Chest Tubes
This is the general term for fluid within the lung space
Pleural effusion
What causes obstructive sleep apnea?
Upper airway obstructed by soft palate or tongue
Name two indications a client may have a tracheostomy in place
Severe neurological impairment
Genetic disorder, TBI, Paralysis, etc
Neck reconstruction surgery
Cancer
Long term ventilation
Severe tracheomalacia - the walls of a child's windpipe, or trachea, collapses when breathing. This can happen when the cartilage in the windpipe doesn't develop properly
Facial/neck trauma, burns, swelling
The nurse notes course crackles over the client's trachea. What should they do?
Suction
The natural rise and fall in pressure, as shown on a pleur-evac canister, is known as what term?
Tidaling
These are the two most common risk factors for the development of OSA
Obesity
Smoking
How does the nurse determine if a trach is cuffed or uncuffed?
A high-pressure alarm on a ventilator could indicate what?
Secretions, tube kinking (biting), pulm edema, or coughing
The chest tube canister should be kept where in relation to the client?
Below the level of the chest
Name two nursing priorities for clients with OSA
Change in sleeping position
Weight loss
Change in habits, ETOH, sedatives, barbiturates
NPPV (CPAP)
Mouth piece
Nasal CPAP
Surgery
What motion should the nurse used to suction a clients trach?
Twirling/swirling
HOB at least 30 degrees
Oral care/Pulmonary toileting (at least every 12 hours)
Ulcer prophylaxis
Preventing aspiration
Turning/Repositioning
Postural drainage
This term is described by a crackling or popping feeling under the client's skin
Crepitus
Irritability
Personality changes
Depression
Memory changes
Decreased energy level
Little interest in doing things
What may the nurse observe if a client is displaying an obstruction of their trach?
dyspnea, noisy breathing, difficulty inserting suction catheter
Why is oral care important for the client with mechanical ventilation?
Movement promotes secretion mobilization
Decrease bacterial growth
Dental care
Suction secretions
Observe tissue integrity
Name 4 emergency supplies that must be kept with the client at all times
Clamp
Petroleum Gauze
4x4 Gauze
Transparent dressing or foam tape
Sterile water
Name three types of data that are collected during a polysomnography
Type of sleep
Respiratory effort
O2 Saturation
CO2 exhalation
Pulse oximetry
Electromyography (EMG)
Name three interventions for aspiration prevention
Small, Slow, Supervised meals
Small meals, small bites, unhurried, closely supervised
Thicken liquids - No Straws
Spoon feed “liquids”
No foods that turn into or generate liquid
Ice cream
Patient Positioning
As close to 90 as possible
Chin tuck
Double Swallow
Dry swallow after each swallow
Continuous monitoring
Monitor for resp distress
Anticipate complications
Suction available and ready to use
What should the nurse do if they are unable to troubleshoot and correct an alarming ventilator?
Begin manual ventilation