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409 > Airway Devices and Mgmt > Flashcards

Airway Devices and Mgmt Flashcards

1
Q

upper airway obstructions

A 
food
vomitus
blood clots
enlargement of tissue
pressue on the walls of the airway
altered LOC
loss of tone (pharyngeal muscles, tongue)
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2
Q

mgmt of upper airway obstruction

A

inspect
palpate
auscultate

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3
Q

name the advance airway devices

A 
oral airway
nasal airway
laryngeal mask airway (LMA)
tracheostomy
endotracheal tube (ETT)
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4
Q

are oral airways seen often in the ICU?

A

yes

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5
Q

what do oral airways contain?

A

bite blocks

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6
Q

what state must the pt be kept in for this to be used and why?

A

pt must be kept unconsconscious bc it hits their gag reflex

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7
Q

is a nasal airway sen often in the ICU and why?

A

yes bc many pts do not have the energy to manage their own nasal secretions

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8
Q

is a laryngeal mask airway seen often in an ICU and why?

A

NO- never
blocks the esophagus
temporary
used by ambulances and anesthesiologists

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9
Q

who can insert an ETT?

A

skilled professionals- MD, Resp Therapists, anesthesiologists

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10
Q

can we insert an ETT?

A

no- but we can assist

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11
Q

where must an ETT be placed

A

2 cm above chorinus

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12
Q

how do you know the ETT has been placed in the correct position?

A

chest x ray and bilateral breath sounds

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13
Q

how do you know if the ETT was placed too far down and what is this also known as?

A

you will hear breath sounds only on one side

aka main stem intubation

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14
Q

The _____ lung is easier bc it is a straight shoot as compared to the ______ lung bc it is curved

A

right

left

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15
Q

what will you see if the ETT has been placed in the esophagus?

A

the stomach will expand and you will not hear breath sounds

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16
Q

what part of the ETT must be checked before intubation?

A

the cuff

17
Q

what is the End Title CO2 and what does it do

A
  • at the end of expiration, it is placed on top of ETT
  • pushes air in
  • when air comes back, it is tested for CO2
  • CO2 will test purple if it CO2, green if stomach acid
18
Q

what part of the ETT allows you to monitor for placement?

A

lip line

19
Q

what is the purpose of an ETT ?

A
  • provide a patent airway for mechanical ventilation

- removal of secretions

20
Q

how is an ETT inserted

A

with the help of a laryngoscope

21
Q

what are some advantages of advanced airway devices

A 
provides patent airway
mechanical ventilation
suctioning secretions
decr work of breathing
improve oxygenation
22
Q

name the disadvantages of advanced airway devices

A 
discomfort
cough and swallowing reflex are depressed
secretions become thicker
incr risk of aspiratiom
VAP
ulceration
stricture
inability to verbally communicate
inadvertent removal
use of restraints
23
Q

how long can you use an ETT for ?

A

10 days at most

24
Q

what are some advantages to using a tracheostomy?

A 
bypasses the upper airway
allows removal of secretions
permits long term mechanical vent
prevents aspiration of secretions
replaced ETT
can be temporary or permanent
ventilation can be well controlled
25
Q

what are some complications of a tracheostomy

A 
bleeding
pneumothorax
aspiration
subcu or mediastinal emphys
laryngeal nerve damage
posterior tracheal wall penetration
26
Q

what are some long term complications of a tracheostomy

A 
airway obstruction
infection
rupture of the innominate artery
dyshpagia
fistula formation
tracheal dilation
tracheal ischema and necrosis
27
Q

what are early interventions for preventing complications r/t a tracheostomy

A 
proper and frequent suctioning
VS
HOB at 30
analgesia, sedatives
manage anxiety and apprehension
28
Q

how do you prevent complications r/t tracheostomy?

A 
admin O2 and humidified warm air
maintain cuff pressure
suction properly and frequently
maintain skin integrity around trach
auscultate lung sounds
monitor for infec
       use sterile technique when suctioning/trach care
29
Q

when administering warm air, what part of the body are you replacing?

A

the nose

30
Q

what are some nursing dx’s r/t ETT and Trach

A 
communication
anxiety
knowledge deficit
ineffective airway clearance
potential for infection

409 (11 decks)

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