Tracheostomy Flashcards
(24 cards)
What is a tracheotomy?
Surgical opening in 2nd and 3rd tracheal rings
Pediatric patients have a _____ lumen. Adult patients have a ______ lumen.
Single. Double.
What is the purpose of a cuffed trach?
Allows for mechanical ventilation and protects airway because there is no movement past the cuff.
Indications for trachs?
Obstruction, edema, suctioning route, long-term mechanical ventilation, respiratory nerve damage
What is our post-op care for tracheas?
Promote patency and humidification. Patient will be on optiflow or humidified oxygen system.
How tight are the trach ties around a peds neck? Adult neck?
1 finger. 2 fingers.
What position should someone with a trach be in?
Semi-fowlers.
Do all patients need hyperoxygenation before suctioning? For how long?
Yes. 30-60 seconds.
How do we know when patients need suctioning?
Coughing, gurgling noises, PRN suction orders, SpO2 is low.
For how long do we need to do sterile technique with suctioning/cleaning of trach?
48 hours
How long is each pass of suctioning trachs?
10 seconds
How many times can we use the same suction catheter without having to get a new one?
3 times
How long are we allowing our patients to rest between suctions? What should we do during these rest periods?
60 seconds. Apply trach cuff.
Why is it important to assess a patient’s hydration status?
Less hydrated = stickier secretions.
Patient’s are unable to do what in regards to elimination? What do we do about this?
Bear down. Stool softeners, mobilize, hydrate.
Why do we use narcotics cautiously with trach patients?
Resp. depression and constipation.
How often are we monitoring the cuff pressure? What can excessive cuff pressure lead to?
q 8 hr. Tissue necrosis.
Granulation tissue can form on the vocal cords, epiglottis, or trachea due to improper inflation of the trachea cuff?
True
What do we do in the event of accidental removal of trachea tube? If you can’t get new trachea?
Dilators, new trach with obturator and then put in new cannula. Call code and get RT there STAT.
What emergency equipment do we need on our trachea carts?
Dilator, 2 spare trachs (one smaller), BVM, suction ON/oxygen ON, green adaptor nipple (what you plug oxygen into), obturator
What are risks of trachea suctioning?
Hypoxia, cardiac dysrhythmias, laryngealspasm, and bradycardia (due to stimulation of vagus).
Why are people with tracheostomy tubes more susceptible to infection?
Warming and filtering action of nose and pharynx are bypassed.
What are assessments that need to be done on a patient with a newly established tracheostomy?
Respiratory, VS (espeically SpO2), the trachea itself, peristomal skin, hydration status, safety equipment/emergency cart, anxiety, pain, communication.
What are important post-op nursing interventions for someone with a newly established trach?
Deep breathing/coughing, suctioning PRN, cleaning PRN, HOB elevated, encourage family to stay with patient/you stay with patient as much as possible.
