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Flashcards in Airway Care Deck (73):
0

Which pharyngeal airway is indicated for unconscious patients, can be used as a bite block, and can facilitate oral suctioning?

Oropharyngeal

1

Which pharyngeal airway is indicated for conscious patients, facilitates deep tracheal suctioning, and is used to decrease trauma during nasotracheal suctioning?

Nasopharyngeal

2

What is the most common complication of a nasopharyngeal airway?

Trauma to mucosa

3

What is epistaxis?

Nasal bleeding

4

What are five purposes for endotracheal intubation?

1. Provide a patent airway
2. Access for suctioning
3. Means for mechanical ventilation 4. Protect the airway
5. Direct instillation of medication

5

What are the medications that can be directly instilled through an ET tube?

Hint: ALIEN V

Atropine (bradycardia)
Lidocaine (PVCs)
Isuprel (bradycardia)
Epinephrine (asystole)
Narcan (drug overdose)
Valium/Versed (sedative)

6

How should an RT respond to an ET Tube by-passing the normal filtration, humidification and warming mechanisms?

Provide adequate humidity

7

How should an RT respond to an ET Tube disrupting the mucus transport system?

Suction PRN

8

What is the most serious complication of intubation?

Laryngospasm

9

What are some complications of intubation?

Infection, right mainstem bronchus intubation, VAPs

10

When it comes to assessment if tube position, what is involved with inspection?

Looking for bilateral chest movement during inspiration

11

When it comes to assessing correct tube position, what is involved in auscultation?

Breath sounds should be heard in both sides of the chest

12

Why are Chest X-Rays good for assessment of correct tube position?

The radiopaque line on the endotracheal tube can be easily visualized to assess placement

13

What is the correct sequence for assessment of tube placement?

Inspection of chest movement
Auscultation for breath sounds
Capnography or CO2 detectors
Chest X-Ray

14

With Tube Maintenance, what helps maintain patency?

Suctioning

15

What is the best way to prevent obstruction when it comes to tube maintenance?

Humidification (100% Humidity @ 37 Celsius)

16

How should an RT troubleshoot a laryngoscope if the light does not work?

1. Tighten Bulb
2. Check handle attachment
3. Change blades
4. Check batteries

17

What equipment is only used for nasal intubation?

Magill Forceps

18

What equipment is used only for oral intubation?

Stylet

19

Where should the ET Tube be at the patient's lips/teeth?

Approximately between 21-25 cm mark

20

Which special tube can be indicated for independent lung ventilation, unilateral lung diseases, and surgery?

Double-lumen endotracheal tube or Carlen's Tube

21

How can an RT replace a Laryngeal Mask Airway (LMA) with an endotracheal tube?

A standard endotracheal tube can be inserted directly through the LMA into the trachea if necessary

22

What level of vacuum pressure is applied to the Hi-Lo Evac/ CASS tubes?

20 mm Hg

23

In extubation, what helps prevent vocal cord damage?

Removing the tube at peak inspiration

24

What is the management response for a patient that shows Mild distress/stridor and a sore throat?

Provide humidity, oxygen and/or racemic epinephrine as necessary

25

What is the management response for a patient that shows moderate distress/stridor?

Oxygen, cool mist aerosol and racemic epinephrine to reduce swelling

26

Why might an RT reintubate a patient after extubation?

Observed severe respiratory distress and/or marked inspiratory stridor

27

What causes vocal chord polyps?

Chronic inflammation

28

What causes mucosal ulceration?

Torn mucosa

29

Does mucosal ulceration require reintubation?

No

30

What is the name for a softening or dilation of tracheal cartilage?

Tracheomalacia

31

What is the name for a gradual obstruction (or narrowing) of the trachea that occurs with healing?

Tracheostenosis

32

Which post-extubation complication causes stridor?

Tracheostenosis

33

When is tracheostomy preferred over endotracheal tube intubation?

Long-term ventilation

34

What circumstances should the tracheostomy tube cuff be inflated?

Eating and positive pressure ventilation

35

If the suction catheter is unable to pass, what should the RT do?

Remove the tube, ventilate, and replace with a new tube

36

What kind of tracheostomy tube is recommended for weaning and temporary ventilation?

Fenestrated

37

What is the purpose of the tracheal button?

Used to maintain the stoma

38

In what circumstances is an extended tracheostomy tube indicated?

Obese patients or those that use cervical collars

39

What is the procedure that disrupts the connection between the upper and lower respiratory tract?

A laryngectomy

40

What is the purpose of bronchial hygiene therapy?

To improve mobilization of secretions, prevent accumulation of secretions, improve ventilation

41

What are the hazards and contraindications of bronchial hygiene therapy?

Unstable cardiovascular system, unstable pulmonary system, unstable post-operative status, untreated tuberculosis

42

What is the result of stimulation of the Alpha Receptors?

Vasoconstriction of arterial smooth muscle

43

Which type of medications elicit the alpha response?

Blood pressure medications

44

What is the result of stimulation of the Beta 1 response?

An increase of the rate and strength of contractility of the cardiac muscle.

45

What kind of medications elicit the Beta 1 adrenergic response?

Cardiac drugs

46

What is the result of the stimulation of the Beta 2 Adrenergic response?

Bronchodilation and a weak vasodilation effect

47

Which kind of drugs elicit the Beta 2 Adrenergic response?

Respiratory medications

48

What is the formula to calculate how man mg are in a medication solution?

(Drug % x 10) dosage = number of mg of drug

49

Example of Dilution calculation:

How many mg are in 20 ml of a 0.5% solution of Albuterol?

100 mg of Albuterol

50

The RT is to administer 2.5 mg of Albuterol. The medication is available in a 0.5% solution. How many ml of Albuterol should be administered?

0.5 ml of Albuterol

51

What kind of Beta 2 Adrenergic medications are theophylline (aminophylline) and caffeine examples of?

Methylxanthine drugs

52

Flovent (Fluticasone), Qvar (Beclomethasone), Pulmicort (Budeniside), Aerobid (Flunisolide), Azmacort (Triamcinolone) and Prednisone are examples of what kind of drug?

Corticosteroids

53

What are two examples of corticosteroids that do not end in the suffix -one?

Budesonide (Pulmicort) and Flunisolide (Aerobid)

54

What antibiotic is used to treat oral candidiasis (thrush)?

Antifungal Agent Nystatin

55

What is the best way to control secretions?

Good hydration

56

What is the primary action of acetycysteine?

Dissolves disulfide bonds

57

Which mucolytic drug is recommended for Cystic Fibrosis?

Pulmozyme

58

What are two examples of cardiac glucosides?

Digitalis and digitoxin

59

Which conditions are cardiac glycosides used to treat?

Treatment of CHF, atrial tachycardia and fibrillation

60

What are two drugs used to treat atrial arrhythmias?

Quinidine and propranolol

61

Which two anti-arrhythmic agents are used to treat ventricular arrhythmias?

Lidocaine and amiodarone

62

Which two drugs are used to treat bradycardia?

Atropine and epinephrine

63

What purpose are vasodilator drugs used for?

Decrease blood pressure

64

What vasodilator drug is used for hypertension?

Sodium nitroprusside (Nipride)

65

What vasodilator drug is used to treat hypotension?

Dopamine

66

What is the effect of Sodium Nitroprusside (Nipride)?

Decreases blood pressure

67

What is the effect of Dopamine?

It's used to increase blood pressure

68

Which diuretic can be used for pulmonary edema, liver and kidney disease, and CHF?

Furosemide (Lasix)

69

What are the indications for the use of sedatives?

Manage fear and anxiety, increase comfort while receiving mechanical ventilation, and induce sleep

70

What are two examples of anesthetics used for critically ill patients?

Propofol (Diprivan) and Ketamine (Ketalar)

71

What are two examples of narcotic analgesics?

Morphine and fentanyl

72

What is the difference between anesthetics and analgesics?

Anesthetics reduce a patients ability to perceive sensations whereas analgesics reduce sensation to pain