Resipratory/Airway management

Question 1

Cheyne Stokes

Answer 1

Cycles of progressively deeper, quicker breathing followed by a gradual decrease leading to temporary apnea

Question 2

Tachypnea

Answer 2

Abnormally rapid breathing

Question 3

Apnea

Answer 3

Temporary cessation of breathing lasting more than 20 second

Question 4

Kussmaul

Answer 4

Rapid, deep labored breathing (to blow off CO2-often seen in DKA)

Question 5

Nasal Canula

Answer 5

1-6 LPM
24-44%

Question 6

COPD appearances

Answer 6

Clubbing of fingers
Barrel chest
SpO2 may be low or normal

Question 7

Simple Mask

Answer 7

6-12 LPM
35-50%

Question 8

Partial Non-rebreather

Answer 8

6-11 LPM
60-75%
Bag inflated 1/3-1/2 full

Question 9

Non-rebreather

Answer 9

10-15 LPM
80-95%
Bag inflated 2/3 full

Question 10

Venturi Mask

Answer 10

4-12 LPM
24-50%
Allows for a specific amount of air to mix with O2

Question 11

Tracheostomy Collar

Answer 11

at least 10 LPM
24-100%
Requires constant humidifacation (we have bypassed the body’s natural humidifiers)

Question 12

High flow respiratory oxygen source

Answer 12

non-rebreather
remember the bag should be inflated, if not something is wrong and the pt is breathing in their own CO2. The O2 flow is probably not high enough if the bag is collapsed.
We want 12-15 LPM

Question 13

Internal Respirations

Answer 13

Bloodstream and cells

Question 14

External Respirations

Answer 14

Alvioli and Capllaries

Question 15

Tracheostomy care and suction

Answer 15

q8h
if visibly soiled or sputum collection observed at the trach opening
SpO2 dropping
C/O SOB
Adventitious breath sounds

Question 16

S/Sx of respiratory depression

Answer 16

Decreased RR
Decreasing SpO2
Decreasing HR
Difficulty to arouse

Question 17

Lung sounds of Asthmatics

Answer 17

Wheezing

Question 18

Early S/Sx of Hypoxia

Answer 18

Tachypnea
Tachycardia
Restlesness/Anxiety/Confusion
Pale skin/mucous membranes
Elevated BP
Use of accessory muscles
Nasal flaring
Adventitious breath sounds

Question 19

Late S/Sx of Hypoxia

Answer 19

Stupor
Cyanotic skin/musous membranes
Bradypnea
Bradycardia
Hypotension
Cardiac dysrhythmias

Question 20

Chest tubes

Answer 20

Drainage containers should always be below chest level and upright.
Connections should be taped to avoid air leakage.
Tubing should be pinned to pt.
All dressings should be kept intact.

Question 21

If tubing of chest tube disconnects to keep air lock what do we do?

Answer 21

Place tube in sterile water

Question 22

If tubing of chest tube is pulled out what do we cover the “sucking chest wound with”?

Answer 22

occlusive dressing taped on 3 sides so air can come out but not be sucked back in.

Question 23

How do we treat bacterial pneumonia?

Answer 23

Antibiotics
Expectorant
Bronchiodilators
O2
Analgesics

Question 24

How do we treat viral pneumonia?

Answer 24

Likely to resolve with rest and Sx management. However some providers may perscribe anti-virals to lessen the duration and severity of Sx.

Question 25

Coughing and deep breathing education.

Answer 25

Take a deep breath and hold it for a few seconds.
Exhale slowly
Repeat 5 times
Brace incision with pillow, try to cough deeply
Repeat q1h while awake
Bracing/splinting the incsion when coughing can help minimize pain.
Coughing and deep breathing expands the lungs.
Sitting upright promotes optimal lung expansion.

Question 26

How is pneumonia diagnosed?

Answer 26

Chest X-ray and sputum samples

Question 27

Compliations of prolonged O2 therapy?

Answer 27

Drying and Cracking of mucous membranes.

Question 28

Prevention of complications from prolonged O2 therapy?

Answer 28

Good oral care
Possible humidifacation
Use of moisturizors on mucous membranes (water based only, NO patroleum products)

Question 29

Crackles/Rales

Answer 29

Fine to coarse bubbly sounds (not cleared with coughing) as air passes through fluid or re-expands callapsed small airways.
Fluid in the lungs

Question 29

Stridor

Answer 29

Upper airway narrowing or obstruction

Question 30

Rhonchi

Answer 30

Coarse, loud, low-pitched rumbling sounds during either inspiration or expiration resulting from fluid or mucous (can clear with coughing) Blockages in bronchi

Question 31

Wheezing

Answer 31

High pitched whistling, musical sounds when air is moving through narrowed airways, usually louder on ecpiration. (fairy muscial)

Question 32

Pleural friction rub

Answer 32

Dry, grating or rubbing sound as the inflamed visceral and parietal pleura rub against eachother during inspiration and/or experiation.

Question 33

What do we do first if a NEW trach tube becomes dislodged?

Answer 33

Call for help! Activate the emergent responce team. Then we assess the pt airway needs. Typically bag them til help arrives.

Question 34

ABC’s

Answer 34

Airway
Breathing
Circulation
If someone is airway compromised or SOB they take priority!!!
Always evaluate and assess for pt needs then choose appropriate intervention.

Question 35

Hydration in relation to airway managment

Answer 35

Helps to thin secretions to allow for expulsion.
Then build on that with the deep reathing and coughing to assist with the expansion of the lungs to prevent atelectasis, and movement of the secretions to be expelled from the airways.

Question 36

Atelectasis

Answer 36

Complete or partial collapse of a lung or lobe of a lung.