The preceptor is working with a new nurse to provide care for a ...

[Mr3Hunna]

The preceptor is working with a new nurse to provide care for a patient with a new tracheostomy.
 
  Which actions by the new nurse indicate need for additional teaching about the procedure? (Select all that apply.)
  a.
  The outer cannula is cleaned with the brush and half-strength H2O2.
  b.
  The new tracheostomy holder is secured before the old soiled one is removed.
  c.
  A Yankauer suction catheter is used to remove secretions from the patient's mouth.
  d.
  Sterile gloves are applied before the soiled dressing is removed from the tracheostomy.
  e.
  Half-strength H2O2 is used to remove crusted secretions around the tracheostomy site.
  f.
  Pain medication is administered to the patient prior to suctioning.

Question 2

The preceptor is working with a new nurse to suction a patient through his new tracheostomy. Which actions by the new nurse indicate need for additional teaching about the procedure? (Select all that apply.)
 
  a. The suction is not applied to the catheter until it is being withdrawn.
  b. The patient is placed in the supine position prior to suctioning.
  c. The suction catheter is twirled side to side as it is being withdrawn.
  d. Suction is applied continuously as the catheter is withdrawn.
  e. The patient's oxygen is reapplied between suction attempts.
  f.
  Water-soluble lubricant is applied to the suction catheter before insertion.

[covalentbond]

Answer to Question 1

ANS: A, D, E
Only the inner cannula of the tracheostomy is removed for cleaning. The outer cannula stays in the trachea to maintain airway patency. Clean gloves are applied before the soiled dressing is removed. Half-strength H2O2 is used to remove secretions that have built up on the inner cannula. Sterile saline should be used to clean the patient's skin as needed.

Answer to Question 2

ANS: B, D, F
The head of the patient's bed should be elevated prior to suctioning to facilitate coughing out secretions. Suction is always applied intermittently as the catheter is withdrawn. Water-soluble lubricant is used when suctioning the naris but not a tracheostomy because the secretions negate the need for additional lubrication.

[Mr3Hunna]

Gracias!

[shailee]

Excellent