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Foundations Final Exam > Tracheostomy Care & Suctioning > Flashcards

Tracheostomy Care & Suctioning Flashcards

1
Q

Tracheostomy

A
  • Long-term airway support

- Opening for tube itself

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2
Q

Tracheostomy Tube

A

Tube inserted to extend through stoma into trachea

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3
Q

Health teaching

A

Encourage pt to clear airway by coughing

Stress importance of adequate hydration

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4
Q

What position should a pt assume?

A

Semi/high fowler’s

Promote lung expansion

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5
Q

Cotton lint/fibres

A

From gauze

May be aspirated, causing a tracheal abscess

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6
Q

Post care assessment

A
  • Character/amount of secretions
  • Drainage form tracheostomy
  • Incision
  • Hr and resp status, compared w baseline
  • Complaints of pain/discomfort
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7
Q

What size syringe is used

A

10 ml

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8
Q

Why do you use minimal occlusive pressure when inflating cuff?

A

Prevent pressure on tracheal tissue

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9
Q

How do you measure appropriate tracheal cuff pressure?

A
  • Stethoscope, auscultate at suprasternal notch for hissing

- If voice audible, occlusion is inadequate

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10
Q

When to perform Suctioning

A

PRN

resp distress/SOB/Coughing/Low O2

Cyanosis

Crackles

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11
Q

Complications of suctioning

A
  • Worsening respiratory status
  • Bloody secretions
  • Coughing
  • No secretions
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12
Q

Techniques to minimize complications

A
  • Hyperinflation

- Hyperoxygenation

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13
Q

How long to perform suctioning

A

10-15 sec

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14
Q

If client has copious secretions:

A

Increase O2 delivery prior to beginning

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15
Q

When is suctioning necessary

A

When pt is unable to cough and clear respiratory tract secretions

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16
Q

When is oropharyngeal/nasopharyngeal suctioning used

A

When pt is able to cough but unable to clear secretions by expectorating or swallowing

After pt coughs

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17
Q

When is orotracheal/nasotracheal suctioning required?

A

The pt is unable to manage secretions by coughing and does not have an artificial airway

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18
Q

Why is a nasal insertion preferred?

A

Gag reflex is minimal

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19
Q

Tracheal suctioning

A

Accomplished through an artificial airway

20
Q

Increase amount of secretions picked up by…

A

Rotating suction tube

21
Q

When inserting suction tube:

A

Occlude tube, DO NOT suction

22
Q

When is an artificial airway required?

A

With pts with a decreased level of consciousness or airway obstruction

Aid in removal pf secretions

23
Q

How is an oral airway measured?

A

Distance from corner of mouth to angle of jaw just below ear

24
Q

If oral airway too large

A

Force tongue toward epiglottis

obstruct

25
Q

If oral airway to small:

A

Tongue is not held in anterior mouth

26
Q

Endotracheal tube

A

Short-term artificial airway

Mechanical ventilation, relieve upper airway obstruction

Protect against aspiration

clear secretions

27
Q

Maintenance/promotion of lung expansion: Ambulation

A

Immobility -> atelectasis and ventilator-associated pneumonia

28
Q

Maintenance/promotion of lung expansion: Positioning

A

Frequent changes prevent atelectasis

45 degreee semi-fowlers

good lung down

pulmonary abcess = bad lung down

29
Q

Incentive spirometry

A

Encouraging voluntary deep breathing by providing visual feedback to pts about inspiratory volume

prevent atelectasis

30
Q

Chest tube

A

Remove air/fluids from pleural space, prevent it from reentering pleural space, reestablish normal pressures

inserted through thorax

31
Q

Pneumothorax

A

Collection of air in pleural space

Loss of intrapleural pressure

Collapsed lung

Sharp pain

32
Q

Hemothorax

A

Accumulation of blood and fluid in pleural cavity between visceral and parietal

Prevents full expansion

33
Q

Possible affects of oxygen

A

Atelectasis or oxygen toxicity

34
Q

Low flow devices

A

Nasal cannulas, simple face masks, reservior masks

Concentrations that vary w patients respiratory pattern

35
Q

High flow devices

A

Deliver O2 above normal inspiratory rates

Venturi mask

36
Q

Nasal cannula

A

up to 6l/min

37
Q

4L/min

A

Not often used, drying on mucosa

If used **Humidifier

Skin breakdown

38
Q

Partial rebreather

A

40-70%

max 10L/min

39
Q

Non-rebreather

A

60-80%

10L/min

40
Q

Venturi mask

A

24-60%

4-12L/min

41
Q

What is an example of effective planning for emergency care for a pt with a tracheostomy

A

Keep an obturator and trach tube at bedside

42
Q

Technique for trach ties

A

Square knot

ensure 2 fingers fit snugly underneath

43
Q

How to ensure catheter us working

A

Suction a small amount of sterile water

44
Q

When providing suctioning for a pt with a mask…

A

keep oxygen mask near face during procedure

45
Q

How do you evaluate effectiveness?

A

Compare pre and post suctioning data

46
Q

What do you do if a pt begins to gag/complains of nausea?

A

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Foundations Final Exam (5 decks)

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