Nurse 220 Exam 2 Study Guide Solved Update

Nurse 220 Exam 2 Study Guide Solved Update Tracheotomy - ANS-surgical incision in the trachea stoma or opening in trachea tracheostomy purpose - ANS-airway management, provide patent airway Upper airway obstruction Removal of secretions Long-term mechanical ventilation Prevent aspiration What illness or conditions might require a tracheostomy? - ANS-you're unable to cough properly because of long-term pain, muscle weakness or paralysis. you have a serious lung infection, such as pneumonia Types of trach tubes - ANS-▪Cuffed or uncuffed ▪Fenestrated - precut opening, allows air to pass thru vocal cords ▪Disposable inner cannula ▪Different sizes (diameter & length) ▪Metal, polyvinyl chloride (PVC), silicon Pediatric Considerations - ANS-Pediatric sized trach tubes No cuff No inner cannulas Prevent damage of trachea Provide warm humidified oxygen to prevent mucus plugs Less suction pressure Suction 5 seconds Suction catheter ½ size of trach tube Obturator - ANS-kept at bedside for emergency use if tube is dislodged it is used to insert replacement After trach tube in place must remove the obturator Tracheostomy Tube Cuff purpose: - ANS-prevent aspiration & prevent the escape of air from mechanical ventilator Trach Inflating the cuff - ANS-10 ml syringe connected to pilot balloon Pressure: 20 - 25 mmHg Nursing Assessment - ANS-▪Respiratory- airway patent, breath sounds, O2 sat respiratory rate, depth & pattern, secretions (amount, color, consistency), HR, work of breathing ▪Skin ▪ Communication ▪ Anxiety ▪Knowledge level/teaching needs Signs of airway obstruction: - ANS-Tachypnea Restlessness Increase WOB, use of accessory muscles Wheezing, crackles, gurgling, Decreased O2 sat, hypoxia Copious secretions Tachycardia, cardiac dysrhythmias Color change Late signs of distress: decreased LOC, cyanosis, change in VS Tracheostomy Care - ANS-▪Explain procedure to patient ▪Wear goggles or face mask and gloves ▪Position patient HOB elevated ▪Gather supplies ▪Have suction available and working ▪Keep extra tracheostomy tube at bedside ▪Assess before & after suctioning Suctioning side effects - ANS-•Hypoxia • Forceful Coughing • Tachycardia • Dysrhythmias • Increased ICP Oral Hygiene - ANS-▪Saliva collects or pools in back of throat ▪Suction oral secretions before deflating cuff ▪Helps to prevent pneumonia by reducing oral bacteria ▪Use soft toothbrush & paste or toothette & Chlorhexidine mouth wash if available CONTINUES...