Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What is the treatment for postextubation stridor?

1. Cold, dry air and antihistamines

2. Warmed, humidified oxygen and nebulized racemic epinephrine

3. Corticosteroids and intravenous fluids

4. Immediate re-intubation

The correct answer is: Warmed, humidified oxygen and nebulized racemic epinephrine

Postextubation stridor occurs when there is upper airway edema that develops after the removal of the endotracheal tube, leading to a risk of airway obstruction. The appropriate treatment for this condition involves the use of warmed, humidified oxygen and nebulized racemic epinephrine. Warmed, humidified oxygen helps to soothe and moisturize the inflamed tissues in the airway, which can alleviate some swelling and ease the passage of air. Nebulized racemic epinephrine is a critical component, as it acts as a vasoconstrictor to reduce edema in the airway through its alpha-adrenergic effects. This can provide rapid relief of stridor and lessen the chances of airway obstruction. While corticosteroids and intravenous fluids can be helpful in reducing airway swelling over a longer duration, the immediate management focuses on the rapid-acting interventions like nebulized racemic epinephrine combined with humidified oxygen to address the acute symptoms effectively. Other options, such as cold, dry air and antihistamines, do not provide the appropriate therapeutic effects needed for treating this specific condition, and immediate re-intubation is usually reserved for cases where there is significant airway compromise that cannot be managed conservatively.