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OR Nurse:
doi: 10.1097/01.ORN.0000360650.38858.27
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Managing the difficult airway

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INSTRUCTIONS Managing the difficult airway


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Managing the difficult airway

GENERAL PURPOSE: To provide the registered professional nurse with an overview of managing the difficult airway in the surgical setting. LEARNING OBJECTIVES: After reading the preceding article and taking the test you should be able to: 1. Define the difficult airway and describe the risk factors associated with it. 2. Discuss recommended management techniques for a difficult airway.

1. A difficult airway is clinically identified as difficulty administering ventilation via face mask or difficulty

a. suctioning the airway.

b. inserting a laryngeal mask airway.

c. visualizing the bronchi.

d. intubating the trachea.

2. Which of the following is not identified as a preexisting temporary factor associated with challenges to airway management?

a. dyspnea

b. excess oral secretions

c. stridor

d. dysphagia

3. Airway management of the patient with halo fixation and no tracheostomy is associated with

a. a high risk for emergent intubation.

b. ineffective preoxygenation.

c. need for removal of the traction.

d. mandatory use of an LMA.

4. One predicting factor for DMV is

a. being age 50 or over.

b. a history of snoring.

c. body mass index of 24 kg/m2.

d. dental implants.

5. The ratio of patients who will have an unpredicted difficult airway is

a. 1 in 1,000.

b. 1 in 10,000.

c. 1 in 100,000.

d. 1 in 1,000,000.

6. The risk of oxygen desaturation during the apneic period of intubation can be reduced by

a. preoxygenation before sedation.

b. administration of a muscle relaxant.

c. artificial ventilation while awake.

d. inducing unconsciousness.

7. Which of the following is not included in the portable unit recommended by the ASA for use in difficult airway management?

a. Magill's forceps

b. LMAs

c. pulse oximeter

d. esophageal-tracheal Combitube

8. Which emergency access management device is inserted blindly and can force gas into the lungs via side perforations in the tube?

a. esophageal-tracheal Combitube

b. flexible FOB

c. tracheostomy tube

d. cricothyrotomy cannula

9. Which emergency access management technique involves insertion of a large-bore, I.V. catheter into the trachea?

a. esophageal-tracheal Combitube placement

b. flexible FOB placement

c. tracheotomy

d. cricothyrotomy

10. The Macintosh laryngoscope blade

a. is utilized in oral tracheal intubation of the anesthetized patient.

b. is utilized for LMA insertion.

c. is positioned directly beneath the epiglottis.

d. obstructs direct visualization of the vocal cords.

11. In an uncomplicated intubation, the tracheal tube is advanced past the vocal cords at a depth of at least

a. 0.5 cm.

b. 1.0 cm.

c. 1.5 cm.

d. 2.0 cm.

12. Which technique best improves visualization of the vocal cords?

a. applying upward pressure to the trachea

b. applying pressure to the cricoid cartilage

c. BURP maneuver

d. bimanual laryngoscopy

13. Initial verification of tracheal tube placement includes auscultation of bilateral breath sounds and

a. X-ray confirmation.

b. confirmation of end-tidal carbon dioxide.

c. analysis of suctioned secretions from the tube.

d. visualization using FOB.

14. Awake tracheal intubation is primarily indicated to eliminate the risk of

a. respiratory arrest.

b. pulmonary edema.

c. pulmonary aspiration.

d. laryngospasm.

15. During conscious tracheal intubation, glycopyrrolate (Robinul) is given to

a. reduce patient anxiety.

b. reduce oral secretions.

c. anesthetize the airway.

d. induce vasoconstriction to prevent bleeding.

16. The LMA

a. requires highly advanced airway management skills.

b. is superior to bag-mask ventilation.

c. requires direct visualization of the vocal cords.

d. effectively protects the airway from aspiration.

17. Which is not identified as a potential complication of difficult airway management?

a. aspiration

b. edema

c. bronchial perforation

d. pneumothorax

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