Which of the following equipment should be kept ready at bedside when a patient is on mechanical ventilation?

NHM MP Staff Nurse - 2015

Medical & Surgical Nursing

Easy

Appeared in: NHM MP Staff Nurse - 2015

Explanation

A manual resuscitator bag (Ambu bag) is a mandatory safety device that must be kept at the bedside for all patients receiving mechanical ventilation.
It serves as a critical backup to provide manual breaths in case of ventilator malfunction, power failure, accidental extubation, or during patient transport.
Its immediate availability ensures that the patient continues to be oxygenated and ventilated, preventing life-threatening hypoxia during an emergency.
Nursing protocols universally require checking for the presence and functionality of a manual resuscitator bag at the start of every shift for a ventilated patient.

Option A: A water seal drainage system is specific to patients with chest tubes, which are used to drain air or fluid from the pleural space (e.g., in pneumothorax). It is not a standard requirement for all patients on mechanical ventilation.
Option C: Modern mechanical ventilators have built-in oxygen analyzers that continuously monitor the fraction of inspired oxygen (FiO2) being delivered. A separate, standalone O2 analyzer is not required at the bedside.
Option D: A tracheostomy cleaning kit is only necessary for patients who have a tracheostomy tube. Many patients on mechanical ventilation are intubated with an endotracheal tube (ETT) via the mouth or nose and do not have a tracheostomy.

Clinical Relevance

Nursing practice connection: Use the key finding related to Patient safety and emergency preparedness for mechanical ventilation to guide bedside assessment, documentation, and the next nursing action.
A core nursing responsibility in critical care is ensuring patient safety by preparing for emergencies. Verifying that a functional manual resuscitator bag is at the bedside is a critical safety check at the start of every shift.
Failure to have this device immediately accessible during a ventilator failure can lead to severe hypoxic brain injury or death within minutes.
The DOPE mnemonic (Displacement, Obstruction, Pneumothorax, Equipment) is a vital tool for nurses to quickly assess and troubleshoot the cause of sudden respiratory distress in an intubated patient.

How to Approach the Question

First, identify the core of the question: it asks for essential bedside equipment for any patient on mechanical ventilation.
Analyze the options based on their applicability. The key is to find the item that is universally required, not just for a subset of patients.
Evaluate Option A (Water seal drainage): This is for chest tubes, not all ventilated patients. Eliminate it.
Evaluate Option D (Tracheostomy kit): This is for tracheostomies, not all ventilated patients (many have endotracheal tubes). Eliminate it.
Evaluate Option C (O2 Analyser): This is typically part of the ventilator machine itself, not a separate bedside item. Eliminate it.
Evaluate Option B (Manual resuscitator bag): This is a fundamental safety backup for any ventilator failure, regardless of the patient's specific condition or airway type. This makes it the most critical and universally required item.

Concept Tested & Keywords

Concept Tested: Patient safety and emergency preparedness for mechanical ventilation.
Stem keywords: mechanical ventilation, bedside, equipment
Lead-in keywords: Which

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E6 Nursing Fundamentals Taylor p. 736-738

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