Author Question: Which measure would be most appropriate for the nurse to do to ensure that a child's ET tube is ... (Read 42 times)

Tirant22 · **on:** Jun 27, 2018

Which measure would be most appropriate for the nurse to do to ensure that a child's ET tube is correctly positioned?

A) Auscultate for abdominal breath sounds
B) Mark the tracheal tube at the child's lip
C) Watch for a yellow display on a CO2 monitor
D) Inspect for water vapor in the tracheal tube

Question 2

A 9-year-old girl who has fallen from a second-story window is brought to the emergency department. Which assessment would be a priority?

A) Evaluating pupils for equality and reactivity
B) Monitoring oxygen saturation levels
C) Asking the child if she knows where she is
D) Using the appropriate pain assessment scale

wtf444 · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

C
Response:
The best way to verify correct tracheal tube placement is to use a CO2 monitor. If the tube is properly placed, the monitor display will turn yellow with each exhalation. Auscultation for breath sounds and inspecting the tube for signs of water vapor are valid confirmations but not as good as using a CO2 monitor. Marking the tube alerts the nurse if the tube becomes misplaced.

Answer to Question 2

B
Response:
Airway is always the priority in any emergency situation. Therefore, monitoring oxygen saturation levels, part of the rapid cardiopulmonary assessment, would be performed before any of the other assessments. Evaluating pupils for equality and reactivity, asking the child if she knows where she is, and using an appropriate pain assessment scale are assessments that would follow the ABCs.