Oral Care Intervention to Reduce Incidence of Ventilator-Associated Pneumonia in the Neurologic Intensive Care Unit

~ Exam ~

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Learning Objectives:

After reading this article, learners will be able to:

  1. Describe the pathophysiology of VAP.
  2. Recognize preventive strategies to prevent VAP
  3. Explain the role of brushing teeth every eight hours and its relationship to VAP.
1. What are the two leading risk factors for VAP?

  a. Colonization of oropharynx and tube feeds.
  b. Colonization of hands and face.
  c. Skin ulcers and microaspiration of tube feed.
  d. Colonization of oropharynx and micro aspiration of contaminated secretions.
2. Where does VAP causing bacterial colonization most often occur?

  a. Saliva in mouth.
  b. Lungs.
  c. Plaque in mouth.
  d. Anal canal.
3. Head of the bed should be elevated __________at all times or put patient in reverse trendelenberg.

  a. 30°
  b. 40°
  c. 50°
  d. 60°
4. Why is toothbrushing so important in the immune impaired?

  a. Stops bad breath.
  b. Allows nursing to give good care.
  c. Mechanically removes plaque therefore decreasing bacteria.
  d. Mechanically removes plaque therefore increasing bacteria.

5. What is the major benefit to using an endotracheal tube (ET) with an extra subglottic port for suctioning?

  a. It provides more flexibility.

  b. It allows the removal of subglottic secretions preventing microaspiration.
  c. It is a cuffless ET tube allowing secretions to drain.
  d. It is cheaper than regular ET’s.

6. Mechanically ventilated neurologic patients are more prone to VAP for all the following reasons except:

  a. Decreased level of consciousness.
  b. Inability to protect the airway and swallow properly.
  c. Good mobility.
  d. Require sedation for their conditions.
7. Which of the following is the only way to remove plaque besides going to the dentist.

  a. Toothettes.

  b. Oral moisturizers.
  c. Mouth rinse.
  d. Toothbrushing.

8. Studies have shown that patients can become colonized with pathogenic bacteria immediately upon admission to a critical care unit.

  a. True.
  b. False.
9. Toothbrushing and oral care along with all the following, except, prevent occurrence of VAP.

  a. Increase patient mobility.
  b. Increase HOB.
  c. Washing hands
  d. Wearing gloves entire shift, patient to patient.
10. Research has shown that oral care can significantly reduce the incidence of VAP. This is in part, due to:

  a. It provides comfort, reduces stress.

  b. Plaque harboring bacteria are eliminated.
  c. Mucosal tissue remain dry and intact.
  d. Provides for frequent assessment and suctioning.