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2goodgabe 2goodgabe
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Posts: 594
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6 years ago
A newly intubated patient is assessed with a color-changing CO2 detection device. The presence of CO2 is confirmed, as is moisture on exhalation. However, auscultation reveals decreased breath sounds on the right side.
 
  This problem can be corrected by doing which of the following?
  a. Extubate and use a laryngeal mask airway.
  b. Order a chest radiograph to determine what is happening.
  c. Reposition the endotracheal tube, and auscultate again.
  d. Push the tube in farther, and listen for bi-lateral breath sounds.



Q. 2  A blind nasal intubation is facilitated by which of the following patient positions?
 
  a. Chin lift c. Neutral head
  b. Jaw thrust d. Extreme head



Q. 3  During intubation, the intubator should stand in which of the following positions?
 
  a. As close as possible to the patient
  b. Approximately 2 feet away from the pa-tient's mouth
  c. As far away from the patient's mouth as possible
  d. Far enough away from the mouth to allow binocular vision



Q. 4  The position that best facilitates the insertion of an oral endotracheal tube is the _____ position.
 
  a. Chin lift c. Neutral head
  b. Sniffing d. Jaw thrust



Q. 5  A patient's endotracheal tube cuff pressure is measured at 35 mm Hg. The most appropriate im-mediate action to take is:
 
  a. extubate the patient immediately.
  b. do nothing; this pressure is acceptable.
  c. add more volume to the cuff, and recheck pressure.
  d. remove some volume from the cuff, and recheck pressure.



Q. 6  Which of the following statements concerning endotracheal tubes and their insertion is true?
 
  a. The straight blade gives better tongue control than the curved blade.
  b. The Macintosh blade must be inserted along the left side of the tongue.
  c. The Miller blade is inserted along the right side of the tongue.
  d. The epiglottis must be hooked with the tip of the Macintosh blade.
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wrote...
6 years ago
(Answer to Q. 1)  ANS: C
This problem is caused by intubation of the right mainstem airway. The patient's endotracheal tube must be repositioned by suctioning the pharynx, deflating the cuff, pulling the endotracheal tube back slightly, reinflating the cuff, then auscultating for bilateral breath sounds.

(Answer to Q. 2)  ANS: C
Instead of the sniffing position, a neutral or slightly flexed head position is optimal for blind na-sal intubation. Jaw thrust and chin lift are used for patients with cervical spine injuries. An ex-treme head position would not facilitate either a nasal intubation or an oral intubation.

(Answer to Q. 3)  ANS: D
Manipulation of the endotracheal tube into the trachea can be facilitated by the proper position of the intubator with respect to the patient. The intubator's head should be far enough away from the patient's mouth to allow binocular vision, as seen in Figure 5-34, A. When the intubator is too close, the clinician's depth perception is compromised.

(Answer to Q. 4)  ANS: B
The sniffing position is ideal for opening up the upper airway and aligning the trachea for intuba-tion. The chin lift or jaw thrust should be used to open the airway of a patient with cervical spine injuries. The neutral head position is most appropriate for blind nasal intubation.

(Answer to Q. 5)  ANS: D
Because of tracheal mucosal blood pressure-flow characteristics, cuff pressure should be below 25 mm Hg to prevent tracheal ischemic damage. High cuff pressure is not an indication for extu-bation. Adding more volume would increase the cuff pressure even more, creating more of a blockage to blood and lymph circulation in the area surrounding the cuff.

(Answer to Q. 6)  ANS: C
The curved blade gives better tongue control than the straight blade. Both types of blades must be inserted along the right side of the tongue. The Macintosh blade lifts the epiglottis indirectly by being placed in the vallecula, not directly on the epiglottis.
2goodgabe Author
wrote...
6 years ago
found this very helpful thank you
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