Question

critical thinking
multiple choice
read each critical - thinking item carefully and then select the one best response.
questions 1 - 5 are derived from the following scenario: you respond to a construction site and find a worker lying supine in the dirt. he was struck by a heavy construction vehicle and flew more than 15 feet (4.6 m) before landing in his current position. there is discoloration and distention of his abdomen about the right upper quadrant (ruq). he is unconscious, and his respirations are 10 breaths/min and shallow, with noisy gurgling sounds.

1. what airway technique will you use to open his airway?

a. head tilt - neck lift maneuver
b. jaw - thrust
c. head tilt - chin lift maneuver
d. cross - finger technique

1. after opening the airway, your next priority is to:

a. provide oxygen at 6 l/min via a nonrebreathing mask
b. provide oxygen at 15 l/min via a nasal cannula
c. assist respirations
d. suction the airway

1. what method will you use to keep his airway open?

a. nasal cannula
b. jaw thrust
c. oropharyngeal airway
d. head tilt - chin lift maneuver

1. while assisting with respirations, you note gastric distention. in order to prevent or alleviate the distention, you should do all of the following except:

a. ensure that the patients airway is appropriately positioned
b. ventilate the patient at the appropriate rate
c. ventilate the patient at the appropriate volume
d. ventilate the patient at a faster rate

1. the patient is now apneic. what is the correct ventilation rate for assisting this adult patient?

a. one breath every 6 seconds
b. one breath every 3 to 5 seconds
c. one breath every 10 to 12 seconds
d. there is no need to assist with ventilations for this patient.
short answer
complete this section with short written answers using the space provided.

1. list five contraindications for cpap.

Explanation:

1. Since the patient may have a spinal - injury due to the high - impact accident, the jaw - thrust maneuver is used to open the airway without moving the neck.
2. The noisy gurgling sounds indicate airway obstruction by secretions, so suctioning the airway is the next priority after opening it.
3. The jaw - thrust can be used to keep the airway open, especially when spinal injury is suspected.
4. Ventilating the patient at a faster rate can increase the risk of gastric distention, while proper airway positioning, rate, and volume help prevent it.
5. For an apneic adult patient, the correct ventilation rate is one breath every 6 seconds (10 breaths per minute).

Answer:

1. B. Jaw - thrust
2. D. suction the airway
3. B. Jaw thrust
4. D. ventilate the patient at a faster rate
5. A. One breath every 6 seconds