A 68-Year-Old Woman Was Admitted to the ICU with Pneumonia

Multiple Choice

A 68-year-old woman was admitted to the ICU with pneumonia and was intubated when she developed progressive hypoxemia.She has been on the ventilator for 5 days and has been tolerating this therapy well.The patient has suddenly become severely agitated and appears to be fighting the ventilator.The ventilator's high pressure alarm is sounding continuously.The respiratory therapist disconnects the patient from the ventilator and begins manual ventilation with 100% oxygen and PEEP.The resuscitator bag is difficult to squeeze,breath sounds are present on the left with no adventitious sounds and absent on the right side,and percussion reveals hyperresonance over the right side.The most appropriate action to address this situation is which of the following?

A) Pull the endotracheal tube back until bilateral breath sounds are heard.
B) Administer a bronchodilator and suction the endotracheal tube.
C) Extubate the patient and reintubate with a larger endotracheal tube.
D) Insert a 14-gauge needle in the second intercostal space, midclavicular line, right side.