Preparation for tracheostomy care in the acute care environment ...

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Preparation for tracheostomy care in the acute care environment includes:
 
  A. Using clean technique, gloves, and supplies
  B. Placing the client in high-Fowler's position
  C. Removing and cleaning the outer cannula
  D. Preparing cotton applicators with normal saline and hydrogen peroxide

Question 2

A critical point in performing ET tube care is:
 
  A. Leaving sufficient slack in the tape
  B. Holding the tube firmly in place at all times
  C. Suctioning the client after care is provided
  D. Removing the oral airway if the client is biting on the ET tube

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Answer to Question 1

D
D. Open two cotton-tipped swab packages, and pour normal saline on one package and hydrogen peroxide on the other.
A. Open sterile tracheostomy kit. Apply gloves. Keep dominant hand sterile throughout procedure.
B. Assist client to position comfortable for both nurse and client (usually supine or semi-Fowler's).
C. While touching only the outer aspect of the tube, remove the inner cannula with nondominant hand. Drop inner cannula into hydrogen peroxide basin.

Answer to Question 2

B
B. Instruct helper to apply pair of gloves and hold ET tube firmly at client's lips or nares. Do not allow helper to hold the tube away from the lips or nares. Doing so allows too much play in the tube and increases the risk of tube movement and incidental extubation. Never let go of the ET tube, even for a moment.
A. The tube must be secure so that the position of the tube remains at the correct depth. The tube can be secured without being tight and causing pressure.
C. Administer endotracheal, nasopharyngeal, and oropharyngeal suction (see Skills 24-1 and 24-2. before cleaning around tube, oral cavity, or dressing site.
D. Do not remove oral airway if client is actively biting ET tube. Wait until tape is partially or completely secured to ET tube.