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Fundamentals II > Test 1 Ch. 37 > Flashcards

Test 1 Ch. 37 Flashcards

1
Q

Where do Pharyngeal airways extend to.

A

extend only into the pharynx

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2
Q

Artificial airways are placed…
and are called…

A

through the mouth & nose into the trachea and are called Endotracheal tube

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3
Q

Process of placing artificial airway into trachea

A

Intubation

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4
Q

When the tube is passed through the mouth on its way to the trachea is called

A

Orotracheal Intubation

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5
Q

When the ET tube is passed through the nose

A

Nasotracheal intubation

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6
Q

What are the 2 pharyngeal airways

A

Nasopharyngeal
Oropharyngeal

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7
Q

This Airway is most often placed to facilitate frequent nasotracheal suctioning

A

Nasopharyngeal

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8
Q

This airway should be restricted to unconscious pt to avoid gaging and regurgitation

A

Oropharyngeal

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9
Q

This airway Maintains pt’s airways by preventing the tongue from obstructing oropharynx

A

Oropharyngeal

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10
Q

What are the 2 types of oropharyngeal airways

A

Geudel and Berman

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11
Q

Has a 2 sided channel sizing

A

Berman

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12
Q

Has a single center channel

A

Geudel

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13
Q

How do you measure an oropharyngeal to fit the pt?

A

From the corner of the pt’s mouth to the angle of the jaw

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14
Q

What can happen if an oropharyngeal is to large?

A

It can push the epiglottis against the larynx leading to obstruction

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15
Q

If the oropharyngeal airway is to small it

A

may not clear the tongue

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16
Q

Oropharyngeal airways must lie at the….. and above……
W/ flange outside

A

base of the tongue above the epiglottis

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17
Q

What is another name for nasopharyngeal

A

nasal trumpet or nasal horn

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18
Q

What are some indications for Nasopharyngeal airway (2)

A

-Facilitate ventilation
-Removal of secretions by nasotracheal suctioning

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19
Q

what is the size used for females in nasopharyngeal airways

A

6

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20
Q

what is the size used for males in nasopharyngeal airways

A

7

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21
Q

If the nasopharyngeal airway is to short it

A

cannot separate the soft palate from the posterior wall of the pharynx

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22
Q

If the nasopharyngeal airway is to large then it may enter the ___________, causing…..

A

larynx, causing laryngeal reflexes or enter the space between the epiglottis and vallecula, leading to potential obstruction

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23
Q

Esophageal Oburator Airway is inserted into the

A

esophagus

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24
Q

Has an opening at the top (for manual ventilation) small holes in mid-section (divert air to lungs)a blind distal end (prevents air from going to stomach)

A

Esophageal Oburator Airway (EOA)

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25
Q

A cuff on top of the distal end prevents

A

aspiration of stomach contents

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26
Q

What are indications for Laryngeal Mask Airway (LMA 2)

A

-Unconscious pts
-unable to perform ET intubation

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27
Q

Contraindications for LMAs

A
  • Does not protect from airway aspiration
    -pts who have not fasted
  • are not profoundly unconscious
    -have severe oropharyngeal trauma
    -short term use
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28
Q

LMA have unstable

A

airways and may cause misplacement of mask & gastric distention

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29
Q

LMA cannot withstand high airway pressures (20b cm H20) w/o causing

A

gastric distention

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30
Q

Esophageal- Tracheal Combitude (ETC) is inserted ___________.

A

blindly

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31
Q

Esophageal- Tracheal Combitude (ETC) may be inserted into the (2 ways)

A

Esophagus or tracheal

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32
Q

When the tube is in the trachea,a large proximal cuff _______ seals off the _________

A

100ml seals off the trachea

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33
Q

Double-Lumen Endotracheal tube (DLT) indications

A
  • Lung isolation (prevent lung to lung spillage of blood pus)
    -surgical procedure on non ventilated lung
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34
Q

DLT has

A

2 connectors, 2 lumens for gas flow, 2 cuffs and 2 distal opening

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35
Q

What are 4 Indications for Artificial airways

A

Relief of airway obstruction
Protection of airway
Suctioning
Support ventilation

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36
Q

Endotracheal tube is an oral _____________ for ____________ ______________

A

intubation for mechanical ventilation

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37
Q

Procedure of establishing access to trachea via neck incision

A

Tracheotomy

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38
Q

Opening in the neck is called

A

Tracheostomy

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39
Q

Removal of the larynx “voice box”

A

Laryngotomy

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40
Q

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

A

Speaking valve

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41
Q

_____________ air is forced to go through the vocal cords making ___________ possible

A

Exhaled; phonation

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42
Q

For a traditional tracheostomy tube to use a speaking valve

A

the cuff must be deflated

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43
Q

For a fenestrated tracheostomy tube the cuff may be ___________, providing the __________ solid canal of the _____________ trachea tube is removed

A

inflated; inner; fenestrated

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44
Q

What supplies do you need for intubation

A

Laryngoscope
Blade
Miller straight
Macintosh (curved)
ET tube (radiopaque line, pilot ballon)
10-12mL syringe
Water- solube lubricant
Stylet
ET tube securing device
Carbon dioxide (co2) detector

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45
Q

How do you use a Mac blade

A

place at vallecula between the base of the tongue and epiglottis. Lifts up tongue and indirectly the epiglottis

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46
Q

How do you use a Miller blade

A

Lift up epiglottis

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47
Q

What are the common blade sizes

A

size 3 or 4

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48
Q

EOT is a

A

blind insertion

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49
Q

LMA sits over the

A

larynx

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50
Q

what is binocular vision

A

direct vision to the vocal cords

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51
Q

Where should the tip of the ET be placed in the body? (Number)

A

3-5 cm above the carina; between second and fourth tracheal rings

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52
Q

what is a bougie?

A

Long tube that you can place in airway at the exact location of the ET tube

53
Q

______________ requires moving the vocal cords

A

Phonation

54
Q

ETT prevents __________ ________ movement and _________ through the cords

A

vocal cord; airflow

55
Q

The goal is to keep capillary perfusion pressure in trachea is

A

20 mmHg to 30

56
Q

With a Minimal Occusion Volume (MOV) you need to inflate

A

cuff slowly until no air leaks are heard at end- inspiration

57
Q

Most common injuries to larynx

A

Glottic edema
Vocal inflammation
Lartngeal/ Vocal ulcerations
Vocal cord polyps or granulomas

58
Q

Endotracheal suctioning should not be done on a

A

preset schedule

59
Q

Pre oxygenate w/ ______ o2
and use vacuum pressure between

A

100% o2; 120-150 mmHg

60
Q

Limit duration of suctioning to

A

<15

61
Q

Suctioning can be preformed via

A

-The upper airway (oropharynx)
- The lower airway (trachea and bronchi)

62
Q

Two techniques for endotracheal suctioning:

A

-Open-steile technique that requires disconnecting pt from ventilator
-Closed- technique uses sterile closed in line suction catheter that is etched to ventilator circuit

63
Q

What is needed for Extubation (5)

A

O2
10-12 ml syringe
Towel
Stethoscope
Intubation box/ cart

64
Q

unplanned extubation may be

A

self- inflicted or accidental

65
Q

______ of unplanned extubation do not require reintubation

A

50%

66
Q

From review
Types of oropharyngeal

A

Berman - 2 sided channel
Guedule- 1 central channel

67
Q

How to insert an oropharyngeal

A

put it in first parallel with the pallet and twist it 180 degrees

68
Q

what type of pts do we use oropharyngeal airways for and why?

A

Unconscious pt, if not then pt could gag and aspirate

69
Q

What does an oral airway prevent?

A

Airway obstruction from the tongue

70
Q

MOST common airway obstruction?

A

Tongue

71
Q

Why would a pt have swelling in their airway (3)

A

trauma
post extubation
allergic reaction

72
Q

How should you measure what size of an oral airway you need

A

mouth to earlobe

73
Q

What kind of pts can we use nasalpharyngeal airways

A

semi conscious
suctioning pts
relive airway obstruction

74
Q

How to measure for a nasal airway

A

earlobe to tip of the nose

75
Q

if nasal airway is to short then it can’t

A

reach to the soft palette

76
Q

if nasal airway is to large it can cause an _______________.

A

obstruction

77
Q

Most common sizes for nasal airway is

A

size 6 and 7

78
Q

How do you insert a nasopharyngeal airway

A

beveled Egde to the septum

79
Q

EOT is what kind of insertion?

A

blind insertion

80
Q

Combe tube prevents____________ b/c of

A

aspiration b/c of the cuffs

81
Q

Does LMA prevent aspiration

A

No

82
Q

LMA sits

A

over the larynx; it does not insert the trachea or esophagus, therefore it does not prevent aspiration

83
Q

2 different pressures for LMA

A

cuff pressure is 60
airway pressure is 20

84
Q

Can LMA be autoclaved up to 40 times?

A

yes

85
Q

What are some reasons why we need to do Independent Lung Ventilation?

A

To Prevent spillage, infection, bronch one lung ; you close off one lung

86
Q

Airway resistance will be higher

A

the smaller the tube

87
Q

T or F. Size 7 1/2 or 8 is used for oral intubation

A

true

88
Q

What can happen to ET tube that can cause increase airway resistance

A

Secretions
kinks

89
Q

Before you intubate you have to do what to your patient?

A

preoxygenate (hyper oxygenate)

90
Q

T or F. You must Check equipment first before you begin intubation

A

true

91
Q

Mac blade is placed in the…..
Miller blade is placed

A

Vellucula ; below the epiglottis and lift it up

92
Q

How long do you have for an unsuccessful intubation before you have to start over?

A

30 seconds

93
Q

What vitals do you watch before intubation?

A

Sats
HR
BP

94
Q

Contraindications of placing nasal airway (2)

A

nasal Trauma
Bleeding

95
Q

Contraindications of placing oral airway (2)

A

oral trauma
Bleeding

96
Q

How do you prevent a nasal airway from coming out? And how does it work

A

Safety pin; prevents from outward inward migration

97
Q

Common reason someone needs to be trached

A

Long term airway

98
Q

What is kept at the bedside incase trachea comes out?

A

obturator

99
Q

Parts of a Trachea tube (7)

A

Inner canula
cuff
obturator
pilot ballon
flange
Outer cannula
Size indicator

100
Q

If a pt has severe stridor then what must we do

A

Intubate pt

101
Q

If tube comes out of airway, what is the best method to fixing it?

A

take it out and replace in the correct location

102
Q

What are the cuff pressures for ET tube and trachea

A
103
Q

Formula for appraise size catheter (F)

A

ET tube x 2= next size smaller French
example: 8 x2=16 you will use 14 French

104
Q

What has to be done in order for a speaking valve to be placed on a traditional tt?

A

cuff must be deflated

105
Q

____________ _______ is used so the pt can talk through their tracheotomy tube

A

speaking valve

106
Q

Cuff Does not have to be deflated to speak thru tracheostomy tube

A

Fenestrated tt

107
Q

Fenestrated tt could be used for pts who

A

will not be trached for a long time or can be used to ween

108
Q

What are some things we monitor after EXTUBATION

A

o2
breath sounds (stridor bbs)

109
Q

What breath cycle do we do extubation on?

A

end-halation (coughing)

110
Q

How long should you suction for? b/c

A

15 seconds; trauma

111
Q

What are the parts of an ET tube

A

Cuff
pilot ballon
Murphy eye
radiopaque line
cliff markings

112
Q

Where do pharyngeal airways extend into?

A

pharynx

113
Q

Where are oropharyngeal airways inserted?

A

into the mouth and over the tongue

114
Q

List 4 types of airways

A

Oropharyngeal
Nasopharyngeal
Endotracheal (ET)
Laryngeal Mask Airway (LMA)

115
Q

What are the four main indications for artificial airways

A

Relief of airways obstruction
Protection of airway
Suctioning
Support ventilation

116
Q

List the 4 most common injures to the larynx

A

Glottic edema
Vocal inflammation
Laryngeal/ vocal cord ulcerations
Vocal cord polyps or granulomas

117
Q

How long do you have to complete an intubation before having to stop and preoygenate again ?

A

30 seconds

118
Q

Inflate cuff unit the leaks stops; remove a small amount of air way slowly until a SLIGHT leak can be heard at end- inspiration. What technique is this?

A

Minimal leak technique (MLT)

119
Q

What pharyngeal airway would be most appropriate for an unconscious patient?

A

Oropharyngeal

120
Q

What is the most common cause of airway obstruction?

A

Tongue

121
Q

List 2 other causes of airway obstruction

A

Secretions
Inflammation

122
Q

Inflate cuff slowly until NO air leaks are heard at end-inspiration. What technique is this?

A

Minimal occlusion volume (MOV)

123
Q

What pharyngeal airway would be most appropriate for a patient that is conscious but needs frequent suctioning?

A

Nasopharyngeal

124
Q

List 2 intraesophgeal airways

A

Double lumen endotracheal tube (DLT)
Esophageal obturator airway (EOA)

125
Q

Suctioning pressures for infants

A

80-100

126
Q

Suctioning pressures for adults

A

120-150

127
Q

Suctioning pressures for children

A

100-120

128
Q

Suction until you meet_____________ or patient _________

A

Resistance or coughs

Fundamentals II (13 decks)

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