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Critical Care: Hewitt > Quiz 2 - Suctioning/Airway Maintenance & Care > Flashcards

Quiz 2 - Suctioning/Airway Maintenance & Care Flashcards

1
Q

Suctioning applies what type of pressure in the airways?

a. positive
b. negative
c. arterial
d. neutral

A

b. negative

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2
Q

Which of the following is an upper airway suctioning route?

a. nasopharynx
b. bronchi
c. trachea
d. oropharynx

A

d. oropharynx

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3
Q

Select each of the following parts of the lower airway that can be suctioned:

I. nasopharynx
II. bronchi
III. trachea
IV. oropharynx

A

II. bronchi

III. trachea

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4
Q

Which of the following would you use while suctioning the upper airway?

I. Bronchoscope
II. Laryngoscope
III. Yankaeur
IV. Flexible catheter

A

III. Yankaeur

IV. Flexible catheter

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5
Q

Advancing catheter to a predetermined length is for:

a. peds
b. adults
c. neonates
d. elderly

A

a. peds

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6
Q

Advancing catheter to a predetermined length is considered:

a. deep suction
b. shallow suction

A

b. shallow suction

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7
Q

Insert catheter until resistance is felt, withdraw slightly in order to suction is for:

a. peds
b. adults
c. neonates
d. elderly

A

b. adults

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8
Q

Insert catheter until resistance is felt, withdraw slightly in order to suction is for:

a. deep suction
b. shallow suction

A

a. deep suction

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9
Q

Requires disconnecting patient from ventilator:

a. open sterile technique
b. closed sterile technique

A

a. open sterile technique

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10
Q

In line suction catheter that is attached to the ventilator circuit:

a. open sterile technique
b. closed sterile technique

A

b. closed sterile technique

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11
Q

Select all of the following indications for inline suction:

I. Positive pressure, PEEP >10 MAP >20 
II. Higher I time 1.5 sec
III. FiO2 60% 
IV. Frequent suctioning 
V. Hemodynamically unstable
A 
I. Positive pressure, PEEP >10 MAP >20 
II. Higher I time 1.5 sec
III. FiO2 60% 
IV. Frequent suctioning 
V. Hemodynamically unstable

All of the above

Others include:
Airborne or droplet precaution
Specality gases like INO & Heliox

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12
Q

T/F: You should always suction patient on a pre-set schedule.

A

False

Do not suction on a pre-set schedule, it’s PRN

  • Visible secretions
  • coarse/rhonci breathsounds
  • Increased vent pressures
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13
Q

T/F: External diameter of suction catheter should be no more than one half of the internal diameter.

A

True

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14
Q

You have a size 4 ETT, what size catheter do you need?

A

6f

4 x 2 = 8
8 - 2 = 6

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15
Q

You have a size 10 ETT, what size catheter would you need?

A

18f

10 x 2 = 20
20 - 2 = 18

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16
Q

T/F: You should always hyper-oxygenate patient prior to endotracheal suctioning.

A

True
100% FiO2 for 30-60 sec
Increased by 10% in neonates

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17
Q

Total suction time should be:

a. 10 sec
b. 15 sec
c. 20 sec
d. 30 sec

A

b. 15 sec

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18
Q

You should limit suction pressures and use shallow suction technique for:

A

Mucosal trauma

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19
Q

You should limit the amount of negative pressure during suctioning to avoid which complication?

A

Atelectasis

20
Q

Recommended suction pressure for adults is:

a. 50-80 mmHg
b. 100-120 mmHg
c. 120-150 mmHg
d. 80-100 mmHg

A

c. 120-150 mmHg

21
Q

Recommended suction pressure for neonates is:

a. -50-80 mmHg
b. -100-120 mmHg
c. -120-150 mmHg
d. -80-100 mmHg

A

d. -80-100 mmHg

22
Q

Recommended suction pressure for children:

a. -50-80 mmHg
b. -100-120 mmHg
c. -120-150 mmHg
d. -80-100 mmHg

A

b. -100-120 mmHg

23
Q

T/F: Nasotracheal suctioning is indicated for patients who have secretions but do not have an artificial airway in place.

A

True

24
Q

Select each that best defines sputum samples:

I. Identify organisms that affect airway
II. Pts can cough strongly into sterile cup

A

I. Identify organisms that affect airway

II. Pts can cough strongly into sterile cup

25
Q

Specimen cup is called:

A

Leuken’s trap

26
Q

The primary cause of airway injury is:

A

Tube friction

Ex)

27
Q

You should maintain cuff pressures at:

A

25-35 cmH2O

28
Q

Which cuff is designed to seal trachea with atmospheric pressure in cuff? Not commonly used in pts who already developed tracheal injury:

A

Foam cuff

29
Q

Which cuff is low volume, high-pressure design that maximizes airflow around tube when deflated?

A

Tight-to-shaft (TTS)

30
Q

T/F: The Tight-to-shaft (TTS) is filled with air because it is made of porous silicone material.

A

False

Inflated with WATER, not air because it is made of porous silicone material

31
Q

T/F: Minimal leaking is not recommended because it allows a small leak to remain.

A

True

32
Q

T/F: Minimal occluding volume technique is preferred over minimal leak technique.

A

True

Minimal occluding volume technique is preferred, it is inflating cuff just enough to eliminate leak

33
Q

Most common method for securing airway is:

A

Taping

Other options: commercial ETT stabilizers, cloth/velcro/steel ties for trach

34
Q

The tube tip should be approx:

A

3 to 5cm above carina

or between 2nd and 4th tracheal rings

35
Q

What % relative humidity is needed at BTPS?

A

100% RH at BTPS (isothermic boundary)

36
Q

HME gives about what % RH?

A

70% RH

37
Q

Heated wick or membrane humidifier gives what % RH?

A

100%

38
Q

If patient has thick, hard to move secretions you should switch from the HME to the:

A

Heated humidifier

39
Q

T/F: There is less chance of contamination from rainout with HME.

A

True

40
Q

T/F: Heated wire circuit for heated humidifier increases rainout.

A

False

DECREASES rainout

41
Q

Safest option in reversing tube obstruction (for ex, kinking or pt biting tube) is to:

A

Swap the tube

42
Q

If there is a herniation of cuff over tip, the first thing you should do is:

A

Deflate the cuff

If that fails, try to pass suction catheter through tube
then swap tube

43
Q

What should you use to loosen mucus?

A

Saline

44
Q

Cuff leaks impair tidal volume in what way?

A

Reduce delivery of tidal volume

45
Q

If pilot tube or valve is leaking, the first thing you should do is:

A

Change the tube as soon as possible

46
Q

Ruptured cuff immediately indicates:

A

Extubation & reintubation using endotracheal tube exchanger

Critical Care: Hewitt (2 decks)

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