Airway maintenance

Question 1

Suctioning can be performed in which airways?

Answer 1

upper airway (oropharynx)
lower airway (trachea and bronchi).

Question 2

You suction the oropharynx with

Answer 2

rigid tonsillar

Yankauer,

Question 3

suction through the nose

Answer 3

nasotracheal suctioning

Question 4

suctioning through the artificial airway

Answer 4

endotracheal suctioning

Question 5

T/F Tracheal suctioning through the mouth should be avoided because it causes gagging.

Answer 5

True

Question 6

What kind of suctioning is when the catheter is inserted until resistance is met and then withdrawn approximately 1 cm before applying suction

Answer 6

deep suctioning

Question 7

What kind of suctioning is when the catheter is advanced to a predetermined depth, which is usually the length of the airway plus the adapter.

Answer 7

Shallow suctioning

Question 8

What kind of suctioning is recommended in infants and children

Answer 8

shallow suctioning

Question 9

T/F Patients should be suctioned according to a predetermined schedule?

Answer 9

False

the patient should be assessed for clinical indicators, such as rhonchi heard on auscultation, which suggest the need for suctioning, instead of scheduled suctioning.

Question 10

Too large a suction catheter combined with negative pressure can cause

Answer 10

atelectasis and hypoxemia.

Question 11

The diameter of the catheter should be less than __% of the internal diameter of the artificial airway in adults.

Answer 11

50%

Question 12

Before suctioning what FIO2 and how long

Answer 12

delivery of 100% oxygen (O2) for 30 to 60 seconds

Question 13

T/F If any major change is seen in the heart rate or rhythm during suctioning, the RT should immediately stop suctioning, administer O2 to the patient, provide ventilation as needed, and notify the nurse and physician.

Answer 13

True

Question 14

Atelectasis can be caused by removal of too much air from the lungs in a short time. This complication can be avoided by doing what 4 things.

Answer 14

(1) limiting the amount of negative pressure used
(2) keeping the duration of suctioning as short as possible,
(3) using the appropriate size suction catheter
(4) avoiding disconnection from the ventilator.

Question 15

What type of suctioning is indicated for patients who have retained secretions but do not have an artificial tracheal airway.

Answer 15

Nasotracheal suctioning

Question 16

While performing nasotracheal suctioning as the catheter enters the lower pharynx, the patient should assume what position

Answer 16

sniffing

Question 17

Male Or Female.

an orotracheal tube should initially be inserted to the 21- to 23-cm mark at the teeth in

Answer 17

Male

Question 18

Male Or Female.

An orotracheal tube should initially be inserted to the 19- to 21-cm mark at the teeth

Answer 18

Female

Question 19

If the patient still needs an artificial airway after approximately 14 days. What should be considered?

Answer 19

tracheostomy

Question 20

The benefits of a tracheostomy versus oral or nasal intubation are

Answer 20

less need for deep sedation
shorter weaning time,
shorter intensive care unit (ICU) and hospital stay.

Question 21

What kind of tracheostomy tube is a double cannulated tube that has an opening in the posterior wall of the outer cannula above the cuff

Answer 21

fenestrated

Question 22

What type of ET tube limits the cuff pressure to 16 to 18 mm Hg.

Answer 22

Lanz tube

Question 23

What kind of cuff is designed to seal the trachea with atmospheric pressure in the cuff .

Answer 23

The foam cuff

Question 24

T/F The foam cuff is not commonly used except in patients who have already developed tracheal injury.

Answer 24

True

Question 25

What are Four reasons for a tube to be obstructed

Answer 25

(1) the kinking of the tube or the patient biting on the tube
(2) herniation of the cuff over the tube tip
(3) obstruction of the tube orifice against the tracheal wall
(4) mucus plugging

Question 26

A small cuff leak can be detected by

Answer 26

noting decreasing cuff pressures over time

Question 27

What would you do if the cuff ruptures and the patient is being mechanically ventilated. ,

Answer 27

extubation and reintubation

This procedure can be done via the standard reintubation procedure or by using an endotracheal tube exchanger

Question 28

What can mimic a cuff leak?

Answer 28

endotracheal tube that is positioned too high in the trachea and near the glottic opening

Question 29

What consists of a short tube and a small mask that is inserted deep into the oropharynx.

Answer 29

LMA

Question 30

T/F The insertion of the LMA requires the use of additional equipment?

Answer 30

False

Question 31

LMA. When the cuff is in place, it is inflated to a maximum of _____ . Inflation causes the mask to rise slightly out of the mouth.

Answer 31

60 cm H2O

Question 32

Contraindication for LMA

Answer 32

conscious or semicomatose patient because of stimulation of the gag reflex.

Question 33

What tube is inserted blindly through the oropharynx and into the trachea or the esophagus. One cuff seals the oropharynx. The second seals the trachea or the esophagus.

Answer 33

The double-lumen airway (Combitube)

Question 34

the insertion of a visualization instrument (endoscope) into the bronchi.

Answer 34

Bronchoscopy

Question 35

The purposes of bronchoscopy are to

Answer 35

inspect the airway
remove objects from the airway
collect samples from the airway
place devices into the airway