After client had tolerated weaning process, physician ordered removal of endotracheal tube and it will be shifted into a nasal cannula. Which of following findings after removal requires immediate intervention by physician?

Correct Answer: C. Coughing out blood.

A sign of a tracheal or esophageal perforation that prevents oxygen from reaching the lungs and can result in internal bleeding. This life-threatening side effect of being intubated requires immediate medical intervention. When hemoptysis begins after endotracheal intubation, upper airway trauma caused by the intubation procedure, endotracheal tube, or endotracheal suction catheters must be considered. If hemoptysis begins after a latent period of 1 or more weeks after intubation, a tracheo-artery fistula may be the source of hemorrhage.

• Option A: Endotracheal tube (ETT) is often necessary to achieve airway control during general anesthesia. However, postoperative sore throat (POST) is considered as a common adverse event after general anesthesia with ETTs. POST continues to be reported with a high frequency and can sometimes persist for several days
• Option B: The incidence of hoarseness after endotracheal intubation varies widely from 14% to 50% but is mostly temporary. In a retrospective study of 3093 patients who had endotracheal intubation during anesthesia, the incidence of hoarseness was 49% in the immediate postoperative period.
• Option D: Neck discomfort is normal and the client should limit talking if it occurs. Many people will experience a sore throat and difficulty swallowing immediately after intubation, but recovery is usually quick, taking several hours to several days depending on the time spent intubated. In most cases, a person will fully recover from intubation within a few hours to days and will have no long-term complications