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Final Dysphagia Exam > Tubes & Dysphagia > Flashcards

Tubes & Dysphagia Flashcards

1
Q

WHY would a person have a tracheostomy tube?

A
  • UPPER AIRWAY OBSTRUCTION or POTENTIAL OBSTRUCTION at or above the level of the VF’s!
  • PROVISION of respiratory care
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2
Q

WHERE & HOW is a trach tube placed?

A

TUBE INSERTED IN TRACHEA

via SURGICAL INCISION b/w 3rd & 4th tracheal ring

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3
Q

WHAT are the 3 parts of the trach tube?

A 
OUTER CANNULA (holds trach site OPEN)
INNER CANNULA ( BREATHING tube) 
OBTURATOR ( SMOOTH TIP for insertion)
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4
Q

Which are the 3 TYPES of trach tubes?

A

CUFFED

CUFFLESS

FENESTRATED

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5
Q

A ______________ tube has a SHORT TERM use.

A

FENESTRATED

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6
Q

A _____________ tube has a LONG TERM use.

A

CUFFLESS

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7
Q

What are some facts of the CUFFED ?

A

prevents ASPIRATION!
used with VENTILATORS
INFLATED for MORE PRESSURE (expands the tracheal walls inside)

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8
Q

Which trach tube does NOT expand the tracheal walls?

A

CUFFLESS

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9
Q

What are some facts of the CUFFLESS ?

A
  • ASPIRATION MAY OCCUR
  • MAY INTERFERE with LARYNGEAL ELEVATION
  • Assists in breathing and SECRETION REMOVAL
  • LONG TERM USE
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10
Q

What are some facts of the FENESTRATED ?

A
  • It is SMALLER
  • used for DECANNULATION
  • SHORT TERM USE
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11
Q

A pt. can use a FENESTRATED trach tube for 3 weeks.

A

FALSE!!! (3-5 days)

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12
Q

What INFORMATION do you need to know before you work on swallowing with a trach patient.

A

1) Pt. hx (symptoms of dysphagia)
2) Know type of trach and if inflated
3) Determine length of time with trach
4) Deflate cuffed tube w/ medical consent
5) Suction oral and trach deflating
6) Occlude pt’s trach with gloved finger during several seconds after each swallow

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13
Q

T or F: It is recommended to write down the directions for swallowing to the trach tube pt.

A

TRUE!

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14
Q

T or F: You can start swallowing tx without having to do any dry swallows first.

A

FALSE! start with dry swallows!!!!

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15
Q

When you are doing the swallowing trials you provide the patient with NO MORE THAN _______ of liquid/paste/puree

A

3cc!

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16
Q

How can you feel hyolaryngeal excursion?

A

5-finger test!!! - should be done during the trial swallows!!!

17
Q

During the swallowing tx. (trials) you want the pt. to _____________!

A

COUGH COUGH COUGH

18
Q

When you are finished giving the pt. the intake for the trial you have them do what?

A

PHONATE a sustained vowel to check if they have a wet gurgly voice

19
Q

T or F: Swallow usually worsens on vent.

A

TRUE!

20
Q

When a person is on a ventilator their ________ period is affected.

A

APNEIC - becomes uncoordinated…respiration is controlled by vent

21
Q

T or F: When a person is on a vent they CAN LENGTHEN EXHALATION for their swallow.

A

FALSE!!! their swallow is disrupted

22
Q

Which kind of trach tube is on a vent?

A

CUFFED

23
Q

What is the main thing you work at during swallowing tx?

A

TIMMING!!! of swallow during exhalation

24
Q

What can the blue dye test reveal?

A

If pt. is aspirating! If blue dye comes out of the trach that means that they aspirated

25
Q

What are some of the COMPLICATIONS that may happen w/ a person that has been INTUBATED?

A
  • LARYNGEAL TRAUMA from tube placement. (TE fistula from tube rubbing)
  • LARYNGEAL PATHOLOGIES: granulomas, vf paresis/paralysis, edema , erythema
26
Q

Can you perform swallowing treatments on a person who is INTUBATED?

A

NO!!!!!!!

Not until is person EXTUBATED for at least 1 week.

27
Q

When a person has been EXTUBATED for a week or more…how can you start swallowing tx?

A

w/ ROM exercises!!!!

28
Q

NG method =

A

tube placed NASALLY

29
Q

PEG method=

A

tube placed by percutaneous endoscopic/laparoscopic gastrostomy

30
Q

RIG method=

A

RADIOLOGICALLY inserted gastrostomy

31
Q

SURGICAL method=

A

OPEN or laparoscopically inserted gastrostomy

32
Q

What are the 7 types of FEEDING TUBES?

A

NNNOGGJ

1) Nasograstric (NG)
2) Nasoduodenal (ND)
3) Nasojejunal (NJ)
4) Orogastric (OG)
5) Gastrostomy (G or GT)
6) Gastrostomy w/ dual port to jejunum (GD)
7) Jejunostomy (GJ or PEJ)

33
Q

T or F : 10% or 20% of weight loss is common and considered moderate.

A

TRUE

34
Q

MORE than _______ of weight loss is considered SEVERE

A

20%

35
Q

What are some signs “red flags” that might tell you that a person is DEHYDRATED?

A
  • rapid weight loss (4+ lbs in 48hrs)
  • thin liquid dysphagia
  • skin turgor
  • complaint of thirst
  • decreased urination
  • hypernatremia (increased serum sodium)
  • elevated BUN (blood urea nitrogen)
36
Q

Which is the most common feeding tube used?

A

NASOGASTRIC

37
Q

T or F: Feeding tubes are only used for people who cannot eat orally.

A

FALSE! They might be used for supplemental nutrition or oral pleasure.

Final Dysphagia Exam (2 decks)

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