Mr Mulhollands Test 2

Front 1

State the proper position of an endotracheal tube, and ways to verify that position.

Back 1

3 to 7 cm above carina is proper placement. Verifying is done with a CXR, on the CXR it should be between T2-T4.

Front 2

Describe and recognize indications for suctioning.

Back 2

Rising PIP on vent, breath sounds, absent/innefective cough.

Front 3

Be able to discuss the importance of humidifaction of inspired gases for patients with artificial airways.

Back 3

If the nose is bypassed, you lose the natural humidification, filtering, and heat.

Front 4

Discuss alternative ways to communicate with patients with artificial airways.

Back 4

Sign language, charts, pen and paper, read lips, talking trach tubes, and passey-mir valves.

Front 5

What are the steps of changing a trach tube?

Back 5

Suction, remove soiled gauze or dressing and discard, look for any abnormalities at the stoma site, use swabs with peroxide to clean area around the stoma and under neck plate, use swabs with sterile water to rinse area, suction, if no inner cannula then thats all for the inside, if there is an inner cannuls and its disposable then throw it away and replace, if reusable clean with pip cleaner,peroxide, and sterile water, then always place a new, sterile drain sponge and soiled dirty trach ties.

Front 6

How do you check to make sure the trach tube ties and or velcro is secure, what happens if its not?

Back 6

Be able to get a finger in betwern tie and skin. If not able to then the skin may become irritated.

Front 7

How do you ensure safe cuff pressures?

Back 7

Make sure theyre in the green zone, if above green zone leak out using MOV and MLT.

Front 8

When should we not do trach care?

Back 8

Within 24 hours post op.

Front 9

Define airway emergencies?

Back 9

All care and skills necessary to deal with sudden, often life threatening events that affect both natural and artificial airways.

Front 10

List three indications for airway management?

Back 10

Respiratory failure, need to protect airways, and impending or actual airway.

Front 11

What are some indications for intubation?

Back 11

Inability to protect airway, coma, inability to cough, loss of gag reflex, compromised airway.

Front 12

What are some hazards of intubation?

Back 12

Broken teeth, bronchospasm, eccymosis.

Front 13

What does bi pap usually fix?

Back 13

Ventilation

Front 14

What does cpap mainly fix?

Back 14

Oxygenation problems.

Front 15

If there is wheezing is it upper respiratory or lower respiratory?

Back 15

Lower.

Front 16

When should.you not do trach care?

Back 16

Within 24 hours post op

Front 17

Who developed the bird mark 7?

Back 17

Forrest bird.

Front 18

Where did forrest bird reside?

Back 18

Idaho.

Front 19

What are three indications for IPPB therapy?

Back 19

Short term ventilatory support, NIPPV to avoid intubation, delivery of aerosolized medications.

Front 20

Contraindications for IPPB therapy?

Back 20

The big one is untreated PTX and tension pneumothorax!!, some others are TE fistula, hempotysis, and ICP.

Front 21

What are some hazards for IPPB therapy?

Back 21

Blebs, increased RAW, and pulmonary barotrauma.

Front 22

Recognize this picture

Back 22

Front 23

What effect does IPPB theraoy have on alveolar pressure?

Back 23

It pulls the alveoli open using positive pressure.

Front 24

In the universal tubing kit, what is the small tube connected to?

Back 24

The exhalation valve.

Front 25

What two opposing forces does the bird mark 7 work off of?

Back 25

Magnetism and pressure.

Front 26

Learn and UNDERSTAND this picture.. ATM=atmospheric pressure.

Back 26

Front 27

Where is the ceramic switch located on the bird mark 7?

Back 27

In the diaphram body between the clutch plates.

Front 28

What does the apnea timer (expiratory timer) do on the bird mark 7?

Back 28

This is the only way to make it a time cycled ventilator, not used in IPPB therapy.

Front 29

The flow rate control on the mark is?

Back 29

The large dial in front on the center body, controls the flow of gas, high flow is 80 L per min

Front 30

What is the function of the Bennet valve on the PR2?

Back 30

on off switch, needs only .5 cmh2o to power on.

Front 31

How does RRT set the volume on the PR2?

Back 31

cannot set volume, only pressure.

Front 32

Air dilution control in the PR2 is located where and does what?

Back 32

Located on the right side, top middle knob, and determines the FIO2

Front 33

The negative press control on the PR2 is?

Back 33

never used during IPPB, it ventilates neonates and evacuates gas from pt circuit, located on the side, bottom of the middle two knob

Front 34

Peak flow control on the PR2 is?

Back 34

Located on the bottom shaft and delivers pressure, vent clockwise, IPPB counter clock

Front 35

The negative press control on the PR2 is?

Back 35

never used during IPPB, it ventilates neonates and evacuates gas from pt circuit, located on the side, bottom of the middle two knobs.

Front 36

If an IPPB ventilator fails to cycle in exhalation (off) the problem is ALWAYS?

Back 36

A leak.

Front 37

When giving IPPB therapy using a Mark 7, changes in delivered FIO2 can be attributed to what?

Back 37

Venturi gate and pressure.

Front 38

An example of IPPB outcome set for a pt with post op atelectasis would be?

Back 38

spontaneous IC of 70 percent of predicted, improved CXR, decreased late inspire crackles, reduced RR under 25 per min.

Front 39

What flow is only.on PR-2?

Back 39

Terminal flow.

Front 40

If one paramter is preset, the other is?

Back 40

Variable.

Front 41

Which machine is positive ONLY?

Back 41

The birdy.