Pre Test: Tracheostomy care

1. Vigorous coughing caused my manipulation of the tube or coughing can result in what?

Accidental decanulation

A safe stable airway

Prior and in between passess

Vigorous coughing can cause accidental decanulation, which refers to the unintentional removal or displacement of a tube that is inserted into the body, such as a tracheostomy tube or an endotracheal tube. When a tube is accidentally decanulated, it can lead to a loss of a safe and stable airway, potentially causing respiratory distress or other complications. Therefore, the correct answer is accidental decanulation.

Explanation

Vigorous coughing can cause accidental decanulation, which refers to the unintentional removal or displacement of a tube that is inserted into the body, such as a tracheostomy tube or an endotracheal tube. When a tube is accidentally decanulated, it can lead to a loss of a safe and stable airway, potentially causing respiratory distress or other complications. Therefore, the correct answer is accidental decanulation.

2. The nurse is performing tracheal suctioning. Which action is essential to prevent hypoxemia during suctioning?

Removal of oral and nasal secretions.

Encouraging the client to deep breath and cough.

Administer 100% oxygen before suctioning.

Auscultate the lungs.

100% oxygen is given before and after suctioning to prevent hypoxemia.

Explanation

100% oxygen is given before and after suctioning to prevent hypoxemia.

3. What is the normal tracheostomy cuff pressure?

30-40 mmhg

20-25 mmHg

15-20 mmHg

40-55 mmHG

The normal tracheostomy cuff pressure is 20-25 mmHg. This pressure range is considered optimal for maintaining an adequate seal around the tracheostomy tube, preventing air leakage and minimizing the risk of aspiration. Higher cuff pressures can lead to tracheal mucosal damage, while lower pressures may result in inadequate sealing and airway complications. Therefore, maintaining a cuff pressure within the normal range is crucial for patient safety and effective ventilation.

Explanation

The normal tracheostomy cuff pressure is 20-25 mmHg. This pressure range is considered optimal for maintaining an adequate seal around the tracheostomy tube, preventing air leakage and minimizing the risk of aspiration. Higher cuff pressures can lead to tracheal mucosal damage, while lower pressures may result in inadequate sealing and airway complications. Therefore, maintaining a cuff pressure within the normal range is crucial for patient safety and effective ventilation.

4. What is the maximum diameter of suction catheter you will use to perform tracheostomy suctioning?

1/3 of the diameter of the trach.

1 to 2 cm in diameter.

No larger than 1/2 diameter of artificial airway d/t atelectasis risk

The maximum diameter of the suction catheter used for tracheostomy suctioning should not be larger than 1/2 the diameter of the artificial airway. This is because using a larger diameter catheter can increase the risk of atelectasis, which is the collapse of the lung tissue. A smaller catheter diameter allows for effective suctioning without causing damage or complications.

Explanation

The maximum diameter of the suction catheter used for tracheostomy suctioning should not be larger than 1/2 the diameter of the artificial airway. This is because using a larger diameter catheter can increase the risk of atelectasis, which is the collapse of the lung tissue. A smaller catheter diameter allows for effective suctioning without causing damage or complications.

5. A senior nurse is supervising a newly hired nurse who is performing tracheostomy care for a client. Which of the following actions by the student should the nurse intervene?

Removing the inner cannula and cleaning using universal precaution.

Suctioning the tracheostomy tube before performing tracheostomy care.

Changing the old tracheotomy ties and securing the tube in place.

Replacing the inner cannula and cleaning the site of the stoma.

When performing tracheostomy care, a sterile field is set up and sterile technique is required. Standard precautions such as washing hands must also be maintained but are not enough when performing tracheostomy care. The presence of tracheostomy tube provides direct access to the lungs for organisms, so sterile technique is used to prevent infection.

Explanation

When performing tracheostomy care, a sterile field is set up and sterile technique is required. Standard precautions such as washing hands must also be maintained but are not enough when performing tracheostomy care. The presence of tracheostomy tube provides direct access to the lungs for organisms, so sterile technique is used to prevent infection.