Respiratory Care Procedures 2 - Exam 5 (Lab) Review
1.King tracheostomy tube:: A King tracheostomy tube is a medical device
used to help people breathe when they have difficulty doing so on their
own. It's a tube that's inserted into a small hole in the throat called a
tracheostomy. The tube connects to a ventilator or other breathing
assistance device, allowing air to flow into the lungs. This helps the
person get enough oxygen and remove carbon dioxide from their body.
The King tracheostomy tube is designed to be easy to insert and secure
in place, providing a reliable way to support breathing for people who
need it.
2.What is the purpose of Nasotracheal Suctioning (NTS)?: To remove
accu- mulated secretions, blood, vomitus, and foreign material from
the trachea and nasopharyngeal area.
3.Describe the procedure of Nasotracheal Suctioning (NTS).: NTS involves
the insertion of a suction catheter through the nasal passage and
pharynx into the trachea without a tracheal tube or tracheostomy.
4.What are the appropriate subatmospheric pressure ranges for different
age groups during Nasotracheal Suctioning?: •Neonates: 60-80 mm Hg
• Infants: 80-100 mm Hg
• Children: 100-120 mm Hg
• Adults: 100-150 mm Hg
5.List the settings where Nasotracheal Suctioning (NTS) can be performed.:
• Critical care
• Emergency room or department
• Inpatient acute care
• Extended care and skilled nursing facility care
• Home care
• Outpatient or ambulatory care
6.What are the indications for Nasotracheal Suctioning (NTS)?: •Inability
to clear secretions effectively
• To stimulate or relieve coughing
• To obtain a sputum sample for analysis
7.Name some contraindications for Nasotracheal Suctioning (NTS).:
•Occlud- ed nasal passages
• Nasal bleeding
• Epiglottitis or croup (absolute)
• Acute head, facial, or neck injury
• Coagulopathy or bleeding disorder
8.What are some complications or hazards associated with
,Nasotracheal Suctioning (NTS)?: •Mechanical trauma
• Hypoxia/hypoxemia
• Cardiac dysrhythmias/arrest
• Bradycardia
• Increase in blood pressure
• Respiratory arrest
9.Describe the limitations of Nasotracheal Suctioning (NTS).: •NTS is a
blind procedure with inherent risks.
• Risks are increased in a combative or uncooperative patient.
• Duration of suction should not exceed 15 seconds.
10.How should the need for Nasotracheal Suctioning (NTS) be assessed?: -
• Baseline assessment for indications of respiratory distress
• Monitoring vital signs and patient's condition
• Assessing effectiveness of cough
11.How is the outcome of Nasotracheal Suctioning (NTS) assessed?:
•Vacuum source
• Calibrated regulator
• Collection vessel and connecting tubing
• Sterile suction catheter
• Sterile disposable gloves
• Nasopharyngeal airway when necessary
12.Who can perform Nasotracheal Suctioning (NTS), and what are the re-
sponsibilities of Level I and Level II personnel?: •Level I caregivers may
provide service after Level II personnel have established the need. They
must demonstrate knowledge of equipment use and patient
assessment.
• Level II personnel assess patients, determine the need for NTS, and
evaluate ef- fectiveness. They have additional skills including
understanding of pathophysiology and ability to modify techniques.
13.What should be monitored before, during, and after Nasotracheal
Suction- ing (NTS)?: •Breath sounds
• Skin color
• Pulse rate
• Oxygenation
• Arterial blood pressure if available
14.How frequently should Nasotracheal Suctioning (NTS) be performed?: -
When indicated and when other methods to remove secretions have
failed.
15.How is infection control managed during Nasotracheal Suctioning (NTS)?
: •Adherence to CDC Guidelines for Standard Precautions.
,• Proper disposal or disinfection of equipment and supplies.
16.What is endotracheal suctioning (ETS)?: ETS is the mechanical
aspiration of pulmonary secretions from a patient's artificial airway to
prevent its obstruction.
, 17.What are the two methods of endotracheal suctioning based on the
selec- tion of catheter, and how do they differ?: •Open suctioning: Requires
disconnect- ing the patient from the ventilator.
• Closed suctioning: Involves attaching a sterile, closed, in-line suction
catheter to the ventilator circuit, allowing suctioning without
disconnecting the patient.
18.Why is shallow suctioning recommended over deep suctioning?:
Shallow suctioning helps prevent trauma to the tracheal mucosa and
has not shown superior benefits over deep suctioning.
19.What is the recommended duration for each suctioning event?: Each
suc- tioning event should be limited to less than 15 seconds.
20.When should endotracheal suctioning be performed?: Endotracheal
suc- tioning should only be performed when secretions are present,
not routinely.
21.What precautions should be taken during patient preparation for
suction- ing?: •Use smaller catheters whenever possible.
• Deliver 100% oxygen (or a 10% increase from baseline in
neonates) for 30-60 seconds prior to suctioning.
• Check the negative pressure of the unit before each suctioning
event.
• Consider closed suctioning for patients at higher risk of desaturation
22.What are some indications for endotracheal suctioning?: •Need to
maintain airway patency and integrity.
• Presence of accumulated pulmonary secretions, evidenced by
various clinical indicators.
23.What are some contraindications to endotracheal suctioning?: There
are no absolute contraindications, but most are relative to the patient's
risk of adverse reactions or worsening clinical condition.
24.What are some hazards/complications associated with endotracheal
suc- tioning?: •Decrease in lung compliance and functional residual
capacity.
• Atelectasis.
• Hypoxia/hypoxemia.
• Tissue trauma to the trachea or bronchi.
• Bronchoconstriction/bronchospasm.
• Increased microbial colonization of the lower airway.
25.How should outcomes be assessed following endotracheal suctioning?: -
• Improvement in ventilator graphics and breath sounds.
• Decreased peak inspiratory pressure.
1.King tracheostomy tube:: A King tracheostomy tube is a medical device
used to help people breathe when they have difficulty doing so on their
own. It's a tube that's inserted into a small hole in the throat called a
tracheostomy. The tube connects to a ventilator or other breathing
assistance device, allowing air to flow into the lungs. This helps the
person get enough oxygen and remove carbon dioxide from their body.
The King tracheostomy tube is designed to be easy to insert and secure
in place, providing a reliable way to support breathing for people who
need it.
2.What is the purpose of Nasotracheal Suctioning (NTS)?: To remove
accu- mulated secretions, blood, vomitus, and foreign material from
the trachea and nasopharyngeal area.
3.Describe the procedure of Nasotracheal Suctioning (NTS).: NTS involves
the insertion of a suction catheter through the nasal passage and
pharynx into the trachea without a tracheal tube or tracheostomy.
4.What are the appropriate subatmospheric pressure ranges for different
age groups during Nasotracheal Suctioning?: •Neonates: 60-80 mm Hg
• Infants: 80-100 mm Hg
• Children: 100-120 mm Hg
• Adults: 100-150 mm Hg
5.List the settings where Nasotracheal Suctioning (NTS) can be performed.:
• Critical care
• Emergency room or department
• Inpatient acute care
• Extended care and skilled nursing facility care
• Home care
• Outpatient or ambulatory care
6.What are the indications for Nasotracheal Suctioning (NTS)?: •Inability
to clear secretions effectively
• To stimulate or relieve coughing
• To obtain a sputum sample for analysis
7.Name some contraindications for Nasotracheal Suctioning (NTS).:
•Occlud- ed nasal passages
• Nasal bleeding
• Epiglottitis or croup (absolute)
• Acute head, facial, or neck injury
• Coagulopathy or bleeding disorder
8.What are some complications or hazards associated with
,Nasotracheal Suctioning (NTS)?: •Mechanical trauma
• Hypoxia/hypoxemia
• Cardiac dysrhythmias/arrest
• Bradycardia
• Increase in blood pressure
• Respiratory arrest
9.Describe the limitations of Nasotracheal Suctioning (NTS).: •NTS is a
blind procedure with inherent risks.
• Risks are increased in a combative or uncooperative patient.
• Duration of suction should not exceed 15 seconds.
10.How should the need for Nasotracheal Suctioning (NTS) be assessed?: -
• Baseline assessment for indications of respiratory distress
• Monitoring vital signs and patient's condition
• Assessing effectiveness of cough
11.How is the outcome of Nasotracheal Suctioning (NTS) assessed?:
•Vacuum source
• Calibrated regulator
• Collection vessel and connecting tubing
• Sterile suction catheter
• Sterile disposable gloves
• Nasopharyngeal airway when necessary
12.Who can perform Nasotracheal Suctioning (NTS), and what are the re-
sponsibilities of Level I and Level II personnel?: •Level I caregivers may
provide service after Level II personnel have established the need. They
must demonstrate knowledge of equipment use and patient
assessment.
• Level II personnel assess patients, determine the need for NTS, and
evaluate ef- fectiveness. They have additional skills including
understanding of pathophysiology and ability to modify techniques.
13.What should be monitored before, during, and after Nasotracheal
Suction- ing (NTS)?: •Breath sounds
• Skin color
• Pulse rate
• Oxygenation
• Arterial blood pressure if available
14.How frequently should Nasotracheal Suctioning (NTS) be performed?: -
When indicated and when other methods to remove secretions have
failed.
15.How is infection control managed during Nasotracheal Suctioning (NTS)?
: •Adherence to CDC Guidelines for Standard Precautions.
,• Proper disposal or disinfection of equipment and supplies.
16.What is endotracheal suctioning (ETS)?: ETS is the mechanical
aspiration of pulmonary secretions from a patient's artificial airway to
prevent its obstruction.
, 17.What are the two methods of endotracheal suctioning based on the
selec- tion of catheter, and how do they differ?: •Open suctioning: Requires
disconnect- ing the patient from the ventilator.
• Closed suctioning: Involves attaching a sterile, closed, in-line suction
catheter to the ventilator circuit, allowing suctioning without
disconnecting the patient.
18.Why is shallow suctioning recommended over deep suctioning?:
Shallow suctioning helps prevent trauma to the tracheal mucosa and
has not shown superior benefits over deep suctioning.
19.What is the recommended duration for each suctioning event?: Each
suc- tioning event should be limited to less than 15 seconds.
20.When should endotracheal suctioning be performed?: Endotracheal
suc- tioning should only be performed when secretions are present,
not routinely.
21.What precautions should be taken during patient preparation for
suction- ing?: •Use smaller catheters whenever possible.
• Deliver 100% oxygen (or a 10% increase from baseline in
neonates) for 30-60 seconds prior to suctioning.
• Check the negative pressure of the unit before each suctioning
event.
• Consider closed suctioning for patients at higher risk of desaturation
22.What are some indications for endotracheal suctioning?: •Need to
maintain airway patency and integrity.
• Presence of accumulated pulmonary secretions, evidenced by
various clinical indicators.
23.What are some contraindications to endotracheal suctioning?: There
are no absolute contraindications, but most are relative to the patient's
risk of adverse reactions or worsening clinical condition.
24.What are some hazards/complications associated with endotracheal
suc- tioning?: •Decrease in lung compliance and functional residual
capacity.
• Atelectasis.
• Hypoxia/hypoxemia.
• Tissue trauma to the trachea or bronchi.
• Bronchoconstriction/bronchospasm.
• Increased microbial colonization of the lower airway.
25.How should outcomes be assessed following endotracheal suctioning?: -
• Improvement in ventilator graphics and breath sounds.
• Decreased peak inspiratory pressure.
