ch41: oxygenation -- interventions

Question 1

review medical record of patient (review nasal, tracheal, or neck injuries/surgeries)

Answer 1

some conditions are contraindications for suctioning because suction catheter through nasal route causes trauma to existing surgery, increases nasal bleeding, or severe bleeding disorders

Question 2

ID patients with an increased risk for ineffective airway clearance

Answer 2

changes in neurological/muscular status impairment increase likelihood that pt is unable to clear respiratory secretions

suctioning should only be performed if pt condition indicates and NOT in hourly schedule

Question 3

assess factors that may affect volume and consistency of secretions

Answer 3

thickened or copious secretions increase risk for airway obstruction

Question 4

assess pt’s peak inspiratory pressure when on volume controlled ventilation

Answer 4

increased peak inspiratory pressure = airway obstruction

Question 5

position pt in semi-fowler’s or high fowler’s

Answer 5

reduces stimulation of gag reflex, promotes pt comfort and secretion drainage and prevents aspiration

Question 6

apply lubricant along catheter tip

Answer 6

water soluble lubricant helps avoid lipid aspiration pneumonia
(excessive amount will occlude catheter)

Question 7

perform tracheal suctioning before pharyngeal

Answer 7

prevent introduction of microorganisms

Question 8

assess for need to repeat suctioning

Answer 8

do not perform more than 2 passes with catheter and allow pt to rest for 1 minute

Question 9

assess for signs and symptoms of increased respiratory distress and hypoxia

Answer 9

pneumothorax, hemothorax, preexisting illness

Question 10

assess for sharp, stabbing chest pain or chest pain on inspiration

Answer 10

may indicate tension pneumothorax

Question 11

chest drainage system should remain upright and below level of tube insertion

Answer 11

upright drainage system = drainage and maintain water seal