question

Oxygen helps maintain adequate _____ oxygenation for clients who have many acute and chronic respiratory problems

answer

Cellular

question

3 ways to maintain a patent airway:

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1. Mobilizing secretions 2. Suctioning airway 3. Managing artificial airways to promote adequate gas engage and lung expansion

question

Device with a sensor probe that attaches securely to the fingertip, toe, bridge of nose, or earlobe Measures pulse saturation (SpO2) via a wave of infrared light that measures light absorption by oxygenated and deoxygenated hemoglobin in arterial blood

answer

Pulse oximeter

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What does SaO2 measure

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Percent of saturation of Hgb (SaO2) when the SaO2 is greater than 70%

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What % do you want to keep SpO2 at

answer

95-100%

question

The percent of O2 a client receives

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FiO2 (fraction of inspired oxygen)

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Hypercarbia

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Elevated levels of CO2

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2 ways to monitor/assess oxygenation

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1. Pulse ox 2. arterial blood gasses (ABG)

question

____________ oxygen delivery systems deliver varying amounts of O2 based on the delivery method and the clients breathing pattern

answer

Low-flow oxygen

question

4 types of low-flow oxygen delivery systems

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1. Nasal cannula 2. Simple face mask 3. Partial rebreather mask 4. Nonrebreather mask

question

2 types of high-flow O2 delivery systems

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1. Venturi mask 2. Aerosol mask

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Aerosol mask = fits loosely around the face and neck

answer

Face tent

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Aerosol mask = a small mask that covers the surgically created opening of the trachea

answer

Tracheostomy collar

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Result of high concentrations of O2 (typically greater than 50%) with long durations of O2 therapy (typically more then 24-48 hrs) and the severity of lung disease

answer

Oxygen toxicity

question

7 nursing interventions that mobilize secretions (that promote adequate gas exchange and lung expansion)

answer

1. Coughing 2. Hydration 3. Positioning 4. Humidification 5. Nebulizer therapy 6. Chest physiotherapy 7. Suctioning

question

Breaks up medications into minute particles that disperse throughout the respiratory tract and improves clearance of pulmonary secretions

answer

Nebulization

question

Use of chest percussion, vibration, and postural drainage to help mobilize secretions - loose resp secretions and move them into central airways where coughing or suctioning can remove them - not for pt's who are pregnant; have rib, chest, head or neck injury; increased intracranial pressure; recent ab surgery; pulmonary embolism; bleeding disorders; osteoperosis

answer

Chest physiotherapy

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When should you suction orally, nasally, endotracheally

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Only when the client needs to - to prevent trauma

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The use of cupped hands to clap rhythmically on the chest to break up secretions

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Percussiion

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The use of a shaking movement during exhalation to help remove secretions

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Vibration

question

The use of various position to allow secretions to drain by gravity

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Postural drainage

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Suctioning - Yankauer or tonsil-tipped rigid suction cath - move cath around the mouth, gum line, pharynx

answer

Oropharyngel

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Suctioning - flexible cath - lubricate distal end 6-8 cm (2-3in) with water-soluble lube

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Nasopharyngeal and nasotracheal

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Suctioning - cath shouldn't exceed 1/2 of the internal diameter of the endotrach tub to prevent hypoxia - hyperoxygenate pt with an FiO2 of 100%

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Endotracheal

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Types of asepsis with suctioning - mouth - all other

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Medical asepsis - mouth Surgical asepsis - all other

question

Sterile surgical incision into trachea through skin and muscles for the purpose of est an airway - emergency or schedule, permanent or temporary

answer

Tracheotomy

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The stoma/opening that results from a tracheotomy to provide and secure a patent airway

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Tracheostomy

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3 ways artificial airways can be placed

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1. Orotracheally 2. Nasotracheal 3. Tracheostomy

question

6 types of artificial airway tube types

answer

1. Single-lumen (cannula) 2. Double- lumen (cannula) 3. Cuffed tube 4. Cuffless tube 5. Fenstrated tube with budd 6. Fenestratred tube without cuff

question

Tube - long, single cannula tube - pts with long or think necks

answer

Single-lumen (cannula)

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Tube - outer cannula fits into stoma and keeps airway open - inner cannula fits snugly into outer and locks into place - obturator - allows removing, cleaning, reusing, replacing - good for pt with excessive secretions

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Double-lumen (cannula)

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Thin, solid tube the provider places inside the tracheostomy and uses as a guide for inserting the outer cannula and removed immediately after outer cannula insertion

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Obturator

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Tube - has a balloon that inflates around the outside of the distal segment of the tube to protect the lower airway by producing a seal between upper and lower airway - permits mechanical vent - prevents aspiration

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Cuffed tube

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Tube - has no balloons and for pts with long-term airway-mgt needs - pt must be low aspiration risk - not for pts on mechanical vent

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Cuffless tube

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Tube - one large or multiple openings in posterior wall of outer cannula with a balloon around the outside of the distal segment of the tube, also has inner cannula - all mech vent - allows pt to speak

answer

Fenestrated tube with cuff

question

Tube - one large or multiple openings in posterior wall of outer cannula with no balloon, also has inner cannula - holes in tube help wean client from trach - allows pt to speak

answer

Fenestrated tube without cuff

question

What do you do in case of accidental decannilation after 72 hours

answer

Immediately hyperextended the next and with obturator inserted into trach tube, quickly and gently replace tube and remove obturator

question

Narrowing of the tracheal lumen due to scar formation resulting from irritation of the trach mucosa from the trach tube cuff

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Tracheal stenosis

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Tissue damage that results when the pressure of the inflated cuff impairs blood flow to the tracheal wall

answer

Tracheal wall necrosis

question

A nurse is assessing a client who has an acute respiratory infection that puts her at risk for hypoxemia. Which of the following findings are early indications that should alert the nurse that the client is developing hypoxemia (select all that apply) A. Restlessness B. Tachypnea C. Bradycardia D. Confusion E. pallor

answer

ABDE

question

A provider is discharging a client who has a rx for home O2 therapy via nasal cannula. Client and family teaching by the nurse should include which instructions (select all that apply) A. Apply petroleum jelly around and inside nares B. Remove nasal cannula during mealtimes C. Check position of cannula frequently D. Report any nasal stiffness, nausea, fatigue E. post "no smoking" signs in prominent location

answer

CDE

question

A nurse is caring for a client who is having difficult breathing. The client is lying in bed and is already receiving O2 therapy via nasal cannula. Which of the following interventions is the nurses priority A. Inc O2 flow B. Assist pt to fowler's position C. Promote removal of pulmonary secretions D. Obtain a specimen for arterial blood gases

answer

B

question

A nurse is preparing to perform endotracheal suctioning for a client. The nurse should follow which of the guidelines (select all that apply) A. Apply suction while withdrawing catheter B. Perform suction on a routine basis, every 2-3 hrs C. Maintain medical asepsis during suctioning D. Use new cath for each suctioning attempt E. limit total suctioning to 5 mins

answer

ADE

question

A nurse is caring for a pt who has a trach. Which of the following actions should the nurse take when providing trach care (select all that apply) A. Apply O2 source loosely if the SpO2 decreases during procedure B. Use surgical asepsis to remove and clean inner cannula C. Clean outer surfaces in circular motion from stoma out D. Replace trach with new ties E. cut slit in gauze to place beneath tube holder

answer

ABC

Airway Management (ATI 53) – Flashcards

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