RES 204 Unit 3 exam Questions With Complete Solutions.

Describe the type of respiratory patients who typically stay at LTACHs and their LOS correct answer: Provide highly focused care to patients with complex medical conditions, including patients who have been ventilator dependent and difficult to wean a. they often have tracheostomy tube and not ETT Recognize a list of commonly encountered problems associated with ventilator weaning correct answer: 8. Difficulty with weaning/troubleshooting -Respiratory insufficiency -Airway Obstructions -Retention of Secretions -Blood in secretions -Patient anxiety Describe communication/equipment adjuncts that are used with trached and intubated patients correct answer: . Communication a. Boards allow patients to communicate by pointing to words and letters. b. Trach devices allow the patient to speak by directing air past vocal cords i. speaking valves, Passey Muir valve and fenestrated trachs Describe the techniques and issues associated with end-of-life situations for patients on mechanical ventilation correct answer: -Terminal wean for families who need extra time to make a decision. -Process of removing ventilator support in stages like reducing FIO2, TV, etc. Identify the problems for RTs associated with a new tracheostomy for ventilator patients correct answer: Identify issues associated with trach tube diameters, lengths and angles correct answer: -Extreme care must be taken to manage a new tracheostomy site. -Gentle cleaning -Guard it from --accidental decannulation --excessive movement (stabilize vent connection) 4. Do not change the trach for 7-14 days unless major issue or decannulation occurs -Tissues often close making re-insertion difficult and likelihood of pushing into false tract -Done only by ENT or surgeon -If controlled, put in a guide catheter into old tube, remove, and thread new trach over it -If the tracheostomy tube is too short, the distal end can obstruct against the posterior tracheal wall. This can be remedied by using --larger tube --angled tube --tube with a flexible shaft