Lab 2 Flashcards
What structure separates the upper and lower airway
the larynx (larynx and everything above is upper RT and everything below larynx is lower RT
what is a percutaneous tracheostomy
when a scope and a light source are inserted into the patient’s trachea to help guide where to make the incision
what are indications for a tracheostomy
-Bypass obstructions at or above the larynx
-long term mechanical ventilation
-facilitate the removal of secretions
-protect the airway in a patient at risk for aspirations
-vocal cord paralysis
-prevention of ventilator associated pneumonia
what are complications with a tracheostomy
-Obstructed tube or mucus plug
-Subcutaneous emphysema
-tracheoesophageal fistula
-tracheal stenosis
-tracheal dilation (When the trachea of the patient dilates and makes it difficult for the cuff to create a seal)
what is the maximum pressure that a trach cuff is usually inflated to
20 mm/hg or the minimum amount of pressure needed to create a seal
which is used more long term a cuffed or uncuffed trach
uncuffed trach since there is less risk for tracheal damage
would a patient be able to speak with an uncuffed trach
possibly if enough air passes around the trach and goes through the vocal cords
what are some advantages of cuffless trachs
-more comfortable for the patient
-may facilitate speaking
-may facilitate eating
-progression toward decannulation
what are some disadvantages of a cuffless trach
-patient can aspirate
-can not be used for ventilation during a code blue/surgery
-can dilute oxygen received through trach mask by mixing with room air from upper airway
-increase air leaks during ventilation
what is the point of a fenestration in a tracheostomy
to allow air to pass through the larynx to facilitate speech
how often is an inner cannula replaced in a tracheostomy
every 24 hours
what supplies are in a trach emergency supplies kit
-new inner cannula
-Trach dilator set
-10cc syringe
-lubricant
-obturator
how often do you clean an inner cannula
every 12hrs
how often is a dressing change and tracheostomy care performed
every 12 hours
what are the different purposes for surgery
-Diagnostic
-Ablative (surgery that destroyes specific tissues that are casuing problems
-palliative
-Reconstructive or restorative (Repairs defects caused by trauma)
-Procurement for transplant
-constructive (Repairs innate defects)
-cosmetic
What is the nursing process for perioperative care
-Assessment
-Diagnosis nursing
-planning
-implementation
-Evaluation
what are some reasons that older adults tend to experience more perioperative complications
-more likely to have chronic illness
-have a lower percent of body water
-tend to have reduced liver and kidney function
-may be poorly nourished
what medications should a nurse double check if they need to be held on the day of surgery
-Glucocorticoids
-Anti diabetics
-Beta blockers
-ACE inhibitors
-Diuretics
-Blood thinners
what are the three key elements that make consent valid
-must be voluntary
-must have the mental capacity to consent/written permission by legally appointed representative
-must be properly informed
who is the only person that can obtain consent from a surgical patient
the surgeon
who are the people that can confirm consent from a patient
the surgeon and the nurse
is consent required for all surgeries
no in some emergencies where life or limb is at risk consent is not required
what spo2 reading would require you to apply supplemental oxygen or turn up oxygen if the patient already has it on
if the patient’s SPO2 is below 92% unless otherwise ordered
how would you prioritize tasks for a patient that has multiple patient problems
- immediate life or limb threatening problems
- Serious but not immediately life threatening problems
- Prevention of future complications or problems
- Routine non urgent care tasks
