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Nursing QUESTION #9249
Question 1
A Head Nurse assesses a mechanically ventilated patient for ventilator-associated pneumonia (VAP). Which COMBINATION of nursing interventions constitutes the evidence-based VAP Prevention Bundle?
  • Frequent suctioning, prone positioning, daily chest X-ray, prophylactic antibiotics
  • Head of bed elevation 30–45°, daily sedation vacation, oral decontamination with chlorhexidine, subglottic secretion suctioning, and DVT prophylaxis✔️
  • Hourly oral suctioning, continuous lateral rotation, nebulized antibiotics, gastric pH monitoring
  • Supine positioning, continuous ETT cuff pressure monitoring, prophylactic antifungals, daily bronchoalveolar lavage
Correct Answer Explanation
Correct Answer: B — VAP Prevention Bundle

Evidence-Based VAP Prevention Bundle (IHI):
InterventionRationale
Head of bed elevation \(30 - 45°\)Reduces aspiration of gastric contents
Daily Sedation Vacation (SAT)Reduces duration of mechanical ventilation
Oral care with Chlorhexidine 0.12%Reduces oropharyngeal colonization
Subglottic secretion drainageRemoves pooled secretions above ETT cuff
DVT prophylaxisComponent of IHI ventilator bundle
PUD prophylaxisH2 blockers or PPIs (component of bundle)
Additional measures: maintain ETT cuff pressure at \(20 - 30 \text{ cmH}_2\text{O}\), avoid unnecessary ventilator circuit changes, hand hygiene.