Conditions that increase the risk for spontaneous tube ...

[maychende]

Conditions that increase the risk for spontaneous tube dislocation include which of the following? (Select all that apply.)
 
  a. Retching/vomiting
  b. Nasotracheal suction
  c. Coughing
  d. Cyanosis

Question 2

A patient with a tracheostomy tube has thick, tenacious mucus that is difficult to remove. The nurse should choose which technique to suction the airway?
 
  a. Normal saline instillation (NSI) before suctioning
  b. Dry suctioning 1 time followed by NSI with suctioning 2 more times
  c. Dry suctioning as long as the heart rate is above 60 beats/min
  d. Dry suctioning

[stanleka1]

Answer to Question 1

A, B, C
Conditions that increase the risk for spontaneous tube dislocation include retching/vomiting, nasotracheal suction, and severe bouts of coughing. Cyanosis may be an indicator of displacement but is not a cause.

Answer to Question 2

D
Normal saline instillation (NSI) into artificial airways is no longer recommended as standard practice. Clinical studies show that suctioning with or without NSI produces similar amounts of secretions and significant decreases in oxygen saturation. Potential side effects include increases in heart rate for 4 to 5 minutes after suctioning using NSI as opposed to dry suctioning. NSI has the potential to increase ventilator-associated pneumonia because bacteria from the upper airway can be dislodged to the lower airway.

[maychende]

Thank you

[stanleka1]

Happy to help you