Respiratory Care Review Exam Correctly Answered

A patient has just been intubated, and the CO2 detector placed on the proximal end of the ETT reads 1.5%. The RT should suspect what? - The tube is in the esophagus (If in trachea, it is 5-6%) Causes of this include edema, postextubation inflammation, bleeding, secretions, foreign substances, laryngospasm, and the tongue - Upper airway obstruction Single lumen tube, placed in difficult to intubate patients, uses two cuffs inflated through a single channel. - King Airway Proper tube placement (cm) for males and females - Male: 22-25 cm Female: 20-23 cm Proper tube size for women and men - Women: 7.0-9.0 Men: 8.0-9.5 This airway consists of a short, hollow tube that is used to replace the tracheostomy tube but can still maintain a patent stoma, in case problems arise. The patient has complete use of the upper airway. - Tracheostomy button This works by directing the patient's inspired air through a valve, but on exhalation the valve closes and directs the air up through the upper airway and vocal cords to allow the patient to talk. The cuff must be deflated for this. - Passy-Muir valve Cuff pressures should be kept between __-__ mmhg or __-__ cmh2o - 20-25 mmhg 25-35 cmh2o Major clinical sign of this is inspiratory stridor, caused by traumatic intubation, oversized ETT, poor ETT maintenance. Stridor is treated with cool aerosol, steroids, racemic epi. - Glottic Edema What level is a chest tube inserted at? - Second intercostal space anteriorly at the midclavicular level The RT notices on a patient's chest tube drainage system that there is fluctuation of the water level in the water-seal chamber with each patient breath and air bubbles seen only in the suction control chamber, which has a suction pressure of -15 cmh2o. What should be done? - Recommend a CXR to determine whether pneumo has resolved If no fluctuation is occurring in the water seal bottle of a chest tube, what should be suspected? - obstruction The RT is performing bag-mask ventilation on a severe COPD patient during CPR. Which of the following describes the best method for ventilating this patient? 1. The bag should be connected to an air wall outlet 2. The flow to the bag should be 10 LPM with no reservoir attachment 3. The bag should be connected to an O2 blender set at 30% 4. The bag should have a reservoir attachment and a flow of 15 lpm - The bag should have a reservoir and a flow of 15 LPM