Mod Iv Tech

Front 1

causes of upper AW obstruction

Back 1

tongue/soft tissue obstruction-most common, tenacious secretions,laryngospasm,laryngeal or subglottic edema, foreign bodies(food,toys,dentures)

Front 2

best postion to establish airway if pt has fractured neck??

Back 2

jaw thrust,or modified jaw thrust

Front 3

adv & disadv of jaw thrust aw position?

Back 3

adv:can do on pt with fractured neck.

disadv: difficult to perform and obtain good seal. tiring and no denture control

Front 4

adv & disadv of chin lift

Back 4

adv easy to perform, no fatigue. control of loose denture

contraind: fractured neck

Front 5

adv & disadv of neck lift

Back 5

adv easy to perform. good for young ones.

dis. not successful on elderly. arm fatigue from neck support.

contraind: fractured neck

Front 6

Oral Pharyngeal AW

Back 6

good for unconscious pts

indication:bite block for et tube, oral suctioning,support base of tongue.

complications: gagging,vomit, laryngospasm

Front 7

Nasal pharyngeal AW

Back 7

good for conscioius pts

support base of tongue
deep trach suctioning

hazards: trama to mucosa,epistaxis,increase RAW

Front 8

suctioning indications

Back 8

accumulated secretions
obstructed AW
depressed cough
inability to swallow

Front 9

suctioning hazards

Back 9

trama to mucosa
contamination
hypoxemia-lead to tachycardia and arrhthmias and bradycardia

Front 10

purpose for suctioning

Back 10

patent aw,specimen collection and stimulate cough

Front 11

suction catheter should not be AW no longer than ??? seconds?

Back 11

15

Front 12

pre and post oxygenation should be ___% O2 and for how many minutes?

Back 12

100 % O2 and 1-2 minutes

Front 13

how often should suctioning be done?

Back 13

only as needed (prn)

Front 14

Reason to intubate?

Back 14

patent aw
access for suctioning
means to mech ventilate
protect aw (aspiration and obstruction)

Front 15

intubation physiologica and psychological alterations

Back 15

by pass normal filtration/humidification and warming. less effective cough. disrupts mucus transport. loss of personal dignity and unable to communicate.

Front 16

complications to intubation

Back 16

infection
cuff pressure
laryngospasm
right stem bronchus intubation

Front 17

cuff pressure on entubation tube should be less than

Back 17

20 torr

Front 18

how can endotracheal tube postion be assessed?

Back 18

bilateral chest expansion during inspiration

auscultation

CXR-should be 2-3 cm above carina

Front 19

ET tube procedure

Back 19

postion head
hyperoxygenate
laryngescope in left hand,et in right,
insert blade in mouth,lift epiglottis(curve blade in vallecula and straight under epiglottis).
insert tube,inflate,assess tube postion, vent and oxygenate.

Front 20

cuff pressure is high pressure/low vol or high vol/low pressure

Back 20

low vol/high pressure

Front 21

clues of complete obstruction

Back 21

marked inspiratory effort w/o air movement.

intercostal,sternal, epigastric retraction

contractions of accessory muscles,
anxious pt
unconcious pt may appear dusky or strong ventiltory efforts

Front 22

clues of partial obstruction

Back 22

noisy inspiration usually inspiration and low tone.
greater the obstruction the louder the noise.
stridor usually refers to a glottic obstruction and high pitched inspiration sound.

Front 23

extubation technique

Back 23

suction tube above and below cuff, have pt inspire deeply,deflate cuff,pull out tube AT PEEK INSPIRATION,have pt cough and clear secretions, observe pt for complications

Front 24

extubation complications

Back 24

severe resp distress and or marked inspiratory stridor. (reintubate). modererate distress o2,cool mist aerosol and racemic epi to reduce swelling.

Front 25

mild distress

Back 25

provide humidity and O2

Front 26

post extubation complication

Back 26

vocal cord polops,mucosal ulceration,tracheomalacia (trach cartilage softening),tracheostenoisis (gradual obstruction narrowing)

Front 27

tracheostomy indications

Back 27

preferred for long term intubation or when upper AW obstruction prevents intubation.(should be done under sterile conditions)

Front 28

tracheostomy adv

Back 28

adv easier to stabilize,suction & tolerate. some have easy to clean inner cannula. pt able to eat and speak. few hazards and minimal RAW.

Front 29

trach hazards

Back 29

first 24 hrs bleeding,pneumothorax,air embloism,subcutaneous emphysema. Later infection, hemorrhage,obstruction,T-E fistula,

Front 30

inflate trach cuff when

Back 30

pt is eating
pt is on Postive pressure ventilation

Front 31

trach tube should not be changed no more than?

Back 31

once a week

Front 32

3 reasons trach should be changed

Back 32

obstruction-can't pass suction catheter

tube too small-very high cuff pressure

punctured cuff-ualbe to seal trach

Front 33

care after trach removal

Back 33

don't suture stoma closed
apply steril dressing and antibotic
clean periodically w/ peroxide
have pt cough to clear secretions

Front 34

laryngoscope straight blade fits

Back 34

directly under epiglottis and is called miller blad

Front 35

laryngoscope curved

Back 35

machintosh-fits into vallecula and indirectly raises epiglottis

Front 36

one cannula trach tube

Back 36

shiley

Front 37

jackson trach tube

Back 37

silver metal trach tube
comes with an inner cannula and optional cuff

Front 38

bivona cuff

Back 38

FOAM FILLED TRACH CUFF

Front 39

TRACHEAL BUTTON USED?

Back 39

TO MAINTAIN STOMA, USED IN SOME SLEEP APNEA CASES.

Front 40

CAUDE TIP CATHETER IS ANGLED TO HELP SUCTION??

Back 40

LEFT MAIN STEM BRONCHUS

Front 41

EXTERNAL DIAMETER OF SUCTION CATHETER SHOULD BE NO GREATER THAN?

Back 41

1/2 INSIDE DIAMETER OF ET OR TRACH TUBE

ET TUBE X 2=CATHERTER NEXT SMALLER SIZE

8ETX2=16 NEXT smaller size 14

Front 42

olympic trach talk CUFF must be inflated or deflated

Back 42

DEFLATED
PT CAN'T BREATH AROUND TRACH TUBE!!! W CUFF INFLATED

Front 43

GAG REFLEX OCCURS WHERE?

Back 43

PHARYNX

Front 44

COUGH OCCURS WHERE?

Back 44

PHARYNX,LARYNX AND TRACHEA AND CARINA

Front 45

SNEEZE OCCURS WHERE?

Back 45

UPPER NASAL PASSAGE

Front 46

SWALLOWING OCCURS WHERE?

Back 46

PHARYNX

Front 47

WHAT SHOULD BE MONITORED DURING SUCTIONING

Back 47

MONITOR CARDIAC STATUS

Front 48

YANKAUR TONSIL TIP FOR?

Back 48

ORAL ASPIRATION FOR LRG AMTS OF MATERIAL VOMITES

Front 49

SWALLOWING OCCURS WHERE?

Back 49

PHARYNX

Front 50

WHAT SHOULD BE MONITORED DURING SUCTIONING

Back 50

MONITOR CARDIAC STATUS

Front 51

YANKAUR TONSIL TIP FOR?

Back 51

ORAL ASPIRATION FOR LRG AMTS OF MATERIAL VOMITES

Front 52

first signs of hypoxia in a pt who is being suctioned

Back 52

tachycardia

Front 53

complications to suctioning

Back 53

change in HR
atelectasis
hypoxia
bronchial bleeding
cardiac arrhyhmias

Front 54

hr decrease while suctioning due to ?

Back 54

vagal stimulation

Front 55

features for manual resuscitators include

Back 55

peep capabliity
easy to assemble
non slip material for bag

Front 56

flow inflating bags are

Back 56

used for anesthesia and peds venting,require gas source, allow user to feel compliance easily

Front 57

types of valves used on manual resuscitators include

Back 57

spring disk
diaphragm and leaf valve
diaphragm and duck bill
spring ball
diphragm

Front 58

complication of manual resuscitation when bag/mask valve is used

Back 58

gastrci distension

Front 59

what would increase fio2 being delivered form a laerdal resuscitation bag

Back 59

add an o2 reservoir to the bag, increase o2 oxygen flow

Front 60

to make sure a manual ventilator is ready for use

Back 60

make sure no gas escapes thru outlet port when closed off, squeeze bag & make sure the air/o2 reservoir intake valve closes properly,

Front 61

self inflating manual resusitator should deliver how many ml of air?

Back 61

800-1200ml (2 to 3 times Vt)

Front 62

self inflating manual resusitator flow?

Back 62

10-15 lpm adult 5-10 kis
85-100% for CPR and suctioning
21-100% for transport-reservior bag should be added to increase fio2.