Endotracheal Intubation Placement Quiz: ET Tube and ETT

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Questions and Answers

What is a common complication associated with Positive End Expiratory Pressure (PEEP)?

Improved venous return to the heart

Decreased basal metabolic rate

Barotrauma (correct)

Increased work of breathing

In what situations is an oral airway commonly used?

During tracheostomy tube insertion

In the ICU for patients biting on an endotracheal tube (correct)

When a patient has a strong gag reflex

For patients with nasal erosion

What should a nurse do if an endotracheal tube (ETT) is at a depth of 25 at the lip?

Administer VERSED or Fentanyl to the patient

Prepare for capnography testing

Ensure the patient's oxygen saturation is above 89%

Auscultate breath sounds and verify placement with a chest X-ray (correct)

What is the primary role of a nurse during endotracheal tube (ETT) placement?

Ensuring the availability of all equipment Signup and view all the answers

What is a key consideration when caring for a nasal airway?

Using the correct size and replacing it every 24 hours Signup and view all the answers

What is the role of sedation in ventilator management?

Decreasing agitation and the work of breathing Signup and view all the answers

What is the average sizing for an endotracheal tube (ETT) at the lip?

$21-22$ Signup and view all the answers

Why is it important to get FIO2 below 50 or 40 on ventilated patients?

To avoid oxygen toxicity Signup and view all the answers

What is the worst-case scenario intervention for upper airway obstruction?

Emergency cricoidectomy Signup and view all the answers

In the context of upper airway obstructions, which condition may necessitate tracheostomy?

Tumor or growth Signup and view all the answers

What is the initial maneuver recommended for a patient with upper airway obstruction due to blood clots?

Suctioning Signup and view all the answers

In the context of upper airway obstruction, what might be a concern when using an oral airway in the ICU?

Induction of vomiting Signup and view all the answers

What intervention might be considered for upper airway obstruction secondary to angioedema?

Steroids implementation Signup and view all the answers

What is the potential risk associated with using an endotracheal tube (ETT) in a patient who is unconscious?

ETT displacement Signup and view all the answers

What might be a concern when considering intubation for a patient with upper airway obstruction due to nasal packing?

ETT displacement Signup and view all the answers

Which intervention is NOT typically used for upper airway obstruction?

Suctioning Signup and view all the answers

What is the responsibility of the respiratory therapist during endotracheal intubation?

Monitor pulse oximetry during the intubation process Signup and view all the answers

What is a potential short-term complication of endotracheal intubation?

Gag and cough reflex suppression Signup and view all the answers

Why is a tracheostomy considered more stable than an endotracheal tube?

It bypasses the upper airway Signup and view all the answers

What is a common long-term complication associated with tracheostomy?

Granulation tissue from constant irritation Signup and view all the answers

What is the purpose of using a mechanical ventilator?

Treat respiratory failure Signup and view all the answers

Which class of ventilator works by pulling the lungs out, much like natural breathing?

Negative pressure ventilation Signup and view all the answers

What does a volume cycle in ventilation refer to?

Go by order of the provider and dependent on weight Signup and view all the answers

What is the benefit of a fenestrated tracheostomy tube?

When stable enough, the patient can eat, drink, and speak Signup and view all the answers

How does the pressure cycled ventilation mode (PCV) work?

Delivers inspiration until it reaches a preset pressure Signup and view all the answers

What is the main issue with high levels of PEEP in ventilator settings?

Decreased venous return to the heart Signup and view all the answers

Why is sedation or paralysis necessary for patients on high frequency oscillatory ventilation?

Due to the high respiratory rate Signup and view all the answers

What is the purpose of a chest cuirass in negative pressure ventilation?

Mimics natural breathing closely Signup and view all the answers

Which ventilator mode is associated with giving breaths every 5-8 seconds as per provider orders?

Intermittent Mandatory Ventilation (IMV) Signup and view all the answers

What is the function of Pressure Support (PS) in positive pressure ventilation?

Counteracts the small breathing hole in the endotracheal tube (ETT) Signup and view all the answers

What distinguishes Synchronous Intermittent Mandatory Ventilation (SIMV) from Intermittent Mandatory Ventilation (IMV)?

Its accounting for spontaneous patient breaths Signup and view all the answers

What is the top priority for terminal weaning of a patient?

Maintain comfort as top priority Signup and view all the answers

What is a common risk for BiPAP and CPAP patients?

Skin breakdown at forehead, nose, and mouth Signup and view all the answers

What distinguishes Non-Invasive Positive Pressure Vents (NIPPV) from Invasive Mechanical Ventilator (IMV)?

The requirement for an endotracheal tube or trach Signup and view all the answers

What does a high pressure alarm on a ventilator indicate?

Dyssynchronous with the ventilator Signup and view all the answers

What is an important step in evaluating a vented patient for extubation criteria?

Performing a CPAP trial Signup and view all the answers

What should be done to promote effective airway clearance for vented patients?

Performing chest physiotherapy Signup and view all the answers

What are common conditions that may require chronic ventilation?

Spinal cord injuries and stroke Signup and view all the answers

What is the primary reason for low pressure alarm on a ventilator?

Disconnected from vent or pulled out Signup and view all the answers

Study Notes

Complications and Considerations

A common complication associated with Positive End Expiratory Pressure (PEEP) is barotrauma.
The primary role of a nurse during endotracheal tube (ETT) placement is to assist the healthcare provider and maintain patient airway.
A key consideration when caring for a nasal airway is to ensure proper humidification to prevent dryness and irritation.
The role of sedation in ventilator management is to promote relaxation and reduce anxiety.
The average sizing for an endotracheal tube (ETT) at the lip is 7-8 mm for adults.

Endotracheal Tube (ETT) Management

If an ETT is at a depth of 25 at the lip, the nurse should verify the tube placement and ensure it is not inserted too far.
The potential risk associated with using an ETT in a patient who is unconscious is the loss of airway.
A tracheostomy is considered more stable than an ETT because it provides a more secure airway.

Upper Airway Obstruction

The worst-case scenario intervention for upper airway obstruction is cricothyrotomy.
Upper airway obstruction due to angioedema may necessitate tracheostomy.
The initial maneuver recommended for a patient with upper airway obstruction due to blood clots is to suction the airway.
A concern when using an oral airway in the ICU is the risk of pushing the obstruction further into the airway.
Intubation may be considered for a patient with upper airway obstruction due to nasal packing, but nasal packing may interfere with intubation.

Ventilation Modes

A mechanical ventilator is used to support breathing and improve oxygenation.
A class of ventilator that works by pulling the lungs out, much like natural breathing, is a negative pressure ventilator.
A volume cycle in ventilation refers to the delivery of a set volume of air with each breath.
The benefit of a fenestrated tracheostomy tube is that it allows for speech and swallowing.

Ventilation Complications

High levels of PEEP in ventilator settings can cause barotrauma.
Sedation or paralysis is necessary for patients on high frequency oscillatory ventilation to prevent respiratory muscle fatigue.
A chest cuirass in negative pressure ventilation helps to create a seal around the chest.
A pressure alarm on a ventilator indicates that the pressure is higher or lower than set.
Low pressure alarm on a ventilator indicates a disconnection or leak in the system.

Weaning and Extubation

The top priority for terminal weaning of a patient is to assess their readiness for extubation.
An important step in evaluating a vented patient for extubation criteria is to assess their ability to breathe spontaneously.
To promote effective airway clearance for vented patients, suctioning and pulmonary toilet should be performed regularly.

Non-Invasive Ventilation

A common risk for BiPAP and CPAP patients is the development of skin irritation or pressure sores.
Non-Invasive Positive Pressure Vents (NIPPV) are distinguished from Invasive Mechanical Ventilator (IMV) in that they do not require intubation.

Chronic Ventilation

Common conditions that may require chronic ventilation include chronic obstructive pulmonary disease (COPD), neuromuscular disorders, and spinal cord injuries.

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Description

Test your knowledge about endotracheal intubation, including placement and the roles of respiratory therapists and nurses. Explore topics such as oral and nasal placement, insertion procedures, sedation and monitoring, duration of placement, and potential complications.

Endotracheal Intubation and Placement Quiz

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