Critical Thinking - Answers "...critical thinking is a disciplined, intellectual process which requires
individuals to consistently examine their beliefs, knowledge and attitudes in the light of evidence. It
means analysing, synthesising and evaluating information, as well as considering underlying values and
assumptions"
Clinical Reasoning - Answers "It is the process by which nurses collect cues, process and interpret the
information, make a judgement about a patient problem or situation, come to a decision, plan and
implement interventions, evaluate outcomes, and reflect and learn from the process"
What are the barriers to clinical reasoning? - Answers Stress
Pressure
Lack of adequate information, experience,
confidence
Fear
Power dynamics
Interruptions
Values may differ
Tracheostomy - Answers a surgical opening below a person's larynx into their trachea.
What are the indications for the insertion of a tracheostomy tube? - Answers Bypass airway obstruction
Trauma or surgery to upper airway
Facilitate removal of secretions
Permit long term mechanical ventilation
What are the complications associated with tracheostomy tubes? - Answers Tracheal necrosis or
aspiration
Swallowing difficulties
Loss appetite- poor nutrition
Loss of speech - developmental delay
Atelectasis, Decrease cough reflex and epiglottis
pressure
, Tube displacement
Tissue trauma, Haemorrhage, Tube obstruction
Scarring, Infection
Identify possible causes of airway obstruction - Answers Aspiration of food or vomit
Oedema and inflammation (allergic reaction, infection,
or burns)
Foreign body
Malignancy, Retrophyangeal abscesses
Trauma
What is the ideal cuff pressure for a tracheostomy tube? - Answers 20-30cmH2O
Ventilation - Answers the process of allowing fresh air into the lungs and exhaling carbon dioxide
Compliance - Answers refers to the ease at which the lungs can be expanded Conditions affecting
compliance: PO, ARDS, PF
Resistance - Answers refers to the forces that oppose airflow within the respiratory passageways
Anatomical dead space - Answers (no gas exchange): volume of air that takes no part in gas exchange
Shunt - Answers opposite to dead space and consists of perfused alveoli (not ventilated) occurs when
blood exits the heart without having participated in gas exchange
Hydrostatic pressure - Answers the force of fluid in a compartment pushing against a cell membrane or
vessel wall.
What is positive pressure ventilation? - Answers Positive-pressure ventilation (PPV) is the primary
method used with acutely ill patients.
During inspiration the ventilator pushes air into the lungs under positive pressure.
Unlike spontaneous ventilation, intrathoracic pressure is raised during lung inflation, rather than
lowered.
Expiration occurs passively as in normal expiration. Modes of PPV are categorised into two groups:
volume and pressure ventilation.
What is BiPAP - Answers A machine that delivers positive pressure in two phases to a spontaneously
breathing patient.