Certified Registered Nurse Anesthetist (CRNA) Practice Exam

A 12-year-old with cerebral palsy was intubated for aspiration pneumonia and develops stridor after extubation. What is the next recommended step?

1. Administer antihistamines

2. Continue aerosol treatments

3. Re-intubation

4. Administer corticosteroids

The correct answer is: Re-intubation

In the case of a 12-year-old with cerebral palsy who develops stridor after extubation, the primary concern is likely related to airway edema and potential compromise. Stridor indicates upper airway obstruction or swelling, which can occur following extubation due to trauma or irritation from the endotracheal tube. Re-intubation is the most appropriate next step in this scenario as it directly addresses the immediate risk of airway obstruction. If the airway is significantly compromised and the child is showing signs of respiratory distress, re-intubating ensures that the airway is secured and allows for adequate ventilation until the underlying issue can be resolved. While administering corticosteroids may help to reduce inflammation and edema, and aerosol treatments can provide symptomatic relief, they are not immediate interventions to secure the airway. Antihistamines are typically not effective in this situation and do not address the potential for severe airway obstruction. Therefore, the urgency of the situation requires prompt re-intubation to prevent respiratory failure and ensure patient safety.