Ch 30 Care of Oxygen therapy and Tracheostomy Flashcards
Best measure to evaluate O2 need/therapy effectiveness
ABG’s
Oxygen toxicity Sx
nonproductive cough, substernal chest pain, GI upset, dyspnea
Absorption atelectasis
O2 levels are high and nitrogen is diluted, nitrogen prevents alveolar collapse
Candidates for a CPAP
sleep apnea, atelytesis after surgery, cardiac induced pulmonary edema
Subcutaneous emphysema
Complication of tracheotomy
Can occur after a tear in the trachea
Skin may feel puffy and crackling
Notify MD!
Tracheomalacia
constant pressure exerted by the cuff causes tracheal dilation and erosion of cartilage
Tracheomalacia manifestations
Increased amount of air required in the cuff to maintain the seal
Larger tracheostomy tube is required to prevent air leak
Food particles seen in tracheal secretions
Pt does not receive the set tidal volume on the vent
Tracheal stenosis Sx
coughing with inability to expel secretions
SOB
Tracheoesophageal fistula
excessive cuff pressure erodes posterior wall of the trachea. A hole is created between the trachea and the anterior esophagus.
Tracheoesophageal fistula Sx
Food in secretions
Coughing while eating
More air required to seal trach
Tracheoesophageal fistula management
Administer O2
Soft tube feeding instead of NG tube
Trachea-innominate artery fistula
Medical emergency!
Incorrect tube position causes necrosis of innominate artery
Trachea-innominate artery fistula manifestations
Pulsating tracheostomy
Bleeding from the stoma
Trachea-innominate artery fistula management
remove trach tube and apply pressure
prep for surgery
Tracheostomy and eating
Deflate cuff if possible
thicken all liquids
Have suction equipment
HOB elevated 30 min after eating
