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NURS 460 - Adult III Exam 1 > wk 3 respiratory ppt/3 > Flashcards

wk 3 respiratory ppt/3 Flashcards

1
Q

ARDS collab mgmt - medical supportive therapy

3

A
  1. maintenance of CO and tissue perfusion
  2. maintenance of fluid balance
  3. minimize hypotension and decreased CO from mechanical ventilation and PEEP
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2
Q

artificial airway indications include

5

A
  1. upper airway obstruction i.e. tumor
  2. apnea
  3. high risk for aspiration
  4. ineffective clearance of secretions
  5. respiratory distress
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3
Q

what would sound the low pressure alarm?

3

A
  1. leak
  2. tubing disconnect
  3. balloon deflated
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4
Q

artificial airways - what is the procedure of choice

A

oral ET intubation

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5
Q

oral ET intubation - pros

2

A
  1. airway can be secured rapidly

2. larger diameter tube can be used

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6
Q

nasal ET intubation is indicated when

A

head and neck manipulation is risky

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7
Q

artificial airway that is indicated when head and neck manipulation is risky

A

nasal ET intubation

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8
Q

tracheostomy

A

surgical procedure performed when need for an artificial airway is expected to be long term

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9
Q

surgical procedure performed when need for an artificial airway is expected to be long term

A

tracheostomy

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10
Q

ET intubation equipment

3

A
  1. self inflating BVM attached to oxygen
  2. suctioning equipment
  3. intravenous access
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11
Q

ET intubation procedure - premedication depends on

2

A
  1. pts level of consciousness

2. nature of procedure

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12
Q

RSI stands for

A

rapid sequence intubation

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13
Q

rapid sequence intubation RSI

A

rapid, concurrent administration of a paralytic agent and a sedative agent during emergency airway mgmt

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14
Q

rapid, concurrent administration of a paralytic agent and a sedative agent during emergency airway mgmt

A

rapid sequence intubation RSI

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15
Q

RSI decreases what

A

risk for aspiration, combativeness, and injury to pt

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16
Q

RSI is not indicated for

A

comatose or cardiac arrest pts

17
Q

RSI - what do we do beforehand

A

preoxygenate, we don’t hyperventilate

18
Q

ET intubation procedure - before intubation

3

A
  1. preoxygenate using BVM with 100% O2 for 3-5 mins
  2. limit each intubation attempt to <30 s
  3. ventilate pt between successive attempts using BVM with 100% O2
19
Q 
ET intubation procedure - following intubation
6
-inflate
-end
-auscultate
-observe
-obtain
-secure
-obtain
A
  1. inflate cuff and confirm placement of ET tube while manually ventilating pt with 100% O2
  2. end-tidal CO2 detector is place between BVM and ET tube - measures exhaled CO2 from lungs
  3. auscultate lung bases and apices for bilateral breath sounds
  4. observe for symmetric chest wall movements
  5. obtain chest x ray
  6. secure ETT and connect to mechanical ventilator
  7. obtain ABGs and continuously monitor pulse ox
20
Q

ET intuabtion - what should to tube typically fall on adults

A

3-5 cm above carina

21
Q

increase Vt and RR will do what

A

drop CO2

22
Q

what to parameters, if increased will drop CO2

A

Vt

RR

23
Q

decrease the Vt and RR will do what

A

help bring CO2 back up if it’s low

24
Q

what to parameters will help bring CO2 back up if it’s low and you decrease these

A

Vt and RR

25
Q 
ET tube intubation nursing mgmt
6
-maintain
-maintain
-monitor
-maintain
-providing
-fostering
A
  1. maintain correct tube placement
  2. maintain proper cuff inflation (20-25 mm Hg)
  3. monitor oxygentation and ventilation
  4. maintain tube patency
  5. providing oral care and maintaining skin integrity
  6. fostering comfort and communication
26
Q

what should ET tube cuff pressure be maintained at

A

20-25 mm Hg

27
Q

what should ET tube suction be suctioned at

A

80-120 suction, intermittent

28
Q

ET tube intubation - indications for suctioning include

2

A
  1. visible secretions in ET tube

2. sudden onset of respiratory distress

29
Q 
ET tube indication for suctioning - sudden onset of respiratory distress
5
-suspected
-increase in
-auscultation 
-increase in
-sudden or
A
  1. suspected aspiration of secretions
  2. increase in peak airway pressures
  3. auscultation of adventitious breath sounds over trachea and/or bronchi
  4. increase in RR and/or sustained coughing
  5. sudden or gradual decrease in PaO2 and/or SpO2
30
Q

potential complications associated with suctioning include

8

A
  1. hypoxemia
  2. bronchospasm
  3. increased intracranial pressure
  4. dysrhythmias
  5. hyper/hypotension
  6. mucosal damage, bleeding
  7. pain
  8. infection

NURS 460 - Adult III Exam 1 (16 decks)

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