Nursing Management of Airway Devices

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Questions and Answers

What is a key responsibility in the nursing management of patients with an endotracheal tube?

Administering medication every hour

Setting up IV fluids

Monitoring respiratory status continuously (correct)

Monitoring blood pressure continuously

What should be checked before inserting a nasopharyngeal tube?

Nutritional needs

Patient's hydration levels

Patient's temperature

Contraindications for insertion (correct)

What is the acceptable range for cuff pressure in tracheostomy management?

20-25 mmHg (correct)

25-30 mmHg

15-20 mmHg

10-15 mmHg

What is a critical step in the management of fenestrated tracheostomy tubes?

Change the inner canula as per local protocol Signup and view all the answers

During tracheostomy care, how many trained nurses are recommended to be present?

Two nurses Signup and view all the answers

What should be done if a patient with a speaking tracheostomy tube wishes to speak?

Change the port as per patient's request Signup and view all the answers

What is the purpose of applying lubrication to the nasopharyngeal tube?

To provide comfort during insertion Signup and view all the answers

What should be monitored continuously after the insertion of a nasopharyngeal tube?

Patient's respiratory status Signup and view all the answers

What is the MOST likely nursing intervention for a patient with an airway obstruction?

Re-establish the airway by clearing the obstruction. Signup and view all the answers

What is a potential complication of airway obstruction?

All of the above Signup and view all the answers

Which of these is NOT a possible cause of airway obstruction?

Pulmonary embolism Signup and view all the answers

Which of the following is a nursing intervention for chest trauma?

Covering a sucking chest wound with a non-porous dressing. Signup and view all the answers

What is a common symptom of lower respiratory tract infections (LRTI)?

Cough Signup and view all the answers

Which of these is a nursing intervention for managing a patient with a chest trauma?

Applying a pressure dressing to a sucking chest wound. Signup and view all the answers

What is the purpose of maintaining adequate hydration for a patient with LRTI?

All of the above. Signup and view all the answers

Which of the following is a common sign of respiratory distress in a patient with an LRTI?

Increased respiratory effort Signup and view all the answers

Study Notes

Endotracheal Tubes (ETT)

Nursing management of ETT patients requires specialized training, potentially including ALS, clinical competencies, or postgraduate courses.
Key responsibilities include continuous respiratory monitoring.
Securing the tube to prevent accidental dislodgement is crucial.
Regular assessments for complications like tube malposition or infection are necessary.
Cuff pressure monitoring (if cuffed) is essential to prevent airway damage.
Maintaining airway patency and ventilatory support are crucial.
Collaboration with the healthcare team for prompt responses to patient condition changes is critical.

Nasopharyngeal Tubes

Contraindications for insertion (e.g., sinus or head trauma) must be checked.
Patients should be positioned supine with a slightly extended head for optimal airway alignment.
Water-soluble lubricant should be used for insertion.
The correct tube size is essential for proper fit and function.
Continuous monitoring for respiratory distress, nasal bleeding, displacement, or obstruction is required.

Tracheostomies

All tracheostomy care requires two trained nurses.
Additional registered nurse training is often required for facility compliance.
Cuff pressure should be monitored within a 20-25 mmHg range.
Cuff inflation/deflation may be needed per established protocol.
Documentation of cuff pressures are necessary.
Dressing changes follow established protocols and facility guidelines.
Humidified oxygen usage necessitates regular line changes.
Fenestrated tracheostomy tubes:
- Inner cannula changes follow local protocols (often once per shift).
- Suctioning as needed is part of the management.
- Dressing changes follow local protocol.
- Ongoing cuff management is essential.
Speaking tracheostomy tubes:
- Port changes occur if the patient desires speaking capabilities.
- Cuff management is required.
- Humidified oxygen management is part of care.

Airway Obstruction

Airway obstruction is a blockage or constriction of air passages, posing a medical emergency.
Difficulty breathing, lack of oxygen, and potentially life-threatening situations can arise.
Obstructions can occur anywhere in the respiratory system.
Possible causes include aspiration, allergic reactions, oedema/inflammation, trauma.
Obstructions can be partial or complete.
Nursing management involves re-establishing the airway (by clearing it), performing airway manoeuvres (e.g., jaw thrust), and assisting with medical interventions (e.g., intubation).

Lower Respiratory Tract Infections (LRTI)

LRTI includes conditions such as acute bronchitis, influenza, COVID-19, pertussis, pneumonia, and TB.
Nursing management involves continuous respiratory assessments (rate, depth, effort).
Oxygen saturation monitoring using pulse oximetry or blood gases.
Early intervention for respiratory distress is crucial.
Appropriate oxygen delivery via prescribed devices; monitor for oxygen toxicity.
Appropriate positioning for optimal air entry.
Maintaining adequate hydration to help loosen mucus.
Pharmacological management (antibiotics, antivirals, bronchodilators, steroids).
Chest physiotherapy.
Comfort measures and reassurance are vital.

Chest Trauma

Chest trauma involves injuries to the chest wall, ribs, lungs, and other thoracic cavity structures.
Causes include motor vehicle accidents, falls, assaults, and industrial accidents.
Management requires prompt assessment, stabilization, and appropriate interventions.
Nursing management involves maintaining a patent airway, administering oxygen, covering sucking chest wounds with a non-porous dressing (three sides), stabilising protruding objects, and preparing for emergency needle decompression and intubation.
Pain relief is crucial.
Pneumothorax may necessitate preparation for chest tube insertion.

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Description

This quiz covers the essential nursing management practices for patients using endotracheal tubes (ETT) and nasopharyngeal tubes. Focus on key responsibilities such as monitoring, securing the tubes, and assessing for complications. Test your knowledge on proper insertion techniques, contraindications, and collaborative care with the healthcare team.