Deck 44: Care of the Patient With an Artificial Airway

Question 1

What is the recommended pressure for a tracheostomy tube cuff?

A) 5 to 15 mm Hg
B) 15 to 25 mm Hg
C) 25 to 35 mm Hg
D) 35 to 45 mm Hg

Answer 1

B
Cuff pressures should be monitored and documented every 4 to 8 hours to prevent tracheal injury.The recommended cuff pressure is 15 to 25 mm Hg.

Question 2

Before suctioning an artificial airway,how many hyperoxygenating breaths with a manual resuscitation bag should be provided?

A) 1 to 2
B) 3 to 5
C) 10 to 15
D) 30 to 40

Answer 2

B
Hyperoxygenate with 100% oxygen for three to five breaths with a manual resuscitation bag before suctioning an artificial airway.

Question 3

Which complication of tracheostomy can occur immediately because of laceration of the mediastinal pleura?

A) Air embolism
B) Pneumothorax
C) Subcutaneous emphysema
D) Aspiration

Answer 3

B
Pneumothorax can occur immediately after tracheostomy because of laceration of the mediastinal pleura at the time of or within 24 hours of surgery (this arises often in children and patients with chronic obstructive lung disease).

Question 4

Which vacuum settings should be used while suctioning?

A) The lowest possible settings (<120 mm Hg)
B) The highest possible settings
C) Between 120 and 200 mm Hg
D) None of the above

Question 5

How often should the pressure of a tracheostomy tube cuff be checked?

A) Once per day
B) Twice per day
C) Every 4 to 8 hours
D) Every 30 minutes

Question 6

How is the size of the suctioning catheter determined?

A) Doubling the size of the tracheostomy tube
B) Tripling the size of the tracheostomy tube
C) Doubling the size of the tracheostomy tube and adding 2
D) Adding 2 to the size of the tracheostomy tube

Question 7

How long should each suctioning procedure last?

A) 5 to 10 seconds
B) 15 to 20 seconds
C) 25 to 30 seconds
D) 35 to 40 seconds

Question 8

Which is true of polyvinyl chloride tracheostomy tubes?

A) Minimize crusting and adherence of secretions
B) Higher in cost than metal tubes
C) Not commonly seen
D) Difficult attachment for inflatable cuffs

Question 9

Which should be performed after suctioning a patient's artificial airway?

A) Check the patient's breath sounds.
B) Monitor the patient for dysrhythmias.
C) Use pulse oximetry to monitor desaturation.
D) All of the above

Question 10

Which airway device is a speaking valve that allows inspiration only and forces exhalation through the upper airway?

A) Olympic tracheostomy button
B) Passy-Muir valve
C) Montgomery T tube
D) None of the above

Question 11

Which can help a nurse or therapist determine the amount of secretions present in an artificial airway?

A) Respiratory rate
B) Lung sounds
C) Oxygen saturation
D) All of the above

Question 12

Which is a purpose for an artificial airway?

A) To bypass upper airway obstruction
B) To assist or control respirations over prolonged periods
C) To prevent aspiration of oral and gastric secretions
D) All of the above

Question 13

Which is needed to reinsert a dislodged outer cannula?

A) Tracheal hook
B) Trousseau dilator
C) Satisfactory tissue retraction
D) All of the above

Question 14

Which is a potential complication from tracheal suctioning?

A) Hypoxemia
B) Cardiac dysrhythmia
C) Bronchospasm
D) All of the above

Question 15

Which is uncommon after extubation?

A) Skin edges are taped together with butterfly strips.
B) Air may escape through the wound.
C) Noise from the partially closed trachea is normal.
D) Dressings over the wound are discouraged.

Question 16

Which postoperative complication of tracheostomy can result from incorrect suctioning technique and the presence of a foreign body in the trachea?

A) Crusting
B) Tracheobronchitis
C) Tracheal stenosis
D) Infection at the surgical site

Question 17

In which position should nasotracheal and pharyngeal suctioning be done?

A) Fully supine position
B) Fowler position
C) Trendelenburg position
D) Side-lying position

Question 18

Which method of airway clearance is most hazardous to health care professionals?

A) Mucociliary escalator
B) The cough reflex
C) Suctioning
D) A cough machine

Question 19

Which complication from tracheal suctioning can be minimized by performing preoxygenation?

A) Infection
B) Bronchospasm
C) Hypoxemia
D) All of the above

Question 20

Which term refers to the removal of an artificial airway?

A) Decannulation
B) Intubation
C) Excision
D) Tracheostomy