NUR 431 – AIRWAY FINAL EXAM
QUESTIONS AND ANSWERS
pt could be biting it, kink in tubing, obstruction, pneumothorax
high frequency ventilatory alarm - Answer-high respiratory rate
could be r/t pain, anxiety, agitation
minute volume ventilator alarm - Answer-can be high or low
if low- can sound when pt is weaning
mandatory tidal volume ventilator alarm - Answer-could indicate leak - alarm would be
for low mandatory tidal volume
ventilator nursing management - Answer-look @ tube size, where it is located (measure
at teeth/gums), assess need for suctioning, are ventilator settings as ordered?
provide oral care every 2-4 hours, move tubing from side to side in mouth
monitor for confusion/delirium
nursing care - intubated pt - Answer-check for symmetry of chest expansion, auscultate
breath sounds
get chest x-ray to verify tube placement and ensure a pneumothorax didn't care
monitor for S&S of aspiration
reposition every 2 hours and as needed to prevent atelectasis
nursing management - pt in acute respiratory distress/arrest - Answer-assess pt's mouth
for obstruction - listen/feel for movement of air
if no movement of air - begin CPR
apply mask to patient's face, create a seal by pressing thumb on bridge of nose and
index finger on chin, with other fingers pull on mandible towards you
suctioning - Answer-purpose: when adventitious breath sounds are detected or
whenever secretions are obviously present
closed suctioning = in line suctioning
QUESTIONS AND ANSWERS
pt could be biting it, kink in tubing, obstruction, pneumothorax
high frequency ventilatory alarm - Answer-high respiratory rate
could be r/t pain, anxiety, agitation
minute volume ventilator alarm - Answer-can be high or low
if low- can sound when pt is weaning
mandatory tidal volume ventilator alarm - Answer-could indicate leak - alarm would be
for low mandatory tidal volume
ventilator nursing management - Answer-look @ tube size, where it is located (measure
at teeth/gums), assess need for suctioning, are ventilator settings as ordered?
provide oral care every 2-4 hours, move tubing from side to side in mouth
monitor for confusion/delirium
nursing care - intubated pt - Answer-check for symmetry of chest expansion, auscultate
breath sounds
get chest x-ray to verify tube placement and ensure a pneumothorax didn't care
monitor for S&S of aspiration
reposition every 2 hours and as needed to prevent atelectasis
nursing management - pt in acute respiratory distress/arrest - Answer-assess pt's mouth
for obstruction - listen/feel for movement of air
if no movement of air - begin CPR
apply mask to patient's face, create a seal by pressing thumb on bridge of nose and
index finger on chin, with other fingers pull on mandible towards you
suctioning - Answer-purpose: when adventitious breath sounds are detected or
whenever secretions are obviously present
closed suctioning = in line suctioning
