Endotracheal Intubation and Placement Quiz

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.