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.

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.