Oxygenation
The process of moving air into and out of the lungs
What is ventilation
What infection control technique is used when performing trach care?
What is surgical asepsis
Rationale: There is direct contact with the patient's airway which bypasses the body's natural defenses
What is the O2 flow rate for a nasal cannula?
What is 1 - 6 L/min
What are some things you should do before performing trach care?
What is:
Wash your hands, assemble all equipment and supplies, check the expiration date on all packages, and explain the procedure to the patient even if they are unresponsive
what are ways to maximize pulmonary mechanics and secretion clearance?
What is:
Turn, cough, deep breath, incentive spirometer and mobility
Oxygen delivery systems
What are:
Nasal Cannula
Simple Face Mask
Partial and Non-Rebreather
Venturi Mask
High Flow Nasal Cannula
CPAP
How much time should the patient be given between passes with suction?
What is allow at least one minute between passes for ventilation and oxygenation (Let them catch their breath)
What symptoms might a patient have that would point to them needing to be suctioned?
What is:
Cannot cough adequately
Audible noisy secretions
Crackles/wheezing
Increased heart rate
What position should the patient be in while performing trach care?
What is:
Semi-fowlers unless contraindicated ( 30 degrees)
This decreases abdominal pressure on the diaphragm and promotes lung expansion
What is the purpose of the disposable inner cannula?
What is:
Easy removal to prevent/clear accumulation of secretions on the outer cannula
Oxygen safety Precautions
WahatAre:
Keep 10 feet away from open flames
Check electrical cords
Secure cylinders
Check fill levels
No smoking
Smoke detectors in home
What preparatory task must be performed before doing the first pass of suction?
You must hyper oxygenate the patient to help ensure they do not low sat during the procedure
Health promotion education for patients in regards to respiratory health?
What is to stop smoking, good nutrition, and exercise
What should you use to clean around the outer cannula and stoma?
What is:
Gauze pads, cotton-tipped applicators , and normal saline. Make sure to squeeze out any extra liquid from the gauze to prevent accidental aspiration
What holds the trach tube in place/
What is the trach ties
Non-Invasive activities that maintain or promote lung expansion
What is ambulation, IS, positioning and turning
What is the proper technique for suctioning a patient with a tracheostomy tube?
What is:
Remove bag or ventilator from tube
Insert catheter into airway
Advance catheter until resistance is met
Pull the catheter back 1 cm before beginning suctioning
Apply intermittent suction by covering and uncovering the suction port with your thumb, pass should last 10-15 seconds
What measures the amount of oxygen saturation?
What is pulse oximetry
What is the safest way to change trach ties?
Fasten the clean ties in place before removing the old ties to prevent tube expulsion. If able, ask the patient to flex their neck while securing the ties. Flexion produces the same neck circumference as coughing and helps to prevent an overly tight tie
True or False
A suction catheter can be used for more than one pass when suctioning the trach tube s long as it is within the same dressing change?
What is false
The absence of respirations for 15 seconds or longer
What is apnea
A nurse is caring for a client who has a tracheostomy. Which of the following actions should the nurse take when providing tracheostomy care?
A.) Apply the oxygen source loosely if the SPO2 decreases during the procedure
B.) Use surgical asepsis to remove and clean the inner cannula
C.) Clean the outer cannula surfaces in a circular motion from the stoma site outward
What are the early signs and symptoms of hypoxia?
What is:
Tachypnea
Tachycardia
Restlessness/Anxiety
Pale skin
Elevated blood pressure
Nasal flaring
What are some complications that can occur within the first 48 hours after tracheostomy tube insertion?
Hemorrhage at the operative site, causing aspiration of blood. Bleeding or edema in tracheal tissue, causing airway obstruction. Aspiration of secretions; introduction of air into pleural cavity, causing pneumothorax. Hypoxia or acidosis triggering cardiac arrest. Introduction of air into surrounding tissues, causing subcutaneous emphysema
What is a surgical procedure where an incision is made through the neck into the windpipe?
What is a tracheostomy