A 70-year-old client has pneumonia and has just had a respiratory arrest. He has just been intubated with an 8- mm endotracheal tube. During auscultation of his chest, breath sounds were found to be absent on the left side.

A 70-year-old client has pneumonia and has just had a respiratory arrest. He has just been intubated with an 8- mm endotracheal tube. During auscultation of his chest, breath sounds were found to be absent on the left side.

The nurse identifies the most likely cause of this as:
A . Inappropriate endotracheal tube size
B . Left-sided pneumothorax
C . Right mainstem bronchus intubation
D . Pneumonia

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Answer: C

Explanation:

(A) Appropriate endotracheal tube sizes for adults range from 7.0C8.5 mm.

(B) Pneumothorax could be indicated by an absence of breath sounds on the affected side.

However, in a recently intubated client, the first priority would be to consider tube malposition.

(C) During intubation, the right mainstem bronchus can be inadvertently entered if the endotracheal tube is inserted too far. Left mainstem bronchus intubation almost never occurs because of the angle of the left mainstem bronchus.

(D) Breath sounds for someone with pneumonia may be decreased over the areas of consolidation. 

However, in a recently intubated client, the first priority would be to consider tube malposition.