Tracheostomy Care
This diagnostic test is often ordered if a child with a trach has recurrent obstruction or unexplained bleeding.
What is a bronchoscopy?
The removable part of a double-lumen trach tube.
What is an Inner Canula?
When a pediatric trach patient becomes decannulated and cannot be immediately recannulated, this is the nurse’s next priority.
What is bag-mask ventilation over the nose and mouth (or stoma if necessary)?
This teaching method is the gold standard for assessing retention and of complex education.
What is the Teach Back method?
***Bonus 200 pts- How would you implement this strategy when teaching a family about assessing respiratory effort***
This condition is the most common indication for a tracheostomy in a pediatric patient?
What is Subglottic Stenosis?
This suctioning method reduces the risk of hypoxemia and infection in ventilated trach patients.
What is the closed in-line suction system?
This trach type requires lubrication of the obturator before use.
What is a Tracoe?
Name three signs of trach obstruction.
What is Increased WOB, Stridor, Cyanosis, Tachycardia, and Decreased SPO2?
These tasks must be completed prior to a family nesting.
What is completed education record, home health equipment delivered and checked by biomed, and completed trach CPR class?
Describe how you would troubleshoot a high-pressure alarm on a ventilator in a patient with a trach.
What is Checking for mucus plugging, kinked tubing, bronchospasm, patient coughing, water in tubing, and ventilator settings?
Nursing assessment after suctioning includes evaluating these 4 items.
What are respirations, SPO2, lung sounds, and respiratory effort?
Name at least three physiologic considerations are important when transitioning a pediatric patient from cuffed to uncuffed trach.
What is the risk of aspiration, tolerance of ventilation, airway leak, potential for improved phonation, and changes in respiratory mechanics?
If a cuffed trach tube suddenly has a persistent air leak despite reinflation, the nurse should anticipate this intervention.
What is tracheostomy tube replacement?
These common activities in summer are important to educate parents on when discharging a new trach patient.
What is Swimming or submerging in water?
This task needs to be completed before trach CPR can be scheduled.
What is a completed education record?
This is the best indicator of adequate humidification in a trach patient.
What are thin, clear secretions?
These safety considerations a crucial when using a speaking valve in a pediatric patient on mechanical ventilation.
What is ensuring the cuff is deflated, patient can protect airway, monitor for desaturation or respiratory distress, and verify ventilator compatibility?
This subtle vital sign trend may indicate impending trach obstruction in an infant before oxygen saturation drops.
What is rising heart rate (tachycardia)?
These strategies can be used to adapt trach teaching for a family with low health literacy and high anxiety
What is the use of simplified language, visual aids, repetition, hands-on practice, small teaching sessions, teach-back, and support persons present?
These are contraindication for trach placement.
What are limited caregivers (<2), rural areas, home utility, home health services, family wishes?
The gold standard readiness test for pediatric trach decannulation.
What is overnight capped sleep study (polysomnography)?
When comparing Shiley trach tubes, how does sizing differ between adults and pediatrics/neonates, and why does this matter for safe care?
What is adult Shiley trachs are sized by inner diameter (ID), while pediatric/neonatal Shileys are sized by outer diameter (OD)?
An infant with a trach is agitated and tachycardic, with mild retractions. SpO₂ remains 96%. Why should the nurse not rely on oxygen saturation alone to rule out respiratory distress?
What is oxygen saturation may lag behind clinical signs; early distress is often seen first in work of breathing, color, and behavior changes?
Families should avoid using this common household cleaning substances near their child’s trach.
What is powder, aerosol sprays?
A 2-year-old with a neonatal 3.5 trach is requiring higher ventilator pressures, the parents state they have been more tachypneic and easily become short of breath when playing. What equipment consideration should the nurse anticipate?
What is the child may need an upsized trach to match growth and ensure adequate ventilation?