What dressing should be applied after chest tube removal ? - Answerairtight sterile
petroleum jelly gauze dressing
What are the indications YOUR pt. may require an artificial airway ? - Answero upper
airway obstruction bleeds, tumor, gcs less than 8, burns)
o sx
o trauma
o neuromuscular diseases
o sepsis
o apnea
o high risk for aspiration
o ineffective clearance of secretions
o resp distress
When a pt. has a tube in their trachea, what do you need to know as a nurse ? - Response
where was it last marked (@ the teeth or lip)
cuff pressure
Two real reasons there's a inflated cuff ? - Response 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 required?
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 rationale for placing the pt. in a sniffing position ? - Correct answer to
optimize the view of vocal cords
Describe rapid sequence intubation.
When is rapid sequence intubation NOT indicated ? - Correct answer BOTH sedative &
paralytic agent are administered to emergency airway pt.s (reduce 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 ?
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.)
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