UPPER RESPIRATORY PROBLEMS

Which choice below would be best for a patient having a  epitaxis episode?

• apply icepack to the back of the head
• pinch the soft part of the nose
• lay the the patient in a 1/2 prone position
• hyper-extend the patient's neck

A patient with allergies should do which of the following to prevent or decrease symptoms?

• know and avoid allergic triggers
• undergo frequent immunotherapy
• use flonase
• use OTC antihistamines and decongestants

A patient is c/o severe throat pain and has a fever also. The patient can barely swallow. The throat appears red with yellow patchy exudates. Which below should be done first?

• Begin antibiotics
• Begin antifungal medications
• Start antibiotics
• Perform a throat culture

What should the RN mention in discharge teaching for a patient with status-post total laryngectomy?

• How to use a mirror when suctioning
• The importance of taking baths rather than showers for personal hygiene
• Never cover the laryngectomy stoma
• Using esophageal speech to communicate

The RN is assessing a status-post total laryngectomy and radical neck surgery patient.  What would the RN expect to find?

• a closed-wound drainage system
• a nasal endotracheal tube in place
• a nasogastric tube in place
• a tracheostomy tube and a mechanical ventilator

A patient is about to undergo a total laryngectomy.  The RN is providing pre-operative teaching.  Which of the following should the RN discuss first?

• use of non-verbal communication techniques
• techniques on how to alleviate dry mouth
• the need for vigorous coughing for the first 24 hours
• support groups for patients with throat cancer

Which below is an advantage of a tracheostomy tube vs. an ET tube?

• a tracheostomy is safer to perform in an emergency
• an ET tube has a higher risk of tracheal necrosis
• a tracheostomy tube allows for more flexibility and movement
• an ET tube is more likely to lead to ventilator acquired pneumonia

While caring for a patient with a cuffed tracheostomy tube containing an inner cannula, which of the following choices is most appropriate?

• deflate the cuff and remove the inner cannula
• remove and replace the inner cannula per institutional guidelines
• remove the inner cannula if the patient 
• keep the inner cannula in place at all times to prevent dislodging

A patient's tracheostomy tube comes dislodged. The RN should first

• attempt to replace the tube
• call the physician
• place the patient in high Fowler's 
• bag the patient with a resuscitation bag

Which of the following statements is correct when working with a patient with a cuffed tracheostomy tube in place?

• tube should changed every 3 days
• cuff pressure should be checked every 8 hours
• mouth care should be performed every 12 hours
• ABGs should be performed Q8 hours