Trach Care & Suctioning an Artificial Airway Flashcards
A tracheostomy ______ establishes an airway. It can be temporary or ______.
Surgically
Permanent
Pt’s c chronic problems, facial trauma, throat cancer, etc.
Indications for a tracheostomy include bypassing an ______ airway obstruction, facilitate removal of ______, permitting long term ______ ventilation for pt unable to wean from ventilator, permits ______ intake and ______ in patients who require long term mechanical ventilation.
UPPER SECRETIONS MECHANICAL ORAL SPEECH
Advantages of tracheostomy for long term therapy include less risk of long term damage to airway compared to ______ tube, pt ______ increased because of no tube in mouth, Pt can ______ with a tracheostomy because tube enters lower in airway, trach tube is more secure and pt ______ is increased.
ENDOTRACHEAL
COMFORT
EAT
MOBILITY
Types of trach tubes include ______, ______, and ______.
CUFF
UNCUFFED
FENESTRATED
The cuff is high ______ but low _______ to prevent erosion. It maximizes airflow through trach and protects airway. The cuff must be inflated for pt on ______ pressure ventilation, ______ or can’t protect airway, and while ______ or ______ and 30 minutes after meal.
VOLUME, PRESSURE
POSITIVE
UNCONSCIOUS
EATING, DRINKING
Use syringe and inflate ______ through end of pilot balloon to minimum volume required to create an airway seal (No ______ with deep breath and pt can’t ______). Should not exceed ______ mmHg or ______ cm H2O which can be measured at bedside.
SLOWLY
SOUND, TALK
20, 25
Excessive cuff pressure can result in tracheal wall ______ (when pressure impairs blood flow to tracheal wall), tracheal ______(narrowing of tracheal lumen due to scar formation).
NECROSIS
STENOSIS
Speaking trach tubes work by placing a ______ on the end of the tube. Openings on the surface of the outer ______ allow air to flow over the vocal cords when the cuff is ______.
CAP
CANNULA
DEFLATED
During tracheostomy insertion an ______ is placed inside outer cannula with rounded tip protruding to ease insertion. After insertion it is immediately removed to allow ______. It is kept at bedside in case trach comes out and no new trach kit is available.
OBTURATOR
AIRFLOW
Post-op trach care includes precautions for accidental tube displacement until the stoma is ______. Tube of equal or ______ size kept at bedside for emergency reinsertion. Tapes not changed for at least ______ hours after insertion. First tube change, if needed, by physician no sooner than ______ days after insertion.
HEALED
SMALLER
24
7
Post-op emergnecy management equipment to keep at bedside includes ______, ______, and ______. (first 72 hours). For accidental dislodging: Open stoma c hemostat, place obturator into replacement tube, lube tube c saline, insert at 45 degree angle to neck, remove obturator.
SUCTION EQUIPMENT
HEMOSTATS
NEW TRACH
If tube can’t be replaced ______ level of respiratory distress. Dyspnea may be alleviated with ______ or ______ fowlers position. Severe distress would indicate need to activate ______ ______ team. Cover stoma c sterile dressing and ventilate with ______ ______ ______ until help arrives.
ASSESS
SEMI, HIGH
RAPID RESPONSE
BAG VALVE MASK (AMBUBAG)
Prioritize using A, B, C, P, S Ineffective airway clearance \_\_\_ Impaired verbal communication \_\_\_ Body image disturbance \_\_\_ Risk for infection \_\_\_ Risk for aspiration \_\_\_ Risk for ineffective therapeutic regimen management \_\_\_
A, B S S C A, B S
For ongoing trach care the tube should be replaced every ______ days. A healed tract will be well formed in several ______. Patient can be taught to change tube using ______ technique at home.
30
MONTHS
CLEAN
A trach can be removed when patient can adequately exchange air and expectorate. The stoma is closed with ______ and covered with occlusive dressing. ______ forms in 24-48 hours. Opening will close in several days without ______ intervention.
TAPE
TISSUE
SURGICAL
