CBL Quiz Week 5 Flashcards
Trach Care and ICC Management
The nurse is caring for a critically unwell patient with COPD who requires delivery of a precise concentration of oxygen. Which of the following is the correct oxygen delivery device?
Simple face mask
Nasal prongs
Oxygen face tent
Venturi mask
venturi mask
A patient has a tracheostomy performed for high grade tumour of the larynx. After one week the tracheostomy is accidently dislodges and can’t be reinserted. The patient is in respiratory distress. Endotracheal intubation be performed?
No
What FiO2 percentage (percentage of oxygen) is delivered when the flow rate through a Hudson mask is 6L / min?
25-30%
30-40%
21-24%
>60%
30-40%
A patient has a tracheostomy performed for prolonged mechanical ventilation. After one week the tracheostomy is accidently dislodges and can’t be reinserted. The patient is in respiratory distress. Endotracheal intubation be performed?
Yes
In addition to a respiratory assessment, nursing assessment of a patient with a chest tube should include:
changing the occlusive dressing Q 3 days and PRN
assessing the insertion site/dressing outwardly following the tube all the way to the drainage system, for loops, kinks, that the clamp is open
checking the drainage system for, air leaks, appropriate suction pressure (if ordered) and ‘bellows’ expand to the indicator mark
noting the colour, consistency, and amount of drainage
All of the above
all of the above
A patient is recovering from a pneumothorax and has a chest tube present. Which of the following is an appropriate finding when assessing the chest tube drainage system?
Intermittent bubbling may be noted in the water seal chamber.
All of these options are appropriate finding
200 mls of drainage per hour is expected during recovery of a pneumothorax.
The chest tube is positioned at the patient’s chest level to facilitate drainage.
Intermittent bubbling in the water seal chamber
A patient is about to have their chest tube removed according to the medical order. As the nurse assisting with the removal, which of the following actions will you perform? Select all that apply:
1. Place the patient in Semi-Fowler's position. 2. Have the patient take a deep breath, exhale, and bear down during removal of the tube. 3. Educate the patient how to take a deep breath out and inhale rapidly while the tube in being removed. 4. Place the patient in prone position after removal. 5. Gather supplies needed which will include a petroleum gauze dressing. 6. Provide analgesia prior to removal as ordered by the doctor.
1,2,5,6
During hourly checks of a patient with a haemothorax, the RN is assessing the function of an UWSD. Which of the following findings should prompt the RN to notify the doctor to review?
Drainage system has been maintained below the patient’s chest.
Tidalling in the tube in the water seal chamber during inhalation and exhalation.
Drainage amount of 140ml in the drainage collection chamber over past hour.
Occlusive dressing in place over the chest tube insertion site
Drainage amount of 140ml in the drainage collection chamber over past hour
You are reviewing the results of arterial blood gas for your patient with respiratory distress. You recognise that the normal value of PaO2 is:
1. 80-100 mmHg 2. 22-26 mEq/L 3. 7.35 – 7.45 4. 35 – 45 mm Hg
80-100mmHg
In a patient who has recently had a tracheostomy performed, all of the following equipment except which one should be at the bedside?
1. A tracheostomy tube one size larger 2. A tracheostomy tube one size smaller 3. A tracheostomy reinsertion kit 4. A tracheostomy tube the same size
Trach tube one size larger
Chest tube clamping is only recommended for:
1. whenever a patient leaves the nursing unit and cannot be monitored 2. it is never beneficial to clamp a patient's chest tube 3. changing the drainage container and this should be done quickly and then promptly unclamped 4. when ambulating a postoperative patient with a chest tube
changing the drainage container and this should be done quickly and then promptly unclamped
To prevent excessive pressure on the tracheal capillaries which may lead to tissue hypoxia, the pressure in the tracheostomy tube cuff should be:
1. Sufficient to fill the pilot balloon until it is tense 2. Monitored every 2-3 days 3. Less than 4 kPa (30 mm Hg or 35 cm H2O) 4. Less than 2.6 kPa (20 mm Hg or 25 cm H2O)
<2.6kPa (20mmHg or 25cm H2O)
A patient with pneumonia has been receiving continuous oxygen therapy for several days. Which of the following is an adverse effect associated with continuous oxygen therapy?
1. Dry, brittle hair 2. Cracks in the oral mucosa 3. Copious respiratory secretions 4. Poor skin turgor
cracks in the oral mucosa
A pneumothorax occurs when extraneous _____ enters the pleural space.
1. infection 2. air 3. blood 4. foreign particles
air
When performing tracheostomy suctioning, what is the maximum period of time allowed?
1. 10 seconds 2. 5 seconds 3. 20 seconds 4. 30 seconds
10 seconds
