QUESTIONS AND ANSWERS BUNDLED
PREMIUM RESOURCE
●● Normal blood gases: CO2
Answer: 35-45
●● Normal blood gases: HcO3
Answer: 22-26
●● Normal blood gases: PO2
Answer: 80 or above
●● Normal vacuum pressures for suction?
Answer: 120-140 mmHg
●● What may a high pressure vent alarm indicate?
Answer: Pt is biting on the tubing, excessive secretions in the tubing,
kinked tubing
●● What may a low pressure vent alarm indicate?
Answer: cuff leak or the tubing is disconnected somewhere
,●● How do you verify positioning of an endotracheal tube?
Answer: -auscultate lung bases and apices for bilateral breath sounds
-observe chest for symmetric chest wall movement
-confirm with end tidal CO2 measure
GOLD STANDARD: chest x-ray
●● t/f: people with ET tubes should be suctioned routinely
Answer: FALSE-- they should be suctioned on an as needed basis
●● what should ET tube cuff pressure be kept at?
Answer: 20-25 mmHg
●● What measures should nurses take to avoid ET tube problems?
Answer: -confirm that exit mark on ET tube remains constant when
providing patient care, repositioning, and transporting patient
-maintain proper cuff inflation (listen for an air leak-- if pt can talk, you
must inflate more)
-continually monitor SpO2, RR, HR and rhythm, mental status, and
ABGs
-pre-oxygenate before suctioning
,●● What should be done if a patient is not tolerating ET tube suctioning?
Answer: STOP and manually hyperventilate with 100% oxygen
●● Measures to prevent aspiration?
Answer: -avoid bolus tube feedings
-monitor tube feeding residuals
-maintain HOB at LEAST 30 degrees or greater
-maintain proper ET tube cuff inflation
-perform frequent oral pharyngeal suctioning
-maintain an NG tube connected to low, intermittent suction if feeding
tube is placed below the pylorus
●● what are recommendations for preventing ventilator associated
pneumonia?
Answer: -manage ventilated patients without sedatives whenever
possible
-interrupt sedation once a day (spontaneous breathing trials)
-provide early exercise and mobility
-provide regular oral care
-minimize pooling of secretions above the ET tube cuff
-use ET tubes with subglottic secretion drainage for patients likely to
require greater than 72 hours of intubation
-keep HOB elevated 30-45 degress
, -change ventilator circuit only if visibly soiled or malfunctioning
●● What is the biggest complication associated with high cervical spinal
cord injuries?
Answer: BREATHING-- the diaphragm is innervated by C3-C5 levels
C4-diaphragm
will likely need mechanical ventilation mgmt
●● signs and symptoms of increased intracranial pressure?
Answer: -altered LOC
-headache
-bradycardia
-decreased respirations
-acute HTN with widening pulse pressure
-N/V
-worsening neuro deficits
-pupils that are nonreactive
●● What are the components of a neuro exam? (7)
Answer: 1. LOC