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Fundamentals II > Lab exam 1 > Flashcards

Lab exam 1 Flashcards

1
Q

2 types of Oropharyngeal airways

A

Berman and Guedel

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2
Q

Has a single center channel

A

Guedel

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3
Q

Has a 2 sided channel

A

Berman

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4
Q

How do you measure an oropharyngeal airway?

A

Measure from corner of pt’s mouth to angle of the jaw

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5
Q

If an Oropharyngeal airway is to large it can push……. leading to an obstruction

A

the epiglottis against the larynx, leading to obstruction

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6
Q

If Oropharyngeal airway is to small it may not

A

clear the tongue above the epiglottis against the larynx

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7
Q

Another name for Nasopharyngeal

A
  • nasal trumpet
  • nasal horn
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8
Q

Indications for Nasal airway (2)

A
  • facilitate ventilation
  • Removal of secretions by nasotracheal suctioning
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9
Q

Nasopharyngeal airways sizes. Female and male

A

Female: 6
Male:7

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10
Q

If nasopharyngeal airway is to short it cannot separate

A

soft plate from posterior wall of pharynx

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11
Q

If nasopharyngeal airway is to long it may enter

A

the larynx, causing laryngeal reflexes or enter the space between the epiglottis and vallecular

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12
Q

How do you measure a nasalphargeal airway?

A

from pt’s earlobe to tip of the nose

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13
Q

How do you inset a nasalpharengeal airway?

A

parallel to the nose floor, beveled edge to the septum

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14
Q

Oropharyngeal airways should be restricted to

A

unconscious pts to avoid gagging and regurgitation

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15
Q

Esophageal Obturator Airway (EOA) is inserted into the

A

esophagus

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16
Q

Laryngeal Mask Airway (LMA) provides a seal over the…..
With a max cuff pressure of

A

larynx; 60 cmH2O

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17
Q

LMA does not protect the

A

airway from aspiration

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18
Q

LMA is what kind of a insertion?

A

Blind

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19
Q

Parts of an ET tube

A
  • Pt end
  • Murphy eye
  • High volume, low pressure cuff
  • Internal diameter
  • Distance in mm
  • Pilot ballon
  • Connection to breathing circuit
  • Inflation valve
  • Machine end
  • Radiopaque line
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20
Q

Esophageal-Tracheal Combitube (ETC) is also called ___________ - ____________ airway

A

Double-Lumen airway

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21
Q

ETC is what kind of insertion

A

Blind

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22
Q

ETC may be inserted into the

A

esophagus or trachea

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23
Q

ETC has 2 cuffs

A
  • Distal cuff
  • Proximal cuff
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24
Q

Double- Lumen Endotracheal Tube (DLT) indications (3)

A
  • Lung isolation
  • prevent lung to lung spillage
  • surgical procedure on non ventilated lung
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25
Q

DLT has 2. (4)

A
  • 2 connectors
  • 2 lumen for gas flow
  • 2 cuffs
  • 2 distal openings
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26
Q

Pilot ballon is used to

A

inflate or deflate the cuff

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27
Q

What are the typical blade sizes

A

Normally 3 and 4

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28
Q

Describe a Miller blade placed and how it is used

A

It is a straight blade and placed below the epiglottis

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29
Q

Describe a Mac blade and how it is used

A

It is a curved blade and Is placed at the vallecula

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30
Q

Indications for Artificial Airways (4)

A
  • Relief of airway obstruction
  • Protection of airway
  • suctioning
  • Support ventilation
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31
Q

Examples of Endotracheal devices

A
  • ET Tube
  • Tracheostomy Tube
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32
Q

Oral intubation is described as

A

uncomfortable, gagging, excessive secretions

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33
Q

Nasal intubation is not as common but is suitable for pts when

A
  • oral route is not available
  • facial or oral surgery
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34
Q

Smaller ET tube means

A

higher airflow resistance

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35
Q

Procedure of establishing access to trachea via neck incision

A

Tracheotomy

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36
Q

Opening in the neck is called

A

tracheostomy

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37
Q

Removal of the larynx (voice box)

A

Laryngotomy

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38
Q

Laryngotomy tube may be inserted into the

A

stoma to keep it open while it heals

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39
Q

One- way valve that allows inspiration but not exhalation through the tracheostomy tube opening

A

Speaking valve

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40
Q

To use a traditional tracheostomy tube to speak the cuff

A

must be deflated

41
Q

For a fenestrated tracheostomy tube the cuff may be _____________ providing the ___________ cannula of that tube is removed

A

Inflated; inner

42
Q

What is an obturator used for?

A

Used for insertion and is placed within the outer cannula

43
Q

Where is an obturator kept?

A

In the pt’s room. Same size tube and 1 size smaller

44
Q

Esophageal examples

A
  • Esophageal Obturator Airway (EOA)
  • Esophageal- Tracheal Combitube (ETC)
45
Q

Equation on suctioning. First multiple the tubes inner diameter by 2, then use the next smallest size catheter (F)
Example: 6- mm endotracheal tube

A

2 x 6 = 12
next smallest catheter is 10 F

46
Q

Contraindications for Oral and Nasal airways

A

Oral- oral trauma/ bleeding
Nasal- nasal trauma/ bleeding

47
Q

Flexible suctioning catheter

A

Red rubber cuddae

48
Q

Red rubber cuddae is used for pts who need

A

frequent suctioning b/c is not as hard as a regular suction catheter

49
Q

Intubation supplies (10)

A
  • laryngoscope
  • blade Miller or McIntosh
  • ET tube
  • 10 or 12 mL syringe
  • water soluble lubricant
  • stylet
  • ET tube securing device
  • carbon dioxide detector
  • Amboo bag
  • Yankauer
50
Q

What is a Bougie?

A

A long tube that you can insert in the pt airways so that you can avoid a full reintubation

51
Q

The ET tube should be placed approximately

A

3- 5 cm above the carina or between second and forth tracheal rings

52
Q

Inflate cuff slowly until NO air leaks are heard at end of inspiration

A

Minium Occlusion Volume (MOV)

53
Q

Inflate the cuff until the leaks stop, remove a small amount of air slowly until a SLIGHT leak can be heard at the end of inspiration

A

Minimal Leak Technique (MLT)

54
Q

Endotracheal suctioning should not be done a

A

preset schedule but PRN

55
Q

Prior to suctioning you do what to your adult pt?
Using pressures between

A

Preoxygenate w/ 100% o2; 120 -150

56
Q

Limit duration of suction to

A

<15 seconds

57
Q

Application of negative pressure to the airways through a collecting tube

A

Suctioning

58
Q

Suctioning can be preformed via what airways? (2)

A
  • The upper airway (oropharynx)
  • The lower airway (trachea & bronchi)
59
Q

Steps to suctioning (7)

A
  1. Assess Pt for Indications
  2. Assemble and Check Equipment
  3. Asses Pt for Hyper-oxygenation
  4. Inset Catheter
  5. Apply Suction and Clear Catheter
  6. Reoxygenate Pt
  7. Monitor Pt and Assess Outcomes
60
Q

Steps to Intubation (9)

A
  1. Assemble and check equipment
  2. Position pt
  3. Preoxygenate and Ventilate Pt
  4. Insert Laryngoscope
  5. Visualize Glottis
  6. Displace Glottis
  7. Insert tube
  8. Asses tube position
  9. Stablize Tube and Confirm Placement
61
Q

2 techniques for Endotracheal suctioning

A
  • Open- steril technique- requires disconnecting pt form vent
  • Closed- technique - uses sterile, closed in line suction catheter, that’s attached to the ventilator
62
Q

What is needed for Extubation (5)

A
  • Oxygen
  • 10 mL syringe
  • towel
  • stethoscope
  • Intubation box
63
Q

Steps for Extubation (7)

A
  1. Assemble Needed Equipment
  2. Suction ETT and Pharynx
  3. Oxygenate Patient well After Suctioning
  4. Deflate Cuff
  5. Remove Tube
  6. Apply Appropriate Oxygen and Humidity
  7. Asses or Reassess Pt
64
Q

Indications for Mechanical ventilation (6)

A
  • Inadequate alveolar ventilation
  • Inadequate lung expansion
  • Inadequate muscle strength
  • Increased WOB
  • Hypoxemia
  • Apnea
65
Q

What are some parts of a Tracheostomy tube

A
  • Inner Cannula
  • Cuff
  • Obutrator
  • pilot ballon
  • Flange
66
Q

LMA requires a large volume of air to inflate the seal to seal the airway. What is the cuff and airway pressures for LMA?

A
  • Cuff pressure is 60 cm H20
  • Airway pressure is 20
67
Q

Suctioning pressures for adults

A

120-150 mm Hg

68
Q

Suctioning pressures for children

A

100- 120 mm Hg

69
Q

Suctioning pressures for infants

A

80-100 mm Hg

70
Q

What is a reason why someone will need to have a trache?

A

Long term airway

71
Q

To prevent a nasal airway from being inserted to far, what is needed?

A

safety pin

72
Q

Nasopharyngeal are used for what kind of pts?

A

conscious pts or semi conscious

73
Q

What does an oral airway prevent?

A

Tongue from falling backwards into airway

74
Q

Oral airways are for what kind of pts?

A

unconscious pts

75
Q

Is LMA easy to insert?

A

YES

76
Q

Can LMA’s be autoclaved?

A

YES

77
Q

Direct vison to vocal cords is called

A

Binocular vision

78
Q

How long should you preoxygenate?

A

30 seconds

79
Q

____% of unplanned or extubations do not require reintubation.

A

50%

80
Q

After extubation what should you monitor?

A
  • O2
  • Breath sounds
81
Q

When do you extubate?

A

on end exhalation ( coughing)

82
Q

If tube is bigger, then

A

airway resistance will be lower

83
Q

EOA has a cuff on top off distal airway end to prevent

A

aspiration of stomach contents

84
Q

When tube is in the esophagus on an ETC, a small distal cuff ____ seals off the esophagus

A

15mL

85
Q

When tube is in trachea, a large proximal cuff ___ seals of trachea on ETC

A

100mL

86
Q

The goal is to keep capillary perfusion in trachea at

A

20 mmHg to 30

87
Q

What are the most common injuries to the larynx

A
  • Glottic edema
  • Vocal inflammation
  • Laryngeal/ vocal cord ulcerations
  • Vocal cord polyps
88
Q

How long should it take to insert ETT before having to preoxygenating again?

A

<30 seconds

89
Q

DLT allows

A

The right or left lung to be ventilated separately

90
Q

What vitals do you check when intubating?

A
  • Sats
  • HR
  • BP
91
Q

This object prevents inward/outward migration of airway

A

Safety pin

92
Q

Routes for artificial airways

A
  • Pharyngeal airways- extend only into the pharynx
  • Artificial airways- placed through mouth or nose into trachea called ET tube
93
Q

Process of placing artificial airway into trachea

A

Intubation

94
Q

When tube is passed thru the mouth on its way to trachea

A

Orotracheal intubation

95
Q

When the tube is passed through the nose

A

Nasotracheal intubation

96
Q

A speaking valve is a one way valve that allows

A

inspiration but not exhalation through the tracheostomy tube opening

97
Q

Suctioning is the application of

A

negative pressure to the airways through a collecting tube

98
Q

Intubation is the process of

A

placing artificial airway into trachea

99
Q

Name the 2 pharyngeal airways

A
  • Oropharyngeal airways
  • Nasopharyngeal airway

Fundamentals II (13 decks)

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