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airway management
ati skills module
| Question | Answer |
|---|---|
| what is chest physiotherapy ? | a set of techniques that include percussion,vibration and postural drainage |
| the purpose of cpt is ? | to loosen respiratory secretions and move them into central airways where they can be removed by coughing or suctioning |
| removing secretions from the airway and not allowing them to accumulate reduces what? | the risk for respiratory infections and atelectasis |
| atelectasis is? | absence of air in the alveoli resulting in loss of lung volume or collapse |
| chest physiotherapy is a crucial procedure for clients especially those who have what? | cystic fibrosis |
| chest physiotherapy is often performed with other therapies ( bronchodilators, antibiotics, mucolytic agents and hydration) to help reduce what? | mucous production and increase airway clearance |
| percussion involves | striking the skin over congested lung fields to dislodge secretions from the bronchial walls |
| when performing percussion .. | cover the area thats being percussed with a towel or gown to reduce discomfort. instruct the client to breath slowly and deeply. percuss each area of lung that is congested for 3-5 min |
| avoid percussion over.. | the breast, sternum, spinal column and kidneys |
| vibration is used.. | after percussion or alternately with percussion to increase the turbulence of exhaled air and loosen secretions |
| when performing vibration .. | move the heel of your hand in a shaking manner to create vibrations through the clients chest when they exhale. when the client is inhaling stop moving hands. perform vibration in sets of three |
| postural drainage is | performed to remove secretion by gravity from different areas of the lungs commonly performed 2-3 times a day ( OFTEN BEFORE MEALS AND AT BEDTIME) |
| postural drainage is best performed when | the clients stomach is empty to avoid gastric reflux and vomiting. if the client is receiving continuous tube feedings, stop the feeding and check gastric residual at least 30 MINS BEFORE performing postural drainage |
| positioning for postural drainage | the client should remain in each position for 10 to 15 mins. first position the client then percuss and vibrate then remove secretions either by having the client cough or suctioning the clients airway |
| what are the positions for postural drainage | left and right upper lobes anterior segments lingula of left lobe right middle lobe lower lobes anterior segments left and right upper lobes apical segments lower and right lower lobes anterior segments left and right lower lobes posterior segments |
| an artifical airway is inserted when.. | a clients airway is at risk for obstruction the artifical airway helps maintain airway patency |
| some common artifical airway devices used are | oropharyngeal airways, nasopharyngeal airways, endotracheal tubes and tracheostomy tubes |
| oral airways are used | to keep the upper airway patent when it is at risk for becoming obstructed by the tongue of by secretions |
| oral airways stimulate | the gag reflex * should only be used on patients whos level of consciousness is altered |
| to determine the right size of oropharyngeal airways for client.. | measure the oropharyngeal airway from the corner of the clients mouth to the angle of the jaw |
| when inserting an oral airway | the curved end should be pointed towards the cheek and be placed over the tongue, once it reaches the back of the mouth it is rotated and should follow the natural curve of the tongue |
| nasopharyngeal airways are used | to keep the upper airway patent * also called nasal trumpets |
| nasopharyngeal airways are inserted | through the nares and extend into the oropharynx * this airway does NOT simulate the gag reflex so it can be used on clients who are alert |
| to determine the right size nasopharyngeal airways for client.. | measure the airway by holding it next to the client's face and ensures it reaches from the tip of the nose to the earlobe |
| endotracheal tubes are used | for clients undergoing a procedure that requires general anesthesia and mechanical ventilation |
| endotracheal tubes are inserted .. | through either the nose or the mouth past the epiglottis and vocal cords into the trachea and down to where the trachea bifurcates into the bronchi |
| endotracheal tubes are not left in place for more than? | 14 days because it places the client at risk for infection and airway injury |
| for adult clients, endotracheal tubes usually | have a cuff that is inflated with air after insertion to prevent air from leaking around the tube and prevent oral and gastric secretions from being aspirated |
| tracheostomy tubes are used for .. | long term airway support, may be permanent or temporary depending on the clients condition and reason for the tracheoscomy * requires surgical procedure |
| tracheostomy tubes are inserted.. | through a small opening in the neck into the trachea * most trache tubes have a inner cannula that is temporarily removed during trache care |
| with tracheostomy tubes, it is essential to .. | keep a manual resuscitation bag, tracheostomy tubes of the same size, tracheostomy insertion tray and obturator at the clients bedside |
| if a clients tracheostomy tube becomes dislodged.. what should you do? | exert min. pressure onto the tube to ease it back into place and re-secure the tube by adjusting the ties to reduce the movement of the tube |
| tracheostomy tube complications include.. | pneumothrax, subcut emphysema, hemorrhage and infection manifested by drainage, erythema , pain and edema |
| suctioning does what.. | clears secretions from the airway of clients who cannot mobilize and expectorate them without assistance |
| most suction catheters have a thumb port to.. | to control when you apply suction |
| suctioning complications include | hypoxia, injury to the airway, nosocomial infections and cardiac dysrhythmias |
| what is important to do before suctioning a client | hyperoxygenate the client and to assess the client before, during and after the procedure |
| a yankauer ( tonsil tip) suction catheter helps | clear secretions from the MOUTH OR OROPHARYNX * clients that require this can cough effectively but cant swallow or expectorate secretions * can be used multiple times before throwing out |
| the most common types of suctioning through a artificial airway is | oropharyngeal, tracheal , and nasopharyngeal suctioning |
| tracheal suctioning helps.. | remove secretions from the lower airway of clients who cannot cough and do not have a artificial airway in place |
| when performing yankauer or tracheal suctioning | insert a small sterile and flexible catheter into the mouth or nares until the tip reaches the pharynx or trachea |
| when performing nasotracheal suctioning it is important to | use surgical asepsis because the trachea is considered sterile |
| if the client requires the suctioning of the orophyanx and trachea.. | suction the mouth last since its considered clean and not sterile |
| critically ill clients who have an endotracheal or tracheostomy in place require suctioning of secretions either with | open or closed ( in line) methods of suctioning |
| when inserting the endotracheal and tracheostomy tube | it is important ti insert the catheter without applying suction because it can injure the airway * after inserting the catheter, apply suction while using a rotating motion to remove it |
| closed (in line) suction system involves | multi-use catheter enclosed in a plastic sheath |
| closed (in line) suctioning is most often used with | clients who are mechanically ventilated and have an endotracheal or tracheostomy tube in place |
| the advantage of the closed system is | it doesn't require you to disconnect the ventilator or oxygen source for the artificial airway when the client's airway needs to be suctioned * reduces the risks of infection and oxygen desaturation |
| in most situations the client is hyperoxygenated with | 100% oxygen |
| the instilling of 0.9% sodium chloride can intoduce | micro-organisms into the lower respiratory tract increasing risk for infection |
| when attaching the suction catheter to the clients ventilation port.. | use your nondominat hand and hold the device securely. with your dominant hand advance the catheter ( 10 to 15s ) with the enclosed sleeve and progressively push the catheter while puling the plastic sleeve with thumb and index ( 10 to 15s ) - suction |
| unlike the single use catheter, the closed in line catheter is usually | not rotated due to the protective catheter sheath. * to avoid obstructing airflow withdraw the catheter completely. |
| when suctioning you can repeat | only once or twice more. WAIT 1 MIN between suction passes for ventilation and oxygenation |
| to remove and clean a catheter you must.. | rinse the inner lumen of the suction catheter by applying the suction while squeezing the vial to rinse- use 5-10 ml of sodium chloride |
| to prevent the suction control mechanism from accidentally pushing and causing harm to the patient... | place the suction mechanism in the lock position before leaving the bedside |
| documentation for chest physiotherapy should include.. | -date and time cpt is performed -breathing sounds, heart rate and oxygenation before and after cpt - type, duration, anatomical area -whether the client is able to cough or required suctioning after -amount, color, consistency and odor |
| documentation for endotracheal tube care includes | date and time of care depth and position of the tube appearance of the mouth, lips and any other areas in contact with the tube, securing device or tape |
| documentation for nasopharyngeal airway should include.. | date and time the airway was inserted reason the airway was inserted size of the nasopharyngeal airway |
| documentation for oropharyngeal should include.. | date and time the airway was inserted reason the airway was inserted size of oropharyngeal airway |
| documentation for suctioning should include.. | date,time and frequency of suctioning breathing sounds, heart rate, o2 before and after suction pre and post suctioning hyperoxygenation amount, color, consistency and odor |
| documentation for tracheostomy should include.. | date and time of care respiratory assessment findings before and after care appearance of the trache site and surrounding skin type and size of tube amount, color, consistency and odor |
Created by:
saharmahmoud
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