Mechanical Ventilation Flashcards
(75 cards)
The correct placement of an endotracheal tube is:
A. 2cm above the bifurcation of the main stem bronchi
B. @ the 2nd tracheal ring
C. 1cm below the level of inominate artery
D. 2cm above the carina
D. 2cm above the carina
To confirm placement, after insertion of an endotracheal tube which of the following assessments should be performed? Select all that apply A. Auscultate breath sounds B. Obtain CXR C. Obtain a pulse ox reading D. Schedule the pt. for a bronchoscopy E. Obtain a RR
A and B
Which of the following are components of a standar trach tube? Select all that apply A. Speaking valve B. Inner cannula C. Obturator D. Outer cannula E. Tracheal button
B, C and D
What is the obturator used for?
Placement during insertion
What is the function of a cuff on a trach tube or endotracheal tube?
A. Prevents dislodgement of the tube
B. Allows the use of mechanical ventilation in adults
C. Decreases pressure on the tracheal wall
D. Decreases pt’s work of breathing
B. Allows the use of mechanical ventilation in adults
The nurse is to place a speaking valve on a pt w/ a cuffed trach tube. What action must the nurse take first?
A. Place the pt. on mechanical ventilation
B. Asses vital capacity
C. Deflate the cuff
D. Remove the inner cannula
C. Deflate the cuff
True or false.
Fenestrated trach tubes are packaged w/ 2 inner cannulas? and why?
True bc can’t suction through fenestrated cannula bc can go through hole and damage trachea
Non-fenestrated trach tubes is used for what?
Suctioning and to put pt on mechanical ventilation
What is the purpose of cuffs?
To seal tubes and seal walls of trachea so air that’s being pushed in can’t turn around and come back out through mouth/nose (ensures air is being delivered to lungs
Test pilot tubes are the little projection sring like thing from the balloon (cuff) what are they used for?
To tell you that a cuff tube is in place and inflated by feeling @ the end b/t fingers and observing for a spongy-air like feel; if flat means cuff is deflated
Why is it important to provide humidity and to sometimes warm the air when providing O2 to pts w/ artificial airways?
Bc bypassing the normal ways of warming and humidifying air
When do we want an inflated cuff?
If pt is on mechanical ventilation or are unable to protect lower airway Ex. unconscious, stroke/aspiration pts
What is the most common trach used?
Universal Trach tube
What is the inner cannula used for?
Holds mucous plugs if occur
Single cannula trach tube has what piece only?
Outer cannula
Single cannula trach tubes can’t be used if?
There are excessive secretions or pt has difficulty clearing secretions
What is a fenestrated trach?
Opening on curvature of outer cannula to permit airflow through upper airways, speech and more effective cough
Fenestrated trachs can be what?
Cuffed or uncuffed
What are speaking valves?
A 1 way valve that allows airflor past vocal cords and upper airways during exhalation
What must be done when a speaking valve is in place?
Cuff must be deflated so pt can exhale when speaking valve is placed on
What is a trach button?
Used to occlude trach for period of times to see if pt. is ready to be decannulated
When are fenestrated trachs used?
For weaning or prolonged trach use
What is the trach button used for?
To prevent air from entering and exiting the trach forcing pt to breathe through upper airway to assess readiness to get off
Trach buttons are used when and w/ what?
During weaning and w/ fenestrated tubes
