Exam (elaborations)
NR 341 Exam 1 (*Respiratory) – Questions & Solutions
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NR 341 Exam 1 (*Respiratory) – Questions & Solutions
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NR 341 Exam 1 (*Respiratory) – Questions & SolutionsWhat dressing should be applied upon chest tube removal ? Right Ans -
airtight sterile petroleum jelly gauze dressing
What are the reasons YOUR pt. may need an artificial airway ? Right Ans -
●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 ?
Right Ans - where was it last marked (@ the teeth or lip)
cuff pressure
Two real reasons there's a inflated cuff ? Right Ans - 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 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 ? Right Ans - 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 ? Right Ans -
to get a better view of vocal cords
Describe rapid sequence intubation.
When is rapid sequence intubation NOT indicated ? Right Ans - 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. ? Right Ans -
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 ?
What are OTHER confirmatory methods for tube placement ?
BUT how is placement verified & confirmed ? Right Ans - 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 ? Right Ans - Pneumothorax
Another word for ambu bag ?
What should ALWAYS be with you when you have this bag ? Right Ans -
bag valve mask
the mask!!!!!!!!!!!!!! w/out the mask, it is useless
If the black line is seen in the middle, then the tube is ?
Cuff pressure should be at ?
If your pt. is on a tube & is talking properly- what's wrong w/this ? Right
Ans - obstructed!
20-25mmHg
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