NR 341; Exam 1 100% GUARANTEED PASS!!
What dressing should be applied upon chest tube removal ? - (ANSWER)airtight
sterile petroleum jelly gauze dressing
What are the reasons YOUR pt. may need an artificial airway ? -
(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 ? -
(ANSWER)where was it last marked (@ the teeth or lip)
cuff pressure
Two real reasons there's a inflated cuff ? - (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
Page 1 of 31
,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 ? - (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 ? - (ANSWER)to get
a better view of vocal cords
Describe rapid sequence intubation.
Page 2 of 31
,When is rapid sequence intubation NOT indicated ? - (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. ? - (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 ?
Page 3 of 31
, What are OTHER confirmatory methods for tube placement ?
BUT how is placement verified & confirmed ? - (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 ? - (ANSWER)Pneumothorax
Another word for ambu bag ?
What should ALWAYS be with you when you have this bag ? - (ANSWER)bag
valve mask
Page 4 of 31
What dressing should be applied upon chest tube removal ? - (ANSWER)airtight
sterile petroleum jelly gauze dressing
What are the reasons YOUR pt. may need an artificial airway ? -
(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 ? -
(ANSWER)where was it last marked (@ the teeth or lip)
cuff pressure
Two real reasons there's a inflated cuff ? - (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
Page 1 of 31
,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 ? - (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 ? - (ANSWER)to get
a better view of vocal cords
Describe rapid sequence intubation.
Page 2 of 31
,When is rapid sequence intubation NOT indicated ? - (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. ? - (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 ?
Page 3 of 31
, What are OTHER confirmatory methods for tube placement ?
BUT how is placement verified & confirmed ? - (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 ? - (ANSWER)Pneumothorax
Another word for ambu bag ?
What should ALWAYS be with you when you have this bag ? - (ANSWER)bag
valve mask
Page 4 of 31
