NRSG 3323 Advanced Assessments
Modules 5-9 Final Exam with Complete
Solutions.
What are some concerns of using artificial airways? How do you prevent that? - Answer
increased risk of infection and airway destruction
prevention- practice sterile technique
Why is the oropharyngeal airway used? Why would it not be used? How would you measure
and insert the tubing? - Answer It is the most simple; keeps upper airway patent when at risk
of tongue or secretion obstruction
can cause gag reflex if patient is conscious, therefore, only use when patient has altered
consciousness
Use plastic tubing- measure from corner of mouth to angle of jaw and curved point should point
upward until it reaches the back of the mouth
What is the nasopharyngeal airway also known as? Why is it used (how is that different from
oropharyngeal airway)? How would you measure and insert the tubing? - Answer "nasal
trumpet"
used for people that are alert because it causes no gag reflex; keeps upper airway patent
use soft flexible rubber- measure from nose to angle of jaw- insert bevel facing septum and
move down and rotate if met with resistance
What are the other 3 types of artificial airways? - Answer endotracheal tube
laryngeal mask airway
tracheostomy tube
What are the four purposes of the endotracheal tube? - Answer 1) administer mechanical
ventilation
2) relieve upper airway obstruction
3) protect against aspirations
4) cleaning copious secretions
,How long can you use the endotracheal tube? exceptions? How is it placed and what type of
material is used? How is size determined? How is the structure of this tubing different from the
oropharyngeal one? - Answer - can use for short term (<14 days) in order to avoid risk of
infection and injury
- can be used longer if treatment will be done soon
- can be placed with laryngoscope (light) and it goes from the mouth to trachea
- size is determined based on age and size of patient
- different in that it has a inflated cuff once put in the trachea- helps decrease escaping air and
secure position
Can a nurse insert a endotracheal tube or any intubation process? What is the nurse's role? -
Answer No; the physician should insert it
-check equipment
- hand equipment to provider
- confirm tube position- by auscultation of the chest, bilateral chest rise, tube location at teeth,
CO2 detector (capnography), checking pulse ox, securing tube with tape/cuff
How accurate is CO2 detector (capnography)? What does purple and yellow results mean? -
Answer not too accurate
non-invasive; pH sensitive
purple- O2 or room air (means the tube is not in and is leaking)
yellow- CO2 (means the tube is in)- good or desired result
How do you stabilize a endotracheal tube (ETT)? - Answer - use two pieces of tape to tape
the ETT onto the face
- maximum 20-25 mmHg cuff pressure
What are nursing interventions you can implement after placing and stabilizing the ETT? -
Answer - assess respiratory system every 2 hours
- check oral/nasal status
- place in semi-fowler's position
- reposition every 2 hours
- move tube to opposite side of mouth every 8 hours
- mouth care every 4 hours
- give white board to patient to help them communicate
, When is the laryngeal mask airway used and why? What does it have in common with the ETT
and what part of it is slightly different? - Answer - it is used in emergency because it is easier
to insert and does not require advanced skills- nurses can insert these due to emergency
- it is an alternative to ET tube
- less risk of injury compared to ETT
- also has inflated cuff like ETT; but it is inflated over the larynx rather than trachea
What is tracheostomy and when/why is it used? How is it slightly different from ETT and
laryngeal mask airway? - Answer - it is a surgical hole in cervical tracheal airway
- placed under larynx and is used to establish an airway
- used for long term airway support
- different in that it allows for people to speak easier than with a ETT or LMA (possible but still
difficult since air is not reaching larynx where vocal cords are)
What are four purposes/indications of tracheostomy? - Answer - replace an ET tube (since ET
tubes are short term)
- mechanical ventilation
- acute or chronic airway obstruction
- copious secretions
What are the four types of tracheostomy tubes? - Answer - single outer cannula- 1 lumen;
not take out for cleaning
- double cannula- 2 lumens; one outer and one inner; better for people with copious secretions;
inner lumen taken out for cleaning
- cuffed/uncuffed
- fenestrated/non-fenestrated
Permanent inner cannula vs disposable inner cannula? - Answer - permanent inner cannula-
cleaned and put back in
- disposable inner cannula- throw out after use
What are the 7 parts used or needed for a tracheostomy? - Answer 1) outer cannula
2) obturator- used to help insert tracheostomy tube (inserted first and then outer cannula and
then inner cannula)
3) inner cannula
4) flange- stabilizes the tube from the outside
5) port- used to inflate the cuff to stabilize the tube once in the trachea
6) cuff- inflates and stabilizes the tube
Modules 5-9 Final Exam with Complete
Solutions.
What are some concerns of using artificial airways? How do you prevent that? - Answer
increased risk of infection and airway destruction
prevention- practice sterile technique
Why is the oropharyngeal airway used? Why would it not be used? How would you measure
and insert the tubing? - Answer It is the most simple; keeps upper airway patent when at risk
of tongue or secretion obstruction
can cause gag reflex if patient is conscious, therefore, only use when patient has altered
consciousness
Use plastic tubing- measure from corner of mouth to angle of jaw and curved point should point
upward until it reaches the back of the mouth
What is the nasopharyngeal airway also known as? Why is it used (how is that different from
oropharyngeal airway)? How would you measure and insert the tubing? - Answer "nasal
trumpet"
used for people that are alert because it causes no gag reflex; keeps upper airway patent
use soft flexible rubber- measure from nose to angle of jaw- insert bevel facing septum and
move down and rotate if met with resistance
What are the other 3 types of artificial airways? - Answer endotracheal tube
laryngeal mask airway
tracheostomy tube
What are the four purposes of the endotracheal tube? - Answer 1) administer mechanical
ventilation
2) relieve upper airway obstruction
3) protect against aspirations
4) cleaning copious secretions
,How long can you use the endotracheal tube? exceptions? How is it placed and what type of
material is used? How is size determined? How is the structure of this tubing different from the
oropharyngeal one? - Answer - can use for short term (<14 days) in order to avoid risk of
infection and injury
- can be used longer if treatment will be done soon
- can be placed with laryngoscope (light) and it goes from the mouth to trachea
- size is determined based on age and size of patient
- different in that it has a inflated cuff once put in the trachea- helps decrease escaping air and
secure position
Can a nurse insert a endotracheal tube or any intubation process? What is the nurse's role? -
Answer No; the physician should insert it
-check equipment
- hand equipment to provider
- confirm tube position- by auscultation of the chest, bilateral chest rise, tube location at teeth,
CO2 detector (capnography), checking pulse ox, securing tube with tape/cuff
How accurate is CO2 detector (capnography)? What does purple and yellow results mean? -
Answer not too accurate
non-invasive; pH sensitive
purple- O2 or room air (means the tube is not in and is leaking)
yellow- CO2 (means the tube is in)- good or desired result
How do you stabilize a endotracheal tube (ETT)? - Answer - use two pieces of tape to tape
the ETT onto the face
- maximum 20-25 mmHg cuff pressure
What are nursing interventions you can implement after placing and stabilizing the ETT? -
Answer - assess respiratory system every 2 hours
- check oral/nasal status
- place in semi-fowler's position
- reposition every 2 hours
- move tube to opposite side of mouth every 8 hours
- mouth care every 4 hours
- give white board to patient to help them communicate
, When is the laryngeal mask airway used and why? What does it have in common with the ETT
and what part of it is slightly different? - Answer - it is used in emergency because it is easier
to insert and does not require advanced skills- nurses can insert these due to emergency
- it is an alternative to ET tube
- less risk of injury compared to ETT
- also has inflated cuff like ETT; but it is inflated over the larynx rather than trachea
What is tracheostomy and when/why is it used? How is it slightly different from ETT and
laryngeal mask airway? - Answer - it is a surgical hole in cervical tracheal airway
- placed under larynx and is used to establish an airway
- used for long term airway support
- different in that it allows for people to speak easier than with a ETT or LMA (possible but still
difficult since air is not reaching larynx where vocal cords are)
What are four purposes/indications of tracheostomy? - Answer - replace an ET tube (since ET
tubes are short term)
- mechanical ventilation
- acute or chronic airway obstruction
- copious secretions
What are the four types of tracheostomy tubes? - Answer - single outer cannula- 1 lumen;
not take out for cleaning
- double cannula- 2 lumens; one outer and one inner; better for people with copious secretions;
inner lumen taken out for cleaning
- cuffed/uncuffed
- fenestrated/non-fenestrated
Permanent inner cannula vs disposable inner cannula? - Answer - permanent inner cannula-
cleaned and put back in
- disposable inner cannula- throw out after use
What are the 7 parts used or needed for a tracheostomy? - Answer 1) outer cannula
2) obturator- used to help insert tracheostomy tube (inserted first and then outer cannula and
then inner cannula)
3) inner cannula
4) flange- stabilizes the tube from the outside
5) port- used to inflate the cuff to stabilize the tube once in the trachea
6) cuff- inflates and stabilizes the tube
