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NBRC Questions > RRT Questions: Airway Care > Flashcards

RRT Questions: Airway Care Flashcards

1
Q

How do you measure an OPA?

A

From corner of the mouth to the angle of the jaw.

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2
Q

How do you measure an NPA?

A

From tip of nose to earlobe.

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3
Q

How often should NPA’s be changed?

A

Every 2 days.

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4
Q

What are the four steps to giving a med via ET tube?

A
  1. Pour med down tube.
  2. Hyperventilate.
  3. Pour 10ml NS down tube.
  4. Suction it all out.
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5
Q

What is an MOV? What is an MLT? How are they different?

A

MOV: Minimal Occulding Volume. Inflate until leak stops.
MLT: Minimal Leak Technique. Inflate until leak stops, then remove a little bit so there is a very small leak.

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6
Q

When you hear “Obtunded”, you should think:

A

Intubate!

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7
Q

What laryngoscope blade should you use for an adult?

A

Adult: size 3

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8
Q

ET tubes use a ___ type of cuff.

Carlens tubes use a ___ type of cuff.

A

ET tubes: Low pressure high volume.

Carlens tubes: High pressure low volume.

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9
Q

Cuff pressures must remain between ___ cm H2O.

A

25-30 cm H2O.

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10
Q

Can a standard ET tube be inserted directly through the LMA into the trachea?

A

Yes.

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11
Q

What size LMA should you use?

A

Adult male: size 5.

Adult female: size 4.

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12
Q

What is a CASS tube? How much suction should you use with it?

A

Continuous Aspiration of Subglottic Secretions.

20 mm Hg.

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13
Q 
If there is post-extubation stridor:
First give \_\_\_.
Then give \_\_\_.
Then give \_\_\_.
Last, you should \_\_\_.
A

First give humidified O2
Second, give racemic epinephrine.
Third, give Heliox 60/40.
Last, re-intubate

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14
Q

What is a tracheal button used for?

A

Maintains a tracheostomy opening.

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15
Q

If you hear medium rales or crackles, what should you do?

A

CPT. Do not suction.

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16
Q

If a patient is hypoxic, what position is best for them? (x3)

A

Fowler’s, semi-fowler’s, or reverse trendelenberg.

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17
Q

If a patient is very obese with air hunger, what position is best for them?

A

Lateral fowler’s.

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18
Q

If a patient is drunk or unconscious and you’re worried about aspiration, what position is best?

A

Lateral flat.

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19
Q

If a patient aspirates, what should you do first?

A

Suction.

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20
Q

How many times per day should you do PEP therapy? How long should the therapy last?

A

3-4 times per day, 15-20 minutes.

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21
Q

To cough up secretions, huff coughing is most effective in what kind of patients?

A

COPD and head trauma.

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22
Q

What is a common hazard of suctioning? What should you do about it?

A

Hypoxemia.

Stop suctioning and oxygenate for 1-2 min.

23
Q

How do you figure out the size catheter to use?

A

Catheter size = inner diameter size x 3 divided by 2.

24
Q

When is q4 suctioning appropriate?

A

NEVER. Never, never be okay with q4 suctioning even if the test pressures you to be okay with it.

25
Q

What are the two goals of humidity therapy?

A

Prevention of mucosal crusting

Compensate for humidity deficit.

26
Q

What is the biggest hazard of humidity therapy?

A

Possible contamination source.

27
Q

What is the optimal aerosol deposition size?

A

0.5 - 0.3 microns.

28
Q

What is the proper way to check humidifier function?

A

Occlude or pinch the connecting tubing and listen for whistling sound.

29
Q

NBRC likes wick humidifiers because it can deliver ___% body humidity, or ___ mg/L. Also there is a low risk of ___ (___).

A

100%, 44 mg/L, cross-contamination/nosocomial infection.

30
Q

HME’s are used during ___ or ___.

Name three reasons to replace them.

A 
Short term ventilation or transport.
Replace if:
Arway pressure increases
During aerosol therapy
Thick, bloody secretions are present.
31
Q

When using a T-piece, you should (increase or decrease) the FiO2 to get more mist. Or you can (increase or decrease) the FiO2 to get less mist.

A

More FiO2 = more mist.

Less FiO2 = less mist.

32
Q

What are four reasons why you might not be getting enough mist in the T-piece?

A

Clogged capillary tube
Low temperatures in heating probe
Low flow
Low water level

33
Q

When do they use a blender with large volume nebulizers?

A

When preciseFiO2 is desired.

34
Q

For COPD’ers, try to keep FiO2 at ___%.
Therapeutic FiO2: ___%.
Emergency FiO2: ___%.

A

24-28
30-60
100

35
Q

Vibratory vest therapy should be done at ___ hertz (___ cycles per min) for ___ minutes, up to ___ times per day

A

5-25 hertz (300-1500)
30 min
6 times per day

36
Q

When using IPV, the high frequency pulse delivery should be done at a rate of ___ cycles per minute at a pressure of ___.

A

100-250 cycles per minute

30 psi

37
Q

When adjusting a vacuum regulator, do it with the tubing (open/occluded).

A

Occluded

38
Q

Suction tubing diameter should be no greater than ___ the diameter of the ET tube.

A

No greater than half the inside diameter of the ET tube

39
Q

What is the longest amount of time that the suction catheter should be in the airway?

A

No longer than 15 seconds.

40
Q

How do you figure out what size ET tube to use?

A

Pt weight in kg divided by 10.

ex: pt weight is 83 kg, use a size 8 tube.

41
Q

An ET tube should be secured at ___ at pt’s lips.

If nasally intubated, it should be secured at ___.

A

Lower 20’s (21-25)

Nasal: 26-29

42
Q

How do you use a 3way stopcock to measure cuff pressures?

A

Make it so the 3 way stopcock communicates with the cuffalator, the tube, and a syringe. Then use the syringe to adjust the pressure.

43
Q

When you check the cuff pressure, the pressure reads zero. What’s the first thing you do?

A

Check to make sure connections are tight.

44
Q

What would happen if you pull the inner cannula out of a fenestrated tracheostomy tube?

A

Pt will be able to speak.

45
Q

There are three common occasions when you have to replace the ET tube or trach tube.

  1. Tube is too ___.
  2. Tube is ___.
  3. The ET Tube cuff is ___.
A

Tube too small
Obstructed tube
Ruptured cuff

46
Q

The cuff on an ET tube leaks. You don’t want to replace it. What an you do?

A

Place a stopcock in the pilot balloon valve
Insert a blunt needle into the pilot line
or
Clamp the pilot line
If those don’t work, replace the tube.

47
Q

What should you do if you have to attach a patient with a larry tube to a ventilator?

A

Remove the larry tube and replace it with an ET tube. Then hook to the ventilator. (Larry tubes don’t have cuffs so they can’t be used with a ventilator.)

48
Q

When doing PEP therapy, pt should inhale a (larger than, less than, equal to) normal tidal volume and exhale actively but not forcefully. Inspiration:expiration should be ___.

A

Larger than

1:2 or 3

49
Q

When doing PEP therapy, expiratory pressures should range from ___ to ___ cm H2O at mid-exhalation.

A

Should range from 10-20 cm H2O.

50
Q

What is used during rapid sequence intubation to prevent aspiration?

A

Cricoid pressure (Sellick’s maneuver)

51
Q

During an RSI attempts, ___ must be available. (Type of drug.)

A

Vasopressors.

52
Q

Prior to an RSI attempt, do a ___ to see how difficult the intubation will be. If it’s going to be difficult, get ___. Then, consider pharmacology. ___ must be available and you must have ___ (drug) available.

A

Mallampati or thyromental distance
Obtain additional equipment like a glidescope
IV access must be available
Vasopressors must be available

53
Q

You’ve gathered all the equipment needed and prepared adequately for an RSI attempt. First, ___ the patient and ___ him/her. Next, ___ the patient. After the patient has lost consciousness, you can ___ the patient. Lastly, you need to ___ the intubation was successful.

A 
Position patient
Preoxygenate
Medicate
Intubate
Confirm intubation.
54
Q

To confirm a successful intubation, first the doctor will ___ that it was successful. Next, you should ___ so see if the tube is in the right place. Attach the ___. Lastly, call for a ___.

A

Observation
Auscultation
End Tidal CO2
Chest Xray

NBRC Questions (22 decks)

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