Lab 2

Question 1

What structure separates the upper and lower airway

Answer 1

the larynx (larynx and everything above is upper RT and everything below larynx is lower RT

Question 2

what is a percutaneous tracheostomy

Answer 2

when a scope and a light source are inserted into the patient’s trachea to help guide where to make the incision

Question 3

what are indications for a tracheostomy

Answer 3

-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

Question 4

what are complications with a tracheostomy

Answer 4

-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)

Question 5

what is the maximum pressure that a trach cuff is usually inflated to

Answer 5

20 mm/hg or the minimum amount of pressure needed to create a seal

Question 6

which is used more long term a cuffed or uncuffed trach

Answer 6

uncuffed trach since there is less risk for tracheal damage

Question 7

would a patient be able to speak with an uncuffed trach

Answer 7

possibly if enough air passes around the trach and goes through the vocal cords

Question 8

what are some advantages of cuffless trachs

Answer 8

-more comfortable for the patient
-may facilitate speaking
-may facilitate eating
-progression toward decannulation

Question 9

what are some disadvantages of a cuffless trach

Answer 9

-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

Question 10

what is the point of a fenestration in a tracheostomy

Answer 10

to allow air to pass through the larynx to facilitate speech

Question 11

how often is an inner cannula replaced in a tracheostomy

Answer 11

every 24 hours

Question 12

what supplies are in a trach emergency supplies kit

Answer 12

-new inner cannula
-Trach dilator set
-10cc syringe
-lubricant
-obturator

Question 13

how often do you clean an inner cannula

Answer 13

every 12hrs

Question 14

how often is a dressing change and tracheostomy care performed

Answer 14

every 12 hours

Question 15

what are the different purposes for surgery

Answer 15

-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

Question 16

What is the nursing process for perioperative care

Answer 16

-Assessment
-Diagnosis nursing
-planning
-implementation
-Evaluation

Question 17

what are some reasons that older adults tend to experience more perioperative complications

Answer 17

-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

Question 18

what medications should a nurse double check if they need to be held on the day of surgery

Answer 18

-Glucocorticoids
-Anti diabetics
-Beta blockers
-ACE inhibitors
-Diuretics
-Blood thinners

Question 19

what are the three key elements that make consent valid

Answer 19

-must be voluntary
-must have the mental capacity to consent/written permission by legally appointed representative
-must be properly informed

Question 20

who is the only person that can obtain consent from a surgical patient

Answer 20

the surgeon

Question 21

who are the people that can confirm consent from a patient

Answer 21

the surgeon and the nurse

Question 22

is consent required for all surgeries

Answer 22

no in some emergencies where life or limb is at risk consent is not required

Question 23

what spo2 reading would require you to apply supplemental oxygen or turn up oxygen if the patient already has it on

Answer 23

if the patient’s SPO2 is below 92% unless otherwise ordered

Question 24

how would you prioritize tasks for a patient that has multiple patient problems

Answer 24

1. immediate life or limb threatening problems
2. Serious but not immediately life threatening problems
3. Prevention of future complications or problems
4. Routine non urgent care tasks