gastric secretions into the lungs, which is a primary cause of VAP.
- It is a simple, non-invasive, and highly effective nursing intervention that is a core component of the 'VAP bundle' of care.
Why Other Options Were Wrong
- Option A: This is a therapeutic position used to improve oxygenation in severe Acute Respiratory Distress Syndrome (ARDS), not a standard preventative measure for VAP in all ventilated patients.
- Option C: While useful for preventing pressure injuries and mobilizing secretions, it does not provide the same level of protection against aspiration as elevating the head of the bed.
- Option D: This position significantly increases the risk of aspiration of gastric and oropharyngeal secretions, making it a major risk factor for developing VAP.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Prevention of Ventilator-Associated Pneumonia (VAP) as background academic context rather than a clinical decision trigger.
- Implementing the VAP bundle, including correct patient positioning, is a critical nursing responsibility that significantly reduces ICU morbidity, mortality, length of stay, and healthcare costs.
- Nurses must ensure the head of the bed remains elevated at the correct angle, as it can lower over time due to patient movement or bed adjustments. Alarms on modern ICU beds can help monitor this.
- What if the patient has a cervical spine injury? In this case, a reverse Trendelenburg position may be used to elevate the head while keeping the spine in neutral alignment, but this decision is made by the interprofessional team and is not a routine VAP prevention strategy.
How to Approach the Question
- First, identify the keywords in the question: 'prevent Ventilator Associated Pneumonia (VAP)' and 'recommended position'.
- Recall the main cause of VAP, which is the aspiration of secretions from the mouth or stomach into the lungs.
- Think logically about how gravity affects fluid. A flat (supine) position would allow secretions to pool and easily enter the airway.
- An upright (semi-recumbent) position would use gravity to keep secretions down and away from the airway, thus preventing aspiration.
- Consider the other positions. Prone is a specific treatment for ARDS, and lateral is mainly for pressure relief. This makes them less likely to be the primary answer for VAP prevention.
- Conclude that the semi-recumbent position is the most logical and evidence-based choice for preventing aspiration-related pneumonia.
Concept Tested & Keywords
- Concept Tested: Prevention of Ventilator-Associated Pneumonia (VAP)
- Stem keywords: ventilated patients, Ventilator Associated Pneumonia, VAP, recommended position
- Lead-in keywords: What is
Question ID
QKseujS7WkxDxEm992UJ-s
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 155-157
Practise the full BHU NO-2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Gas Exchange and Respiratory Function Questions
- Which is the most relevant knowledge about oxygen administration to a client with COPD?
- Patient in emergency department diagnosed to have fluid and air present in lung. What is the above-mentioned condition known as?
- Patient is suffering from dyspnea. Which position will you provide for patient to relieve?
- Identify the following instrument which is used in diagnostic procedures:
- Identify the instrument shown in the following image:
- Identify the tube in the following image:
- Which of the following method is used for high flow oxygen administration:
- The following conditions can be diagnosed using chest X-ray; EXCEPT:
- The X-ray finding in a patient with pleural effusion reveals that fluid starts to build up as a result of gravity in:
- Surgical procedure used to correct a deviated nasal septum is:
More BHU NO-2019 Questions
- For tracheal intubation of a child of 6 years uncuffed tracheal tube of following size would be appropriate:
- Hemophilia A is characterized by the deficiency of:
- Which of the following is normal position of uterus:
- A 34 years old female has 3 months history of disturbed sleep with early morning awakening, decreased appetite, lethargy, multiple body pains, feelin…
- Lactose is composed of following two sugars:
- A 25 years female presents with repeated vomiting and several episodes of low grade fever. On examination, she was icteric and had right upper quadra…
- When a nurse is performing a surgical hand hygiene, she must keep hands:
- Concentration of oxygen in expired air is about?
- The appendix is located in?
- How much distance should be maintained from bililight to neonate?