BKAT Study Set Questions and Answers (100%
Correct Answers) Already Graded A+
Normal blood gases; pH [ Ans: ] 7.35-7.45
Normal blood gases: CO2 [ Ans: ] 35-45
Normal blood gases: HcO3 [ Ans: ] 22-26
Normal blood gases: PO2 [ Ans: ] 80 or above
Normal vacuum pressures for suction? [ Ans: ] 120-140
mmHg
What may a high pressure vent alarm indicate? [ Ans: ] Pt
is biting on the tubing, excessive secretions in the tubing,
kinked tubing
What may a low pressure vent alarm indicate? [ Ans: ] cuff
leak or the tubing is disconnected somewhere
How do you verify positioning of an endotracheal tube? [
Ans: ] -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 [
Ans: ] FALSE-- they should be suctioned on an as needed
basis
what should ET tube cuff pressure be kept at? [ Ans: ] 20-
25 mmHg
What measures should nurses take to avoid ET tube
problems? [ Ans: ] -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? [ Ans: ] STOP and manually hyperventilate
with 100% oxygen
Measures to prevent aspiration? [ Ans: ] -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? [ Ans: ] -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 HOB elevated 30-45 degress
-change ventilator circuit only if visibly soiled or
malfunctioning
What is the biggest complication associated with high
cervical spinal cord injuries? [ Ans: ] BREATHING-- the
diaphragm is innervated by C3-C5 levels
C4-diaphragm
Correct Answers) Already Graded A+
Normal blood gases; pH [ Ans: ] 7.35-7.45
Normal blood gases: CO2 [ Ans: ] 35-45
Normal blood gases: HcO3 [ Ans: ] 22-26
Normal blood gases: PO2 [ Ans: ] 80 or above
Normal vacuum pressures for suction? [ Ans: ] 120-140
mmHg
What may a high pressure vent alarm indicate? [ Ans: ] Pt
is biting on the tubing, excessive secretions in the tubing,
kinked tubing
What may a low pressure vent alarm indicate? [ Ans: ] cuff
leak or the tubing is disconnected somewhere
How do you verify positioning of an endotracheal tube? [
Ans: ] -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 [
Ans: ] FALSE-- they should be suctioned on an as needed
basis
what should ET tube cuff pressure be kept at? [ Ans: ] 20-
25 mmHg
What measures should nurses take to avoid ET tube
problems? [ Ans: ] -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? [ Ans: ] STOP and manually hyperventilate
with 100% oxygen
Measures to prevent aspiration? [ Ans: ] -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? [ Ans: ] -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 HOB elevated 30-45 degress
-change ventilator circuit only if visibly soiled or
malfunctioning
What is the biggest complication associated with high
cervical spinal cord injuries? [ Ans: ] BREATHING-- the
diaphragm is innervated by C3-C5 levels
C4-diaphragm
