trach care and suctioning

Question 1

what is a tracheotomy

Answer 1

long term air support

tracheotomy is the opening made for the tube itself

Question 2

tracheotomy tube

Answer 2

is the tube itself that is inserted to extend thru the stoma into the trachea

Question 3

equipment

Answer 3

trach tube
obturator
inner cannula

Question 4

cuffed trac tubes

Answer 4

airtight seal
seals prevent air leakage
ess when mech suctioning

Question 5

client asses

Answer 5

Respiratory status
ease of breathing
RR
Resp Rhythm
O2 saturation
HR
secretions 
drainage on trach dressing 
Appearance of incision

Question 6

trach care

Answer 6

Suctioning (if required)
Removing soiled trach dressing
Cleaning around stoma
Cleaning / changing the inner cannula
Replacing the trach ties

Question 7

potential complications for trachs

Answer 7

inability to remove secretions
infection
contaminating clean area with dirty dressing
improper rinsing of cleaning solution
failure to remove excess solution/failure to lock canula

Question 8

complications/risk factors

Answer 8

cotton lint or gauze can be aspirated
excessive movement of trac can cause irritation
failure to tie the straps which causes loosening or shifting
dislodgement of trach
knot (maybe due to swelling) maybe too tight causing pressure and irritation

Question 9

types of suctioning

Answer 9

oropharngeal
nasopharngeal
orotracheal
nasotraceal
tracheal

Question 10

symptoms for suctioning

Answer 10

PRN
respiratory distress
SOB
coughing
low o2 sat 
cyanosis
increased RR
audible crackles

Question 11

complications of suctioning

Answer 11

worsening respirtory status
bloody secretions
coughing
no secretions

Question 12

techniques to decreases complications

Answer 12

hyperinflation

hyper oxygenation

Question 13

To avoid trauma to trach

Answer 13

Apply suction intermittently only as the catheter is withdrawn.

never apply suction pressure while inserting the catheter,

maintain suction pressure less than 150 mm Hg in adults

Question 14

open method of suctioning

Answer 14

open suctioning involves sterile cathered thagt is opened at the time of suctioning

sterile gloves are worn to perform this tasks

Question 15

closed suctioning

Answer 15

involves multiple use suction cathered encased in a plastic sheath

Closed suctioning is most often used on patients who require mechanical ventilation to support their respiratory efforts, because it permits continuous delivery of oxygen
while suction is performed, thus reducing the risk of oxygen desaturation

Question 16

oral airways

Answer 16

The oral airway, the simplest type of artificial airway, prevents obstruction of the trachea by displacement of the tongue into the oropharynx

The oral airway extends from the teeth to the oropharynx, maintaining the tongue in the normal position.

Question 17

oral airways sizing

Answer 17

Proper oral airway size is determined by measuring the distance from the corner of the mouth to the angle of the jaw just below the ear.

Question 18

oral airway sizing complications

Answer 18

If the airway is too small, the tongue is not held in the anterior portion of the mouth

if the airway is too large, it may force the tongue toward the epiglottis and obstruct the airway.

Question 19

artificial airway

Answer 19

An artificial airway is for a patient with decreased level of consciousness or airway obstruction and aids in removal of tracheal bronchial secretions.

Question 20

techniques for good lung expansion and lung expansion

Answer 20

positioning
ambulation
incentive spirotermoy
chest tubes

Question 21

chest tubes

Answer 21

a cathered inserted into the thorax that drains fluid or air

Chest tubes are commonly used after chest surgery and chest trauma and for pneumothorax or hemothorax to promote lung re-expansion

Question 22

mediastinal chest tube

Answer 22

is commonly used following open heart surgery. It is inserted in the mediastinum (below the sternum) and is connected to a drainage system.

Question 23

pneumothorax

Answer 23

is a collection of air in the pleural space. The loss of negative intrapleural pressure causes the lung to collapse.

Question 24

hemothorax

Answer 24

accumulation of blood and fluid in the pleural cavity between the parietal and visceral pleurae, usually as a result of trauma. It produces a counterpressure and prevents the lung from full expansion

Question 25

single chamber drainage sys

Answer 25

single-chamber system allows air from a pneumothorax to bubble out of the water seal and escape through the air outlet, preventing air from re-entering the intrapleural space

Question 26

A two- or three-chamber system

Answer 26

drains both a hemothorax and a pneumothorax. The two-chamber system allows fluid to flow into a collection chamber and air to flow into the water seal chamber

A three-chamber system permits the drainage of fluid and air through controlled suction
The two- and three-chamber systems have two compartments—one for fluid or blood and a second for a water seal or a one-way valve