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Airway Management
| Question | Answer |
|---|---|
| What is the primary indication for tracheal suctioning? | ineffective coughing |
| What is the most common complication of suctioning? | hypoxemia |
| Complications of tracheal suctioning include all of the following: | bronchospam, mucosal trauma and elevated intracranial prssure |
| How often should patients be suctioned? | when physical findings support the need |
| What is the normal range of negative pressure to use when suctioning an adult patient? | -100 to -120mm Hg |
| What is the normal range of negative pressure to use when suctioning children? | -80 to -100mm Hg |
| You are about to suction a 10-year-old patient who has a 6-mm (internal diameter) endotracheal tube in place. What is the maximum size of catheter that you would use in this case? | 10 Fr. You times diameter of endotracheal tube x 2, then go down a size |
| You are about to suction a female patient who has an 8-mm (internal diameter) endotracheal tube in place. What is the maximum size of catheter you would use in this case? | 14 Fr. |
| To prevent hypoxemia when suctioning a patient, the respiratory care practitioner should initially do which of the following? | Preoxygenate the patient with 100% oxygen |
| To maintain positive end-expiratory pressure (PEEP) and high FIO2 when suctioning a mechanically ventilated patient, what would you recommend? | Une a closed-system multiuse suction catheter. |
| Total application time for endotracheal suction in adults should not exceed which of the following? | 10 to 15 seconds |
| While suctioning a patient, you observe an abrupt change in the electrocardiogram wave form being displayed on the cardiac monitor. What action would be most appropriate? | Stop suctioning and immediately administer oxygen. |
| What methods can help to reduce the likelihood of atelectasis due to tracheal suctioning? | Limit the amount of neg pressure used. Hyperinflate pt. before and after procedure. Suction for as short a period of time as possible. |
| What can help to minimize the likelihood of mucosal trauma during suctioning? | Rotate the catheter while withdrawing. Limit the amount of neg pressure. |
| Absolute contraindication for nasotracheal suctioning includes which of the following? | epiglottitis and croup |
| What equipment is NOT needed to perform nasotracheal suctioning? | laryngosocope with MacIntosh and Miller blades. |
| After repeated nasotracheal suctioning over 2 days, a patient with retained secretions develops minor bleeding through the nose. Which of the following actions would you recommend? | stop the bleeding and use a nasopharyngeal airway for access |
| Before the suctioning of a patient, auscultation reveals coarse breath sounds during both inspiration and expiration. After suctioning, the coarseness disappears, but expiratory wheezing is heard over both lung fields. What is most likely the problem? | |
| What general condition requires airway management? | airway compromise, respiratory failure, and the need to protect the airway |
| Which conditions require emergency tracheal intubation? | upper airway or laryngeal edema, loss of protective relexes, cardiopulmonary arrest and traumatic upper airway obstruction |
| Which autonomic or protective neural responses represent potential hazards of emergency airway management? | hypotension, bradycardia, cardiac arrhythmias, and laryngospasm |
| All of the following indicate an inability to adequately protect the airway except: | wheezing, coma, lack of gag reflex or inability to cough Ans: Wheezing |
| Which types of artificial airways are inserted through the larynx? | nasotracheal tubes and orotracheal tubes |
| The advantages of oral intubation include all of the following: | reduced risk of kinking, easier suctioning and less traumatic insertion. |
| Compared with the oral route, the advantages of nasal intubation include all of the following: | less retching and gagging, less accidental extubation and greater long-term comfort. |
| Compared with translaryngeal intubation, the advantages of tracheostomy include all of the following except: | decreased frequency of aspiration |
| What is the standard size for endotracheal or tracheostomy tube adapters? | 15mm external diameter |
| What is the purpose of the additional side port (Murphy eye) on most modern endotracheal tubes? | ensure gas flow if the main port is blocked |
| What is the purpose of a cuff on an artificial tracheal airway? | seal off and protect the lower airway |
| What is the purpose of the pilot balloon on an endotracheal or a tracheostomy tube? | protect the airway agnaist aspiration |
| Which of the following features incorporated into most modern endotracheal tubes assist in verifying proper tube placement? | length markings on the curved body of the tube, imbedded radiopaque indicator near the tube tip and an additional side port (Murphy eye) near the tube tip |
| The removable inner cannula commonly incorporated into modern tracheostomy tubes serves which of the following purposes? | aid in routine tube cleaning and tracheostomy care and provide a patent airway should it become obstructed. |
| What is the purpose of a tracheostomy tube obturator? | minimize trauma to the tracheal mucosal during insertion. |
| In the absence of neck or facial injuries, what is the procedure of choice to establish a patent tracheal airway in an emergency? | orotracheal intubation |
| While checking a crash cart for intubation equipment, you find the following: suction equipment, oxygen apparatus, two laryngoscopes and assorted blades, five tubes, Magill forceps, tape, lubricating gel, and local anesthetic. What is missing? | syringe, resuscitator bag or mask and tube stylet |
| Before beginning an intubation procedure, the practitioner should check and confirm the operation of which of the following? | laryngoscope light source, endotracheal tube cuff and the suction equipment |
| While checking a Miller and a MacIntosh blade on an intubation tray during an emergency intubation, you find that the Miller blade “lights” but the MacIntosh blade does not. What should you do now? | Check and replace the bulb in the MacIntosh blade |
| What size endotracheal tube would you select to intubate a 3-year-old child? | 4.5 to 5.0 mm |
| What size endotracheal tube would you select to intubate a 1500-g newborn infant? | 3.0 mm |
| What size endotracheal tube would you select to intubate an adult female? | 8.0 mm |
| What is the purpose of an endotracheal tube stylet? | adds rigidity and shape to ease insertion |
| To make oral intubation easier, how should the patient’s head and neck be positioned? | neck flexed, with head supported by towel and tilted back |
| What should be the maximum time devoted to any intubation attempt? | 30 seconds. |
Created by:
ldrozd