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Exam (elaborations)

BKAT Study Set Latest Update (2022/2023) Rated A+

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BKAT Study Set Latest Update (2022/2023) Rated A+ Normal blood gases; pH 7.35-7.45 Normal blood gases: CO2 35-45 Normal blood gases: HcO3 22-26 Normal blood gases: PO2 80 or above Normal vacuum pressures for suction? 120-140 mmHg What may a high pressure vent alarm indicate? Pt is biting on the tubing, excessive secretions in the tubing, kinked tubing What may a low pressure vent alarm indicate? cuff leak or the tubing is disconnected somewhere How do you verify positioning of an endotracheal tube? -auscultate lung bases and apices for bilateral breath sounds -observe chest for symmetric chest wall movement -confirm with end tidal CO2 measure GOLD STANDARD: chest x-ray t/f: people with ET tubes should be suctioned routinely FALSE-- they should be suctioned on an as needed basis what should ET tube cuff pressure be kept at? 20-25 mmHg What measures should nurses take to avoid ET tube problems? -confirm that exit mark on ET tube remains constant when providing patient care, repositioning, and transporting patient -maintain proper cuff inflation (listen for an air leak-- if pt can talk, you must inflate more) -continually monitor SpO2, RR, HR and rhythm, mental status, and ABGs -pre-oxygenate before suctioning What should be done if a patient is not tolerating ET tube suctioning? STOP and manually hyperventilate with 100% oxygen Measures to prevent aspiration? -avoid bolus tube feedings -monitor tube feeding residuals -maintain HOB at LEAST 30 degrees or greater -maintain proper ET tube cuff inflation -perform frequent oral pharyngeal suctioning -maintain an NG tube connected to low, intermittent suction if feeding tube is placed below the pylorus what are recommendations for preventing ventilator associated pneumonia? -manage ventilated patients without sedatives whenever possible -interrupt sedation once a day (spontaneous breathing trials) -provide early exercise and mobility -provide regular oral care -minimize pooling of secretions above the ET tube cuff -use ET tubes with subglottic secretion drainage for patients likely to require greater than 72 hours of intubation -keep

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