Trach suctioning and assessment

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Across
  1. 5. A ________ is a suction device for accessing the more copious oropharyngeal and oral secretions, when patient is able to cough but unable to clear the secretions.
  2. 6. The catheter can be inserted in nasopharyngeal route about 16 cm in this age group, and 4-7.5 cm in infants and young children. The rule of thumb is tip of nose to angle of mandible.
  3. 8. Assess hx of patient nasal problems such as nasal trauma, polyps, chronic sinusitis or ________.
  4. 9. This type of collar is a curved device with an adjusttable strap that fits around patient's neck, with two ports.
  5. 13. Some classes of medications such as ____________ can cause bronchospasms.
  6. 15. While performing oropharyngeal suctioning it is important to monitor baseline oxygenation status, keeping this device on patient will indicate any changes immediately.
  7. 16. Observe for _________ secretions, soiled or damp tracheostomy ties or dressings to indicate care is needed.
  8. 20. The RPN assesses the patient's _________ throughout the suctioning procedure. If pulse drops 20 or rises 40 bpm, or if Sp02 falls below 90%, stop suctioning.
  9. 22. The Yankauer or tonsillar tip suction catheter is required in patients with artificial airway to provide _______ hygiene.
  10. 24. This term refers to the preoxygenation and deep breathing required to reduce suction-incuded hypoxemia.
  11. 27. adaptor, A t-tube or _____ _______ is the t- shaped device with a 15 mm connection that connects oxygen to the artificial airway.
  12. 28. These temporary airway management tubes are inserted through the nares or mouth by HCP, RT, specially trained nurses and emergency personel.
Down
  1. 1. The RPN must consult the_________ Therapist for all patients with a tracheostomy/laryngectomy.
  2. 2. The main difference between oropharyngeal and _________ suctioning is the depth required, need for sterility, and the complications.
  3. 3. Patients who have an artificial airway need constant _______ to the airway.
  4. 4. Apply ________ suction for no more than 15 seconds in adults for nasopharyngeal, and no more than 10 sec intermittent or continuous for nasotracheal suctioning.
  5. 7. Use of caution is necessary when suctioning patients with a head injury. The suctioning process can raise __________. This risk can be reduced by hyperventilation creating a state of hypocarbia.
  6. 8. Auscultate for presence of these sounds to determine presence of secretions in lower airway.
  7. 10. Oxygen saturation below 90%, wheezing and crackles upon auscultation, restlessness, tachypnea, change in BP, cyanosis, decreased LOC, drooling are all indication for _________.
  8. 11. A common side effect of some narcotics known as ________ cause respiratory depression, so performing systematic respiratory assessment is especially important in these patients.
  9. 12. Regular adminsitration of this type of medication to help manage tracheostomy site symptoms, and before dressing changes and suctioning is helpful in promoting comfort.
  10. 14. Reposition patient to ______ to encourage draining, and if patient has decreased l.o.c.
  11. 17. Insertion of suction catheter should be on inhalation to avoid inserting when epiglottis is open. Catheter must never be inserted with suction applied, or during swallowing. If pt becomes nauseated, or gags the catheter is likely in the ____________.
  12. 18. The recommended flow rate of oxygen is 10 L/min with a _______ set.
  13. 19. These tests include arterial blood test, and pulse oximetry
  14. 21. Tracheal suctioning has many risks, including hypoxemia, which can lead to cardiac dysrhythmias or __________.
  15. 23. Procedure with a narrow, flexible fibreoptic scope is passed into trachea and bronchi to visualize tracheobronchial tree, to obtain fluid, sputum, or biopsy sample. It can also be utilized to remove foreign bodies, or mucus plugs.
  16. 25. Secretions that are not removed from mouth, pharynx and trachea require suctioning to avoid this complication.
  17. 26. The RPN is responsible for identifying risk factors for airway obstruction: Impaired cough, impaired swallowing, weakend respiratory muscles and that the _______ ______ is intact.