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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 36
Airway Management
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Airway The Airway
• The respiratory system
• The importance of a clear airway
– Factors that jeopardize airway patency
• Upper and lower airways
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
QuestionQuestion
•Is the following statement true or false?
The upper airway consists of the nose and pharynx.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
True.
The upper airway consists of the nose and the pharynx, which is subdivided into the nasopharynx, oropharynx, and laryngopharynx.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Airway and Related StructuresThe Airway and Related Structures
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Airway (cont’d)The Airway (cont’d)
• Structures that protect the airway from inhaled substances
– Epiglottis
– Tracheal cartilage
– Mucous membrane
– Cilia
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cilia and Mucus-Producing CellsCilia and Mucus-Producing Cells
(Refer to Figure 36-2 in the textbook.)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Airway (cont’d)The Airway (cont’d)
• Definition of sputum:
Mucus raised to the level of the upper airways
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Natural Airway Management Natural Airway Management • Liquefying secretions
– Encouraging adequate hydration
– Inhalation therapy
• Mobilizing secretions
– Postural drainage; Percussion
– Vibration
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
QuestionQuestion
•Is the following statement true or false?
Hydration keeps mucous membranes moist and mucus thin.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
True.
Hydration, the process of providing adequate fluid intake, tends to keep mucous membranes moist and mucus thin.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Aerosol Therapy Aerosol Therapy
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Collecting a Sputum SpecimenCollecting a Sputum Specimen
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Lung Segments and Corresponding Postural Drainage Positions
Lung Segments and Corresponding Postural Drainage Positions
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Performing Postural DrainagePerforming Postural Drainage
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Performing PercussionPerforming Percussion
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Natural Airway Management (cont’d)
Natural Airway Management (cont’d)
• Suctioning secretions
– Nasopharyngeal suctioning
– Nasotracheal suctioning
– Oropharyngeal suctioning
– Oral suctioning
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
QuestionQuestion
•The Yankeur-tip device is used when performing which type of suctioning?
a. Nasopharyngeal
b. Nasotracheal
c. Oropharyngeal
d. Oral
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
d. Oral
Nurses perform oral suctioning, which is a removal of secretions from the mouth, using a suctioning device called a Yankeur-tip or tonsil-tip catheter.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Variations in Suction PressureVariations in Suction Pressure
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Suctioning the AirwaySuctioning the Airway
(Refer to Skill 36-1 in the textbook.)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Placement of a Nasopharyngeal Tube
Placement of a Nasopharyngeal Tube
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Natural Airway Management (cont’d)
Natural Airway Management (cont’d)
• Suctioning secretions (cont’d)
– Oropharyngeal suctioning
– Oral suctioning
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Yankeur-Tip Suction Device for Oral Suctioning
Yankeur-Tip Suction Device for Oral Suctioning
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Artificial Airway Management Artificial Airway Management
• Oral airway
• Tracheostomy
– Tracheostomy tube
– Tracheostomy suctioning
– Tracheostomy care
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
QuestionQuestion
•Is the following statement true or false?
An oral airway is a curved device preventing the tongue from obstructing the upper airway.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
True.
An oral airway is a curved device that keeps a relaxed tongue positioned forward within the mouth, preventing the tongue from obstructing the upper airway.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Inserting an Oral AirwayInserting an Oral Airway
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
A Cuffed Tracheostomy Tube A Cuffed Tracheostomy Tube
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Suctioning Through a Tracheostomy Tube
Suctioning Through a Tracheostomy Tube
(Refer to Figure 36-10 in the textbook.)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Providing Tracheostomy Care Providing Tracheostomy Care
(Refer to Skill 36-2 in the textbook.)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Implications Nursing Implications
• Nursing diagnoses
Ineffective Airway Clearance
Impaired Gas Exchange
Risk for Infection
Impaired Spontaneous Ventilation
Anxiety
Deficient Knowledge
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ineffective Airway ClearanceIneffective Airway Clearance
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
General Gerontologic ConsiderationsGeneral Gerontologic Considerations
• Pathologic pulmonary changes in older adults
• Age-related changes affecting the older adult’s respiratory system
• Pneumonia in older adults
• Cough in older adults
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
General Gerontologic Considerations (cont’d)
General Gerontologic Considerations (cont’d)
• Respiratory secretions in older adults
• Dysphagia in older adults
• Cardiac dysrhythmias in older adults
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