Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Critical Care: Hewitt > Quiz 1: Airways/Intubation > Flashcards

Quiz 1: Airways/Intubation Flashcards

(75 cards)

Start Studying
1
Q

What type of deadspace is associated with the upper airways?

A

Anatomical airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anatomical airways means there is no _______ in the upper airways.

A

Gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Artificial airways bypasses where what occurs exactly?

A

Where filtering, humidification, and warming occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the standard positioning for opening the airway?

A

Head tilt/chin lift aka “sniffing position”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some appropriate circumstances for head tilt/chin lift?

A

Emergency - LOC
Patients airway is obstructed by tissue
Manual ventilate patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

You should NEVER use the sniffing position when:

A

Patient has a suspected or confirmed head/neck/spine injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What position should you use when neck trauma or injury is suspected?

A

Jaw thrust maneuver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the airways that only reach the pharynx called?

A

Pharyngeal airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T/F: Endotracheal tubes can go through both the nose and the mouth.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which of the following are indications for artificial airways?

I. Protect airway patency
II. Decreased LOC
III. Facilitate suctioning
IV. Mechanical Ventilation (PPV)
V. Bronchoscopy/Surgery
A

All of the above are indications for artificial airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which of the following are conditions that commonly need artificial airways?

I. Pierre Robin syndrome 
II. Treacher Collins
III. Trisomy 21
IV. Cleft Palates
V. Guillan Bierre
A

I. Pierre Robin syndrome
II. Treacher Collins
III. Trisomy 21
IV. Cleft Palates

all except V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which of the following are ways we can keep an airway patent?

I. Heat and humidification
II. Proper coughing technique
III. Hyperinflation/CPT
IV. Suction airway

A

All of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which of the following are risks associated with suctioning?

I. Decreased risk of infection
II. Increased saturation
III. Arrythmias
IV. Mucosal trauma 
V. Increased ICP
A

III, IV, and V

Possible complications include 
***increased risk of infection
***desaturation
arrhythmias
mucosal trauma
hypotension
atelectasis
increased ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 2 types of oropharyngeal airways?

A

Berman and Guedel

Berman - channels on the side
Guedel - channel down the middle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T/F: You should only place OPAs on patients who are unconscious without a gag reflex.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is an OPA fitted?

A

Measured from teeth/gums to angle of jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

T/F: You should always tape OPAs in place.

A

False

Never tape in place - if patient regains consciousness, take it out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F: NPAs are used to facilitate NT suctioning.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How often do NPAs need to be switched to the other side in order to prevent sinus infection or blockage?

A

24 - 48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How are NPAs measured?

A

Measured from tip of nose to earlobe (length most important)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If NPA is placed too far what can happen to the patient?

A

They will start coughing/gagging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

You should NEVER use NPAs if:

A

Patient has suspected or confirmed basilar skull injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

T/F: You should always lubricate when inserting a nasal airway.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are some risks associated with endotracheal tubes?

I. Higher risk of self extubation
II. Left mainstem intubation
III. Occlusion from biting
IV. Injury to tissue

A

I, III, and IV

***Right mainstem intubation is a risk, not left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do you identify an endotracheal tube on CXR?
Radiopaque line
26
T/F: Endotracheal intubation is for short term use, while tracheal airways are for long term use.
True Tracheal airways: Long term airway More stable and tolerated better then ETT May or may not be used for mechanical ventilatory support Size is usually the internal diameter but can be in mm or F Aids feeding, speech and oral care Less risk of decannulation
27
T/F: Patient must be be conscious, able to follow commands, and protect airway on their own in order to qualify for extubation.
True Pt should be able to manage and clear secretions, have good cough and gag reflex, and can maintain oxygenation and ventilation
28
T/F: Negative leak tests are ideal prior to extubation.
False Listen for leak around cuff, Positive leak test indicates airway is not as likely to swell shut after airway removal BUT patient still may have stridor
29
T/F: You should always hyperoxygenate the patient prior to suctioning and attempting extubation.
True
30
When should you pull the tube during suctioning? a. during exhalation b. during inhalation
b. during inhalation inhalation allows airway to open up more and prevent damage
31
How soon after extubation can edema develop? a. 1 hour b. 6 hours c. 2 hours d. 12 hours
c. 2 hours
32
T/F: You should always consider steroids before attempting re-extubation.
True
33
Which of the following are the proper treatments for laryngospasm? I. FiO2 II. Bronchodilator III. Possible re-intubation IV. Steroids
I, II, and III I. FiO2 II. Bronchodilator III. Possible re-intubation Laryngospasm = spasm of the vocal cords = increased WOB / distress
34
Your patient is experiencing moderate post-extubation laryngeal edema. Your treatment would be: a. racemic epinephrine b. cool bland aerosol 12-24 hours c. re-intubation d. corticosteroids
a. racemic epinephrine
35
T/F: Patients are allowed to have new pulmonary infections for decannulation.
False Criteria for decannulation: - strong cough / muscle strength - NO new pulmonary infections - manageable secretions - patent upper airway - adequate swallow strength
36
Fennestrations in tracheostomies are useful for:
Phonation and air flow to upper airway
37
T/F: You should always have spare trach equipment nearby during decannulation.
True
38
If patients voice sounds hoarse for more than one week, you can suspect: a. vocal cord paralysis b. tracheal stenosis c. laryngotracheal web d. vocal cord ulcers
d. vocal cord ulcers
39
If your patient has recurrent laryngeal nerve damage, you can suspect: a. vocal cord paralysis b. tracheal stenosis c. laryngotracheal web d. vocal cord ulcers
a. vocal cord paralysis
40
If your patient has necrotic tissue at glottis, leading to excessive fibrin formation, the patient will have stridor and needs to be suctioned out. You suspect this patient has: a. vocal cord paralysis b. tracheal stenosis c. laryngotracheal web d. vocal cord ulcers
c. laryngotracheal web
41
You should always keep cuff pressures at: a. 20 - 30 cmH2O b. 30 - 40 cmH2O c. 25 - 35 cmH2O d. 10 - 20 cmH2O
c. 25 - 35 cmH2O
42
If your patient has a lesion at the cuff site and a narrow airway, you can suspect this patient has: a. vocal cord paralysis b. tracheal stenosis c. laryngotracheal web d. tracheal malacia
b. tracheal stenosis Tracheal stenosis refers to abnormal narrowing of the trachea that restricts your ability to breathe normally.
43
Your patient's cartilaginous tissues in the trachea are lost, they are at risk for airway collapse due to loss of support. you can suspect this patient has: a. vocal cord paralysis b. tracheal stenosis c. laryngotracheal web d. tracheal malacia
d. tracheal malacia Tracheomalacia occurs when the cartilage in the windpipe, or trachea, has not developed properly or was damaged, so instead of being rigid, the walls of the trachea are floppy or flaccid.
44
T/F: The Combitude ET tube is a model that is deisgned to be inserted blindly.
True
45
Suction should be set at: a. 10 - 15 cmH2O b. 20 - 30 cmH2O c. 35 - 45 cmH2O
b. 20 - 30 cmH2O
46
Laryngeal Mask Airway (LMA) is ideal for ventilation when intubation is not possible.
True
47
Laryngeal Mask Airway (LMA) cuff should be inflated to MAX:
60 cmH2O
48
Laryngeal Mask Airway (LMA) pressure over 20 cmH2O can cause risk of:
Gastric inflation
49
Laryngeal Mask Airway (LMA) should NEVER be used on conscious patients.
True
50
Preferred method of intubation: a. oropharyngeal b. orotracheal c. nasopharyngeal d. tracheostomy
b. orotracheal
51
T/F: You should always test the tube cuff prior to intubation.
True
52
T/F: During intubation, the RT should always have endotracheal tubes at least one size smaller and 1 size larger nearby.
True
53
All attempts to intubate should be no longer than:
30 seconds
54
T/F: You should always ventilate the patient while checking placement.
True
55
T/F: There should be an absence of gastric bubbling during breath delivery.
True
56
Once you secure the endotracheal tube, you should note the depth at:
Teeth/gum
57
Tip of endotracheal tube should be __ to ___ cm from carina.
3-5 cm
58
T/F: If RT is performing a blind nasal intubation, the patient must be breathing spontaneously.
True
59
If you do not hear any air movement during intubation, or visualize the vocal cords, what is most likely the problem?
You're in the esophagus
60
T/F: Direct nasal intubation needs magill forceps to place tube along with laryngoscope.
True
61
Tracheostomy tube incision is placed: a. 2nd or 3rd tracheal ring b. 3rd or 4th tracheal ring
a. 2nd or 3rd tracheal ring
62
Perc dilation is indicated during emergency cases for tracheostomy procedures.
False Pec Dilation is for non emergent cases and people >12 years old
63
Cuff must be deflated on Passy Muir speaking valve in order for patient to phonate
True
64
If your patient appears to be in respiratory distress while the ventilator pressure alarm is sounding in the middle of a trach change, you should leave the trach tube in.
False Pull tracheostomy tube out! If the second attempt is not successful, cover the stoma with clean gauze and bag mask the patient
65
In order to keep tongue from blocking airway, you would use a(n):
oropharyngeal airway Measured from lip to ear lobe
66
If you want to facilitate suctioning in a way that decreases trauma to nasal mucosa when catheter is passed you would use what type of airway?
Nasopharyngeal airway Measured from tip of nose to earlobe
67
T/F: Tracheal airways must only be used if patient needs mechanical ventilatory support.
False May or may not be used for mechanical ventilatory support aids feeding, speech and oral care less risk of decannulation
68
Which of the following are cons associated with tracheal airways? I. Costly and requires OR II. Risk of infection III. Impaired cough IV. Granulomas
``` I. Costly and requires OR II. Risk of infection III. Impaired cough IV. Granulomas ALL of the above ```
69
Physician wants to insert tube blindly that is specifically for independent lung ventilation, you would use a: a. CASS b. double lumen combitude c. LMA d. Cuffed
Double-lumen tube "Combitude" Has two inner cuffs, lumens, openings
70
You want to suction secretions that accumulate above the cuff, you would use the: a. CASS b. double lumen combitude c. LMA d. Cuffed
a. CASS - continuous aspiration of subglottic secretions SET SUCTION TO 20 - 30 cmH2O Helps prevent VAP
71
The physician is inexperienced and the patient has a difficult airway. We need something that is ideal for ventilation when intubation is now not possible. You would use a: a. CASS b. double lumen combitude c. LMA d. Cuffed
c. LMA Cuff inflated max 60 cmH2O Dont use on conscious pt and beware of gastric inflation >20 cmH2O
72
A Mallampati score of III or IV indicates:
Need additional assistance during intubation. Possible need for specialty airways, video laryngoscope, awake intubation, or changing the procedure to a surgical route.
73
Which of the following are indications for a tracheostomy? I. Obstruction/trauma II. Continued need for artifical airway after intubation >7-14 days III. Long term
All of the above
74
A cap on a trach is used for:
Weaning
75
Trach button is for:
Plugging stoma

Critical Care: Hewitt (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions