Everything Airway
A respiratory therapist is educating a group of students about pediatric tracheostomies. Which of the following is the most common age range for tracheostomy placement in children, and what are the primary indications for this procedure?
First year of life, upper airway obstruction, prolonged ventilatory support, and pulmonary toilet
You have just extubated your patient and you hear a very strange high pitch noise. What is happening and how are you going to fix it.
Patient has upper airway swelling or edema. This is reversible by nebulized epinephrine.
ROP
Retinopathy of Prematurity: a condition in which premature babies experience disorganized blood vessel growth in which receiving high concentrations of oxygen can lead to blindness of retinal scarring.
Nasal cannula on a neonate with choanal astresia..
Best mode of action is a mask, oral airway, or oxyhood.
A 10-month-old child has been brought into the emergency room (ER) by his or her parents, who state that after few days with low-grade fever, malaise, and rhinorrhea, their child presented with a “barking” cough and increased work of breathing. What condition is this child likely exhibiting?
Laryngotracheobronchitis (LTB)
Croup
When intubating a neonatal or pediatric patient, what formula is used to find proper depth of ETT.
ETT size x3
What are the most common causes of death in tracheotomy-dependent children?
Mucous plugging and accidental dislodgement
SABA and LABA
Short acting b2-agonists, long acting b2-agonists
Nasophyngeal suction pressure set at 100 mmH20 on a 4 week old...
Neo: 60-80 mmH20
Peds: 80-100 mmH20
What appears to be the strongest identifiable predisposing factor for developing asthma?
Atopy (increased IgE) seems to be the strongest identifiable predisposing factor for developing asthma, with atopic dermatitis often preceding its onset.
The therapist is about to perform endotracheal intubation on a 2-year-old infant. What size endotracheal tube needs to be used?
4.5 mm ID
A pediatric patient with a tracheostomy tube was in the activity area playing with a therapy dog. When the patient was moved back to their bed, a respiratory therapist observes signs and symptoms of acute respiratory destress. Which of the following should the therapist do first?
Reinsert the tracheostomy tube
GBS
Group B streptococcus is the most common microorganisms that affect pregnancy outcomes
A respiratory therapist should avoid what areas while performing CPT/ACT....
SubQ Emphysema, pnuemothorax, frank hemoptysis, bony promises, fractures, surgical sights
A respiratory therapist is educating a group of students on the risks associated with gestational diabetes mellitus (GDM). Which of the following complications is the infant of a mother with poorly controlled GDM most at risk for?
Infants of mothers with poorly controlled GDM are at increased risk of macrosomia (large body size) due to excessive glucose crossing the placenta and stimulating fetal insulin production. After birth, the high fetal insulin levels can cause hypoglycemia when maternal glucose supply is removed. Other risks include shoulder dystocia, stillbirth, and neonatal metabolic disorders.
What is the purpose of placing a small towel under the upper back/shoulder area of a 4-year-old patient who is undergoing oral intubation?
To obtain a better alignment and visualization of the airway
Head bobbing, nasal flaring, and grunting are exhibiting signs of which of the following?
Respiratory distress
OPA
Oral pharyngeal airway. An intervention a therapist should perform when an infant is born with choanal atresia in respiratory distress.
You are training a therapist to work in the neonatal intensive care unit and they ask why you should routinely avoid advancing the catheter tip beyond the distal end of the endotracheal tube when performing endotracheal suctioning on a neonate.
To prevent the development of bronchial stenosis and granulomas
A 4-year-old child is brought into the emergency room (ER) by her parents, who state that an abrupt high fever developed along with a severe sore throat, dysphagia with drooling, and cough. In the ER, the girl exhibits stridor, muffled voice without hoarseness, air hunger, and cyanosis. She also has suprasternal, substernal, and intercostal retractions, with nasal flaring, bradypnea, and dyspnea. The child is sitting upright with her chin thrust forward and her neck hyperextended in a tripod position. What condition is she likely exhibiting?
Epiglottitis
Where should the therapist secure a 4.0-mm endotracheal tube after the intubation procedure?
12 cm at the lip
A child orally intubated 2 weeks ago because of laryngotracheal stenosis. They have failed three spontaneous breathing trials over the last week. What action does the therapist take now?
The therapist needs to insert an oral ETT smaller than the one in place.
MSMAID
Machine, suction, monitors, airway, IV, drugs
A mechanically ventilated patient of inhalation injury has a set Vt of 10-12 ml/kg....
Conventional volume limited ventilation in patients with inhalation injury is usually instituted at a tidal volume of 6 to 8 mL/kg. Lung compliance, system resistance, compressive volume loss, oxygenation, and ventilation must be considered when tidal volumes are selected.
While working with a preterm neonate, the therapist notices the infant become apneic, cyanotic, and hypotonic. Consequently, the therapist nudges and stimulates the infant. On the basis of this scenario, what type of episode has occurred?
An apparent life-threatening event