T1-Ch 25: Concepts of Care in Oxygen Therapy and Tracheostomy Care

Question 1

Most patients with hypoxia require an oxygen flow of _____L/min via nasal cannula or up to _____% via Venturi mask to achieve an oxygen saturation of at least 95%

Answer 1

2-4 L/min
40%

Question 2

For a patient who is hyperemic and has chronic hypercarbia the FiO2 delivered is adjusted to correct the hypoxemia and achieve generally acceptable oxygen saturation between ____-_____%

Answer 2

88-92%

Question 3

Humidification should be used at rates of _____ L/min or higher

Answer 3

4L/min

Question 4

Patients on oxygen should be checked in these locations ever Q____ for skin break down (3)

Answer 4

Q4-8 hrs
-ears
-face
-back of neck

Question 5

Oral care for patients on oxygen is Q___hrs and as need

Answer 5

Q8 hrs

Question 6

Clean cannula or mask Q ___ hrs

Answer 6

Q 4-8 hrs

Question 7

Nasal canula
________ L/min
________ %

Answer 7

1-6 L/min
24-44%

Question 8

Oxygen-conserving cannula
________ L/min
________ %

Answer 8

8 L/min
30-50%

Question 9

Simple face mask
________ L/min
________ %

Answer 9

6-12 L/min
35-55%

Question 10

Partial non-rebreather mask
________ L/min
________ %

Answer 10

10-15 L/min
60-90%

Question 11

Venturi mask
________ %

Answer 11

24-50%

Question 12

High-flow nasal cannula
________ L/min

Answer 12

Up to 60 L/min

Question 13

CPap/BiPap
________ %

Answer 13

21-100%

Question 14

Oxygen delivery system:
Inexpensive, disposable, simple

Answer 14

nasal cannula

Question 15

Oxygen delivery system:
Long-term use at home

Answer 15

oxygen-conserving cannula

Question 16

Oxygen delivery system:
Short periods of use

Answer 16

Simple face mask

Question 17

Oxygen delivery system:
Short periods of use
humidified

Answer 17

partial no-rebreather mask

Question 18

Oxygen delivery system:
Provides a specific amount of oxygen

Answer 18

Venturi mask

Question 19

Oxygen delivery system:
Provides a wide range of FiO2

Answer 19

High-Flow nasal cannula

Question 20

Oxygen delivery system:
cannot use in artificial airway patients

Answer 20

CPap/BiPap

Question 21

Low-flow oxygen delivery devices (4)

Answer 21

-Nasal Canula
-Oxygen-conserving cannula
-Simple facemark
-Partial non-rebreather

Question 22

High-flow oxygen delivery device (2)

Answer 22

-Venturi mask
-High-flow nasal cannula

Question 23

Noninvasive ventilation device (2)

Answer 23

-CPap
-BiPap

Question 24

Pre-op care for tracheostomy

Answer 24

education regarding the procedure

Question 25

tracheostomy procedure (3)

Answer 25

-incisions are made through the neck and tracheal rings to enter the trachea -tracheostomy tube is inserted and secured with sutures -chest x-ray determines proper placement

Question 26

Post-op care for tracheostomy (3)

Answer 26

-ensure a patent airway -confirm bilateral breath sounds -hourly respiratory assessment

Question 27

Possible tracheostomy complications (6)

Answer 27

-tube obstruction -tube dislodgment/ accidental decannulation -tracheomalacia -tracheal stenosis -tracheosophageal fistula (TEF) -trachea-innominate artery fistula

Question 28

Prevention of tracheal tube obstruction (4)

Answer 28

-cough/deep breath -providing inner cannula care -humidifying oxygen -suctioning

Question 29

Tube dislodgment/ accidental decannulation prevention (1)

Answer 29

secure the tube in place

Question 30

Tube dislodgment in the first ____ hours after surgery is an emergency because:

Answer 30

72 hours tracheostomy tract has not matured

Question 31

What to do if tracheal tube becomes dislodged:

Answer 31

-Extend patients' neck and open the tissue of the stoma with a curved Kelly clamp to secure the airway -with the obturator inserted int to he tracheostomy tube, quickly and gently replace the tube, and remove the obturator -check the airflow through the tube and for bilateral breath sounds

Question 32

constant pressure exerted by the cuff causes tracheal dilation and erosion of cartilage, leading to loss of tissue integrity

Answer 32

tracheomalacia

Question 33

narrowed tracheal lumen is caused by scar formation from irritation of tracheal mucosa and impaired tissue integrity but he cuff

Answer 33

tracheal stenosis

Question 34

excessive cuff pressure causes erosion of the posterior wall of the trachea and loss of tissue integrity; causes a hole between the trachea and the anterior esophagus

Answer 34

tracheosophageal fistula (TEF)

Question 35

Patients with _______ and tracheas are at highest risk for TEF

Answer 35

NG tube

Question 36

poorly positioned tube causes its distal tip to push against the lateral wall of the trachea

Answer 36

trachea-innominate artery fistula

Question 37

trachea-innominate artery fistula: continuous pressure causes _______ and ______ in the innominate artery

Answer 37

necrosis and erosion

Question 38

trachea-innominate artery fistula is a:

Answer 38

medical emergency

Question 39

T/F: bleeding the first few days after trachea placement is a medical emergency

Answer 39

false; bleeding can be expected first few days

Question 40

To prevent infection _____ should be used while suctioning trachea

Answer 40

sterile technique

Question 41

To prevent infection, stoma should be assessed Q_____ for s/s of infection

Answer 41

Q8