NR 341; Exam 1
What dressing should be applied upon chest tube removal ? - CORRECT ANSWER airtight sterile
petroleum jelly gauze dressing
What are the reasons YOUR pt. may need an artificial airway ? - CORRECT ANSWER ●upper airway
obstruction (bleeds, tumor, gcs less than 8, burns)
●sx
●trauma
●neuromuscular diseases
●sepsis
●apnea
●high risk for aspiration
●ineffective clearance of secretions
●resp distress
When a pt. has a tube in their trachea, what do you need to know as a nurse ? - CORRECT ANSWER
where was it last marked (@ the teeth or lip)
cuff pressure
Two real reasons there's a inflated cuff ? - CORRECT ANSWER when cuff inflated, prevent
secretions from going to lungs (infections)
when pt. on ventilator, CERTAIN amount of gas that'll be going through each ventilator. with the cuff
inflated, the volume is more accurate. with the cuff slightly deflated, theres no telling how much
amount of volume is going to the lungs- BASICALLY prevents escape of ventilating gases
Patient needs an artificial airway, how are we going to prepare for this procedure ?
What should you do to prepare ?
What equipment is needed ?
,What position should the pt. be in ?
What should be done before intubation ? - CORRECT ANSWER preparation
-dentures & plates NEEDS to be removed
*equipment
-oxygen, suction tubing, cardiac monitor, yankuer, tonsil tip suction
*before intubation
-sniffing position (pt. supine with the head extended & the neck flexed)
-pre-oxygenate / BVM 100% O2 for 3-5 minutes
-meds (sedative, paralytic agent, analgesic)
What's the reason behind putting the pt. in a sniffing position ? - CORRECT ANSWER to get a better
view of vocal cords
Describe rapid sequence intubation.
When is rapid sequence intubation NOT indicated ? - CORRECT ANSWER BOTH sedative & paralytic
agent are given to emergency airway pt.s (decrease aspiration, )
crashed airway-unstable pt. (cardiac arrest OR )
if pt. not awake, then this wont be done known difficult airway
there is not time for all this.
Nursing responsibilities when assigned to a airway pt. ? - CORRECT ANSWER maintain correct tube
placement
maintain proper cuff inflation
, monitor oxygen & vent
maintain tube patency
oral care & skin integrity
comfort & communication
assess for complications
How to maintain proper tube placement ?
What are OTHER confirmatory methods for tube placement ?
BUT how is placement verified & confirmed ? - CORRECT ANSWER mark the tube with an exit mark
confirm that the mark remains constant throughout the whole shift (rest, positioning, transporting
etc.)
-----------------------------------------------------------
bilateral chest expansion
auscultate lungs & throat
ABG's
-----------------------------------------------------------
placement is VERIFIED w/ an end-tidal CO2 (ETCO2) detector device (lavender) -how much being
exhaled& CONFIRMED by chest x-ray
If a dislodged tube is not repositioned soon
-minimal oxygen is delivered to the lungs
-NO oxygen at all is going to the lungs
-the entire Vt (tidal volume) is delivered to one lung
ALL of these scenarios places the pt. at risk for ? - CORRECT ANSWER Pneumothorax
What dressing should be applied upon chest tube removal ? - CORRECT ANSWER airtight sterile
petroleum jelly gauze dressing
What are the reasons YOUR pt. may need an artificial airway ? - CORRECT ANSWER ●upper airway
obstruction (bleeds, tumor, gcs less than 8, burns)
●sx
●trauma
●neuromuscular diseases
●sepsis
●apnea
●high risk for aspiration
●ineffective clearance of secretions
●resp distress
When a pt. has a tube in their trachea, what do you need to know as a nurse ? - CORRECT ANSWER
where was it last marked (@ the teeth or lip)
cuff pressure
Two real reasons there's a inflated cuff ? - CORRECT ANSWER when cuff inflated, prevent
secretions from going to lungs (infections)
when pt. on ventilator, CERTAIN amount of gas that'll be going through each ventilator. with the cuff
inflated, the volume is more accurate. with the cuff slightly deflated, theres no telling how much
amount of volume is going to the lungs- BASICALLY prevents escape of ventilating gases
Patient needs an artificial airway, how are we going to prepare for this procedure ?
What should you do to prepare ?
What equipment is needed ?
,What position should the pt. be in ?
What should be done before intubation ? - CORRECT ANSWER preparation
-dentures & plates NEEDS to be removed
*equipment
-oxygen, suction tubing, cardiac monitor, yankuer, tonsil tip suction
*before intubation
-sniffing position (pt. supine with the head extended & the neck flexed)
-pre-oxygenate / BVM 100% O2 for 3-5 minutes
-meds (sedative, paralytic agent, analgesic)
What's the reason behind putting the pt. in a sniffing position ? - CORRECT ANSWER to get a better
view of vocal cords
Describe rapid sequence intubation.
When is rapid sequence intubation NOT indicated ? - CORRECT ANSWER BOTH sedative & paralytic
agent are given to emergency airway pt.s (decrease aspiration, )
crashed airway-unstable pt. (cardiac arrest OR )
if pt. not awake, then this wont be done known difficult airway
there is not time for all this.
Nursing responsibilities when assigned to a airway pt. ? - CORRECT ANSWER maintain correct tube
placement
maintain proper cuff inflation
, monitor oxygen & vent
maintain tube patency
oral care & skin integrity
comfort & communication
assess for complications
How to maintain proper tube placement ?
What are OTHER confirmatory methods for tube placement ?
BUT how is placement verified & confirmed ? - CORRECT ANSWER mark the tube with an exit mark
confirm that the mark remains constant throughout the whole shift (rest, positioning, transporting
etc.)
-----------------------------------------------------------
bilateral chest expansion
auscultate lungs & throat
ABG's
-----------------------------------------------------------
placement is VERIFIED w/ an end-tidal CO2 (ETCO2) detector device (lavender) -how much being
exhaled& CONFIRMED by chest x-ray
If a dislodged tube is not repositioned soon
-minimal oxygen is delivered to the lungs
-NO oxygen at all is going to the lungs
-the entire Vt (tidal volume) is delivered to one lung
ALL of these scenarios places the pt. at risk for ? - CORRECT ANSWER Pneumothorax
