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Nurs 325 > Tracheostomies > Flashcards

Tracheostomies Flashcards

1
Q

Tracheostomy

A

artifical airway
- temporary or permanent

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2
Q

indications for traches

A
  • head and neck cancers
  • subglottic stenosis
  • neuromuscular disease (MS)
  • spinal cord injuries
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3
Q

oral artificial airway

use

A

used to prevent tracheal obstruction caused by tongue displacement

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4
Q

oral artificial airway

components

A

measure from corner of mouth to earlobe and put in arch side down then twist 180
- channel is inside the piece for suctioning

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5
Q

Endotracheal airway

use

A

used to relieve and ventilate upper airway from an obstruction
- only for short term use
- “intubation” (GCS less than 8 time to intubate)

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6
Q

Endotracheal airway female sizing

A

7-7.5mm

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7
Q

Endotracheal airway sizing for men

A

8-9mm

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8
Q

Tracheostomy

use

A

used long term and is completed through surgery

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9
Q

tracheostomy sizing for women

A

10 mm

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10
Q

tracheostomy sizing for men

A

11 mm

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11
Q

indicastors for tracheostomy

4

A
  • prolonged mechanical ventilation (day 10-14)
  • upper airway obstruction
  • upper airway surgeries (ENT)
  • patient needs assistance monitoring long term
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12
Q

Shiley tracheostomy tube

characteristics

A
  • long term
  • can be cuffed or uncuffed
  • inner canula for cleaning
  • can be fenestrated which allows for plugging
  • non-fenestrated inner canula must be in before suctioning
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13
Q

portex tracheostomy tube

characteristics

A
  • short term (days to weeks)
  • cuffed
  • non fenestrated
  • may have inner canula
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14
Q

cuffed vs un-cuffed tracheostomy

A

whether or not there is a filled balloon seperating the upper and lower airway

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15
Q

fenestration allows for…

A

patient to still breathe through airway

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16
Q

parts of shiley trach tube

A
  • shaft (main tube)
  • inner canula
  • pilot balloon (where you insert air to inflate cuff)
17
Q

obterator

A

used to insert trach

18
Q

Flange

A

sits outside of trachea on surface of neck to keep tube from falling in

19
Q

hypoxia resultung from tracheostomy

and interventions

A

occurs due to arterilal O2 lowering during suctioning
- prevent through hyperoxygenation prior to suctioning for at least 5 breaths

20
Q

tissue trauma resulting from tracheostomy

and interventions

A

occurs due to over suctioning (will see blood tinged sputum)
- intervention is only suction when needed, making sure to draw back when resistance is felt, deflate cuff as needed

21
Q

infection resulting from tracheostomy

and interventions

A

increased secretions, increased HR RR and temp, local infection around stoma; can be caused by cuff leaks
- follow asepsis to avoid, routine suctioning, provide oral care, ensure hydration and nutrition is adequate

22
Q

bronchospasm resulting from tracheostomy

and interventions

A

caused by stimulation of lungs (hit where it breaks off between right and left main stem)
- prepare to use ventolin or atrovent

23
Q

indications for suctioning

5

A
  • secretions
  • respiratory distress
  • request
  • aspiration
  • need to obtain sample
24
Q

open system for suctioning

A

sterile catheter and glove

high risk for infection and must wear full PPE

25
Q

closed system for suctioning

A

In-line catheter

decreases chance of environmental contamination

26
Q

suctioning basics

pressure, how to do it, duration, time between, passes allowed

A
  • sterile
  • pressure of 120-150
  • pass until resistance is felt then pull back a bit
  • no longer than 10-15 sec
  • allow 5 breaths in between
  • only 2 passes
27
Q

aspiration

potential complicatiomn of suctioning

A

elevate HOB to 30-45, NPO, swallow assessment, monitor for abdominal distention

28
Q

assessment

sputum

A

trend changes and monitor for infection (amount, color, thickness)
- auscultate lungs, check labs (WBC), temp,

unexpected is green, yellow, thick brown

29
Q

cuff leak

complication of trach/suctioning

A

can cause aspiration and inadequate seal can lead to infection
- check if intact and inflated

30
Q

bleeding through and around stoma

complication of trach/suctioning

A

apply O2 and pressure, call physician, inspect stoma

31
Q

safety for bedside

before suctioning

A

bagger and mask, 10cc syringe, OPA, full O2 cylinder, sterile catheter and yankeur

32
Q

site care of trach

assessment timing and tie change timing

A
  • care is done q12 hours (inner canula and dressing change)
  • tie changes done q24 hours (make sure you can fit 2 fingers or 4-5 cm)

clean around stoma, assess for skim breakdown

33
Q

psychosocial considerations

A
  • yes and no questions
  • involve patient
  • explain who you are

Nurs 325 (6 decks)

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