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RES111

Airway Management

QuestionAnswer
What is the largest single group of drugs among aerosolized agents used for inhalation Adrenergic bronchodilators
Which term is used to describe a drug that stimulates a receptor responding to norepinephrine Adrenergic
What is the duration of action for the formulation of ipratropium bromide plus albuterol sulfate (DuoNeb)? 4 to 6 hours
What short-acting catecholamine is used for it's strong a1-vasoconstricting effects to reduce swelling in the nose and larynx and to control bleeding during bronchoscopic biopsy? Racemic epinephrine
Ipratropium bromide should be used with precaution in all of the following diseases/conditions except: prostatic hypertrophy urinary retention kidney stones glaucoma kidney stones
Which phase describes the time course and disposition of a drug in the body based on its absorption, distribution, metabolism, and elimination? Pharmacokinetic
Ipratropium bromide (Atrovent) is indicated for maintenance treatment of the following diseases, except: chronic bronchitis emphysema asthma chronic obstructive pulmonary disease asthma
Which of the following devices is NOT used with metered dose inhaler therapy to reduce the need for hand-breathing coordination & oropharyngeal impaction of aerosolized drugs? Nonvalved spacer devices One-way spacer Holding chambers Drying chambers Drying chambers
What is the usual neurotransmitter in the sympathetic system? Norepinephrine
Which of the following is NOT a short-acting noncatecholamine bronchodilator? Pirbuterol Terbutaline Albuterol Salmeterol Salmeterol
Proventil and Ventolin are brand names for which of the ß-adrenergic bronchodilators? Albuterol
What amount of ipratropium bromide (Atrovent) is delivered by metered-dose inhaler? 18 µg/puff
Which of the following methods limits the systemic distribution of an inhaled aerosolized drug? Use of a fully ionized drug. Use of a partially ionized drug. Use of metabolites. Use of the generic form of the drug. Use of a fully ionized drug
Which of the following short-acting noncathecholamine agents is a prodrug? Albuterol Levalbuterol Terbutaline Bitolterol Bitolterol
Short-acting adrenergic bronchodilators are considered what type of agent according to the National Asthma Education and Prevention Program? Rescue
Which of the following is an ultra-short-acting catecholamine bronchodilator? Ipratropium Terbutaline Isoetharine Metaproterenol Isoetharine
What is the dosage for ipratropium bromide (Atrovent)? 2 puffs four times daily
What is the duration of action for ipratropium bromide? 4 to 6 hours
Pharmacologic control of the airway is mediated by receptors found on all of the following structures, except: alveolar epithelium
When stimulated, which of the following receptors cause bronchoconstriction? M3 M2 a1 ß2 M3
Foradil is a brand name for which ß-adrenergic bronchodilators? Formoterol
What is NOT an advantage for the treatment of the respiratory tract with inhaled aerosols? Doses are usually smaller Onset of drug action is rapid Delivered dose is consistent w/ each admin Systemic side effects are fewer & less severe Delivered dose is consistent with each administration.
What is the average duration of action of the short-acting noncatecholamine agents? 4 to 6 hours
What are some potential adverse effects with use of adrenergic bronchodilators? I. Hypokalemia II. Dizziness III. Worsening ventilation/perfusion ratio (V/Q) IV. Bradycardia I. Hypokalemia II. Dizziness III. Worsening ventilation/perfusion ratio (V/Q)
What are assmnt features to evaluate pt response to bronchodilator therapy? Reversibility of airflow obstruction Change in flow rates using peak flowmeter or portable spirometry Vital sign change Vent & oxygenation change Pt subjective reaction to I. Reversibility of airflow obstruction II. Changes in flow rates using a peak flowmeter or portable spirometry III. Changes in vital signs IV. Changes in ventilation and oxygenation V. The patient's subjective reaction to treatment
Which of the following phases constitute the course of drug action from dose to effect? I. Drug administration II. Pharmacognosy III. Pharmacokinetic IV. Pharmacodynamic I. Drug administration III. Pharmacokinetic IV. Pharmacodynamic
The long-acting adrenergic bronchodilator salmeterol (Serevent) is not well suited for relief of acute airflow obstruction because it takes about how long for peak effect to occur. 3 to 5 hours
Which phase describes the mechanism of drug action by which a drug causes its effects within the body through drug-receptor interactions? Pharmacodynamic
Adrenergic bronchodilators improve flow rates for all the following diseases except: asthma acute bronchitis chronic bronchitis pulmonary fibrosis pulmonary fibrosis
Which of the following lung availability/total systemic availability (L/T) ratios demonstrates the most efficient aerosol delivery? 0.46 0.23 0.1 0.6 0.6
A MD is concerned about tracheal damage due to tube movement in a pt who recently underwent tracheotomy and is now receiving 40% oxygen through a T-tube (Briggs adapter). Which of the following would be the best way to limit tube movement in this patient? Switch from the T-tube to a tracheostomy collar
After intubation of a cardiac arrest victim, you observe a slow but steady rise in the expired CO2 levels as measured by a bedside capnometer. Which of the following best explains this observation? Return of spontaneous circulation
How often should patients be suctioned? When physical findings support the need.
You are about to suction a female patient who has an 8-mm (internal diameter) endotracheal tube in place. What is the maximum size of catheter you would use in this case? 14 Fr
Which features incorporated into most modern endotracheal tubes assist in verifying proper placement? Length markings on the curved body of the tube. Imbedded radiopaque indicator near the tube tip. Additional side port near the tube tip. I. Length markings on the curved body of the tube. II. Imbedded radiopaque indicator near the tube tip.
Complications of tracheal suctioning include all of the following except: bronchospasm hyperinflation mucosal trauma elevated intracranial pressure hyperinflation
Which of the following statements are FALSE about methods used to displace the epiglottis during oral intubation? Levering the laryngoscope against the teeth can aid displacement.
To maintain positive end-expiratory pressure (PEEP) and high FIO2 when suctioning a mechanically ventilated patient, what would you recommend? Use a closed-system multiuse suction catheter.
Tracheal stenosis occurs in as many as 1 in 10 patients after prolonged tracheostomy. At what sites does this stenosis usually occur? I. Cuff site II. Tip of the tube III. Stoma site I. Cuff site II. Tip of the tube III. Stoma site
Which of the following techniques may be used to diagnose injury associated with artificial airways? I. Laryngoscopy or bronchoscopy II. Physical examination III. Air tomography IV. Pulmonary function studies I. Laryngoscopy or bronchoscopy II. Physical examination III. Air tomography IV. Pulmonary function studies
What is the normal range of negative pressure to use when suctioning children? -80 to -100 mm Hg
What equipment is NOT needed to perform nasotracheal suctioning? Suction kit (catheter, gloves, basin, etc.) Laryngoscope with MacIntosh and Miller blades Oxygen delivery system (mask and manual resuscitator) Bottle of sterile water or saline soluti Laryngoscope with MacIntosh and Miller blades
What should be the maximum time devoted to any intubation attempt? 30 seconds
What factors should be considered when deciding to change from an endotracheal tube to a tracheostomy tube? I. Pt tolerance of endotrach tube II. Relative risks of continued intubation versus tracheostomy III. Pt severity of illness/overall condition. IV. Time that the pt will need an artificial airway. V. Patient's ability to tolerate a surgical procedure.
What is the purpose of the additional side port (Murphy eye) on most modern endotracheal tubes? Ensure gas flow if the main port is blocked.
Which of the following injuries are NOT seen with tracheostomy tubes? I. Tracheomalacia II. Tracheal stenosis III. Glottic edema IV. Vocal cord granulomas III. Glottic edema IV. Vocal cord granulomas
What can help to minimize the likelihood of mucosal trauma during suctioning? I. Use as large a catheter as possible. II. Rotate the catheter while withdrawing. III. Use as rigid a catheter as possible. IV. Limit the amount of negative pressure II. Rotate the catheter while withdrawing. IV. Limit the amount of negative pressure.
Ideally, the distal tip of a properly positioned endotracheal tube (in an adult man) should be positioned about how far above the carina? 4 to 6 cm
After repeated nasotracheal suctioning over 2 days, a patient with retained secretions develops minor bleeding through the nose. Which of the following actions would you recommend? Stop the bleeding and use a nasopharyngeal airway for access.
Total application time for endotracheal suction in adults should not exceed which of the following? 10 to 15 seconds
What is the standard size for endotracheal or tracheostomy tube adapters? 15 mm external diameter
What is the purpose of a cuff on an artificial tracheal airway? Seal off and protect the lower airway.
Which of the following techniques or procedures should be used to help minimize infection of a tracheotomy stoma? I. Regular aseptic stoma cleaning II. Adherence to sterile techniques III. Regular change of tracheostomy dressings I. Regular aseptic stoma cleaning II. Adherence to sterile techniques III. Regular change of tracheostomy dressings
A pt is being evaluated for tracheal damage sustained while having undergone prolonged tracheostomy intubation approximately 3 months earlier. The flow-volume loop demonstrates a fixed obstructive pattern. What is the most likely cause of the problem? Tracheal stenosis
To make oral intubation easier, how should the patient's head and neck be positioned? Neck flexed, with head supported by towel and tilted back.
Soon after endotracheal tube extubation, an adult patient exhibits a high-pitched inspiratory noise, heard without a stethoscope. Which of the following actions would you recommend? STAT racemic epinephrine aerosol treatment.
Absolute contraindication for nasotracheal suctioning includes which of the following? I. Epiglottitis II. Croup III. Irritable airway I. Epiglottitis II. Croup
What is the average distance from the tip of a properly positioned oral endotracheal tube to the incisors of an adult man? 21 to 23 cm
Which of the following conditions require emergency tracheal intubation? I. Upper airway or laryngeal edema II. Loss of protective reflexes III. Cardiopulmonary arrest IV. Traumatic upper airway obstruction I. Upper airway or laryngeal edema II. Loss of protective reflexes III. Cardiopulmonary arrest IV. Traumatic upper airway obstruction
What is the purpose of the pilot balloon on an endotracheal or a tracheostomy tube? Monitor cuff status and pressure.
Created by: AlayneStone