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Question Answer
The slower a BVM is deflated and inflated, the _______ the oxygen concentration will be delivered.
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higher
What happens during the preweaning phase?
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The patient's ability to breathe spontaneously is assessed. Clarity of lungs. Neuro, F & E, hemodynamic, Hgb and nutrition are assessed.
What are 5 common indications for ET intubation?
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Upper airway obstruction, apnea, increased risk of aspiration, ineffective clearance of secretions, and respiratory distress.
_______ intubation is contraindicated for patients with facial fractures, basilar skull fractures or post-operatively after cranial surgery.
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Nasal
The _______ technique for cuff inflation involves inflating until no leak is heard during inspiration, then deflating it until a slight leak is heard.
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Minimal Leak Technique (MLT)
The _______ technique for cuff inflation involves inflating until no leak is heard at the end of inspiration.
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Minimal Occluding Volume (MOV)
What is pardoxic breathing and what does it signify?
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Abdomen and chest move out during exhale and in during inhale. *Severe respiratory distress.
_______ can suggest hypercapnia has occurred during the night.
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Severe morning headache
Tachycardia and HTN are _______ signs of respiratory failure.
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early
What type of respiratory failure can result from the airflow obstruction or trapping associated with asthma, COPD and CF?
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Hypercapnic
_______ coughing prevents the glottis from closing during a cough and clears central airways and mobilizes secretions.
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Huff (usually COPD)
What are potential complications associated with the use of closed suction?
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Hypoxemia, bronchospasm, increased intracranial pressure, dysrhythmias, HTN, hypotension, mucosal damage, pulmonary bleeding and infection.
What are the 7 indications a patient with an ET tube needs to be suctioned?
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Secretions in the tube, sudden onset respiratory distress, aspiration of secretions, increase in peak airway pressure, adventitious breath sounds, increased respiratory rate/sustained coughing, and increase in PaO2 and/or SpO2.
What is the 1st step in treating a V/Q mismatch?
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O2 Therapy
What are the disadvantages of using a nasal ET when compared to an oral ET?
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More likely to kink, increased WOB due to increased airflow resistance, suctioning/secretion removal is more difficult, and linked to sinus infections.
How can suctioning an airway result in dehydration?
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Hypoxemia can lead to myocardial hypoxia, vagal stimulation when irritating the trachea, and SNS stimulation caused by anxiety, pain or discomfort.
What 2 steps can prevent hypoxemia secondary to suctioning?
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Hyperoxygenate prior and limit each suctioning pass to 10 seconds or less.
An ET tube should be repositioned and retaped every _______.
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24 hours and as needed
A suction catheter should be no wider than _______ for a patient with an ET tube.
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1/2 the diameter of the tube
A person who can only speak phrases is most likely in _______ respiratory distress.
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moderate (*severe=words)
What brain structure is the 1st to detect oxygenation problems?
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Cerebral cortex (source of mental status changes)
How does a large bore ET tube decrease work of breathing?
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There is less airway resistance (when compared with a small bore ET tube).
Volume or Pressure Ventilation? Controlled Mandatory Ventilation, (CMV), Assist Controlled Ventilation (ACV), and Synchronized Intermittent Mandatory Vent (SIMV).
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Volume ventilation
_______ ventilation is the type where peak inspiratory pressure is controlled and tidal volume (V+) varies.
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Pressure ventilation
What should be done if a patient develops dysrhythmias during suctioning?
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Stop suctioning
What type of respiratory failure can occur even when the patient has perfectly normal lungs?
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Hypercapnic (*can be due to obesity, brain injury, muscle fatigue, neuro-muscular disease, etc.)
_______ failure results from an interruption of O2 transfer into the blood.
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Hypoxemic resp. failure
What can cause hypoxemic respiratory failure?
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Pneumonia, pulmonary edema, PE, smoke inhalation, ventilator induced injury, heart failure, and shock.
Patients likely to be without food for _______ should have a feeding tube placed.
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3-5 days
_______ respiratory failure results from an imbalance of ventilatory supply and demand.
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Hypercapnic


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