Artificial ariway critical care

Question 1

What type of intubation tube is often used to help a pat with an orally place tube wan off of a ventilator

Answer 1

trach tube

Question 2

What are the indications for intubation

Answer 2

Upper airway obstruction like burns, tumor, bleeding
Apnea
High risk for aspiration like stoke pats
Ineffective clearance of secretions
Respiratory distress

Question 3

What is a way to assess if the cuff on an intubation tube like a trach, is in the wrong place or has deflated

Answer 3

if they can talk

Question 4

What is a consideraton for intubation tube size

Answer 4

the larger the tube the easier it is to breath so advocate

Question 5

Are arm restraints common with intubated pats

Answer 5

yes

Question 6

When does the placement of an ET need to be checked

Answer 6

after position change

Question 7

When do you need to suction ET tube

Answer 7

only when you see fluid in tube or when their coughing up stuff around the tube
sudden decrease in O2 or increase in RR

Question 8

What is a consideration for O2 and suctionign

Answer 8

give 100% O2 before suctioning

Question 9

Nursing care for ventilator pats

Answer 9

HOB 30 degrees
oral care q2h
turned q2h
sedation vacation and spontaneous breathing trial daily
meds for pneumonia prevention, pep ulcers and preventing DVT within first 24hr

Question 10

Oral care considerations

Answer 10

moisturize lips and mouth

Question 11

Complications of intubation tubes

Answer 11

tube comes out (low pressure alarm goes off)
occlusion (high press alarm)
pat is able to talk
aspiration

Question 12

What is a complication of Positive End-Expiratory Pressure (PEEP)

Answer 12

lowered BP bec the lungs encroach on the hearts space

Question 13

What does Positive End-Expiratory Pressure (PEEP) do

Answer 13

supplies a little positive pressure during exhalationi so the lungs dont fully collapse, keeping the alveoli open

Question 14

What are some ways to combat low BP from PEEP

Answer 14

give fluids possible bolus

meds

Question 15

Who gets CPAP

Answer 15

sleep apnea

Question 16

When would you use High-frequency Oscillatory Ventilation (HFOV)

Answer 16

usu when they have tried everything else

Question 17

Whats a med that might be used in situations where pat isnt getting better O2 sat

Answer 17

nitric oxide

Question 18

What is a positioning technique used to assist oxygenation in severe ARDS pats

Answer 18

prone

Question 19

What is ECMO

Answer 19

Extracorporeal Membrane Oxygenation

pulls blood through a machine and hyperoxygenates it

Question 20

When is ECMO used

Answer 20

after things like HFOV, nitric oxide and prone positioning have been used

Question 21

What are considerations for Positive pressure therapies

Answer 21

people with compliant resp problems like COPD are at risk for barotrauma or bleb rupture

Question 22

What is a common way to provide safe care for COPD pats using positive pressure vents

Answer 22

using small tidal volume

Question 23

What is Ventilator-associated pneumonia (VAP)

Answer 23

happens within 48 hours

Question 24

Complications of Positive pressure ventilators

Answer 24

barotrauma
Ventilator-associated pneumonia (VAP)
sodium and water 
imbalances
decreased LOC from decreased blood flow and 
pep ulcers 
constipation 
impaired mobility 
delerium 
impaired nutrition

Question 25

Where do ventilators always need to be pugged into

Answer 25

the red outlet

Question 26

What test should you do hourly for a paralyzed pat

Answer 26

train of 4

Question 27

What is a train of 4 test

Answer 27

send electrical impulses to check for twitches

score 0-4, give one point per twitch

Question 28

Is TPN usu signed off by two people

Answer 28

yes

Question 29

What do you need before feeding with an NG tube

Answer 29

X ray for position

Question 30

What pats dont usu get sedation vacations

Answer 30

paralyzed pats

pats on BP meds to keep BP up