Dys. Trach Tubes, Intubation, Mech Ventilation

Front 1

An artificial opening in the trachea that facilitates the passage of air and removal of secretions

Back 1

tracheostomy

Front 2

a tube inserted into the trachea b/t 3rd and 4th tracheal rings below larynx; size 8 typical for adults

Back 2

tracheostomy tube

Front 3

portion of respiratory tract beginning at the mouth and nose and ending at the larynx

Back 3

upper airway

Front 4

portion of respiratory tract beginning at the larynx and ending at smallest units in lungs

Back 4

lower airway

Front 5

trach tube indications

Back 5

indicated for upper airway obstruction @ or above level of true vocal folds

Front 6

name some reasons for a trach tube

Back 6

-foreign body
-stenosis
- tvc paralyzed
- airway burns
- upper airway obstruction
-spinal cord cereal

Front 7

Describe the three parts of a trach tube

Back 7

-outter cannula stays in place to hold site open

- inner cannula that remains in tube except for cleaning

-obturator-inserted to provide a smooth rounded tip for insertion of the tube

Front 8

what are the two types of trach tubes

Back 8

cuffed/not
fenestrated/not

Front 9

what is a cuffed trach tube used for

Back 9

a balloon that surrounds the cannula and when inflated prevents air from coming up and going into lower airway - closed ventilatory system

Front 10

if cuff is deflated

Back 10

suctioning is necessary to catch material that has accumulated around the cuff

Front 11

what is a fenstrated trach tube used for

Back 11

allows for greater airflow thru the larynx for speech

Front 12

what are the changes that happen to the voice with a trach tube

Back 12

softer and more breathy

Front 13

explain the changes to secretions with a trach tube

Back 13

increased mucus and viscosity
decreased ability to bring up mucus

Front 14

describe a passy muir valve

Back 14

a one way air valve that fits onto the end of the trach tube

valve is always closed until pt inhales - closed position allows patient to create a positive airway pressure and restres a more normal closed respiratory syst.

Front 15

benefits of passy muir valve

Back 15

restores positive airway pressure
superior voice/speech prod
improves swallow
may reduce aspiration
can use with a ventilator
improves oxygenation
improves olfaction
facilitates secretion management
facilitates infection control

Front 16

describe intubation

Back 16

endotrach tube thru mouth or nose -down pharynx thru vocal folds to provide airway

severely compromises swallowing
larynx may be damaged
pt subject to dry mouth lesions of lips tongue and buccal mucosa

Front 17

describe ventilator dependant pts.

Back 17

-increase in dysphagia bc respiration under control of machine
-pt cannot lengtehn exhalation to allow for swallow
-normally have a trach tube in place with cuff inflated

Front 18

what should you use when testing swallowing on a ventilator dependent pt

Back 18

1/3 tsp and present @ beginning of exhalation phase

Front 19

what test is used for aspiration

Back 19

blue dye test- 1/3 tesp of variety of blue dyed foods- suction trach immediately - presence of blue dyed material indicates aspiration

Front 20

Describe the Patient Self Determination Act of 1991

Back 20

allow pts to fully participate in decisions regarding their health care
-est. a pt.- physician relationship allowing a balance b/t the individuals morals and values agnst the known risks and benefits of proposed medical care.

Front 21

what are the two parts to the advance directive

Back 21

-living will
-durable power of attorney

Front 22

when should a therapist turn over pt care to an aide

Back 22

tx task is regular
-prof judgmt not needed
-not making active progress

Front 23

should tx be scheduled during mealtime

Back 23

only if pt switching from nonoral to oral and specific strategies are being used

Front 24

what are the three sourches that lunch infrection can result from

Back 24

aspiration during swallow
retension of swallowed contents
aspiration of gastroespageal contents

Front 25

what are physical signs of aspiration pneumonia

Back 25

shortness of breat
rapid heart rate
acute mental confusion
incontinence
infection
fever
increase in sputum with cough

Front 26

how do you diagnose aspiration pneumonia

Back 26

chest x ray

Front 27

true or false
all pts that aspirate develop aspiration pneumonia

Back 27

false

Front 28

what is the first line of defenxe for larynx

Back 28

coughing

Front 29

what are some clinical signs that may be predictive of aspiration pneumonia

Back 29

coughing
dysphonia
dysarthria

Front 30

which pts are suspective of asp pneumonia

Back 30

those with
advanced age
poor oral hygiene
cant self feed
comornidities
taking many meds
prior history of asp pneunmonia
compromised resp syst

Front 31

what are the resons for placing a feeding tube

Back 31

pt unable to sustain nutrition orally although swallow response is safe

pt requires sufficient calories on a short term basis to overcome acute medical problem

pt is at risk for tracheal aspiration

Front 32

true or false
feeding tubes prolong life beyond expected limits

Back 32

false

Front 33

true or false
feeding tubes reduce incidence of aspiration pneumonia

Back 33

false

Front 34

for pts with longer life expectancies or those with dementia that arent interested in eating tube feeding may extend life without undue risk

Back 34

true

Front 35

what are the benefits to tube feeding

Back 35

relieves burden of trying to maintain nutrition orally

quality of life for the pt improves

improved nutirtion and hydration

Front 36

what are risks of tube feeding

Back 36

depressed or anxious about not eating

social withdrawal

may have to be sedated to recieve tube feedings (dementia)

Front 37

does the pt have the right to discontinue or refuese tx

Back 37

yes

Front 38

what are some responsibilities of slp

Back 38

determination of efficacious treatement approaches
educate
accept
advocate
continue or disc. tx

Front 39

once peg tube feeding has been initiated can it be discontinued

Back 39

yes