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Upper Respiratory ProblemsMedical Surgical Nursing

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How large should a suction catheter for a tracheostomy be?
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No more than 1/2 the lumen of the trach tube
What should suction pressure be when suctioning a tracheostomy?
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-120 to -150 mm Hg with the tubing occluded
How is a suction system tested prior to use on a patient with a tracheostomy?
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Suctioning water through the catheter
________ should be provided to the patient immediately prior to suctioning.
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Oxygenation through a ventilator, reservoir equipped resusucitation bag, or if they are capable, asking the patient to take 3-4 deep breaths
When should suction be applied while suctioning a tracheostomy, during insertion or withdrawal?
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It should be intermittently applied while slowly withdrawing and rotating the catheter.
When, if ever, should continuous suctioning be applied while suctioning a tracheostomy?
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If there is a large amount of secretions
What is the longest length of time sunctioning can be applied?
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10 seconds
When should suctioning of a tracheostomy be immediately discontinued?
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-if the heart rate decreases from baseline by 20 BPM -if it increases by 40 bpm -if a dysrhythmia occurs -if SpO2 decreases below 90%
What should be done in between suctioning passes of a tracheostomy?
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Reoxygenation with 3-4 breaths using a ventilator, MRB or deep breathing Rinse the catheter with sterile water
Once tracheostomy suctioning is complete, the cathether should be rinsed and the ______ should be suctioned.
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Oropharynx
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How is a catheter used for tracheostomy sunctioning disposed?
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Wrapping it around the gloved hand and pulling the glove over it. Place it in the proper waste container
What should be recorded after tracheostomy suctioning?
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Time, amount, character of secretions, patient response to suctioning
T/F Adequate humidification may cause secretions not to accumulate around the inner cannula of a tracheostomy, allowing for one not to be used at all.
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True
When should cuffed tracheostomy tubes be used?
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When the patient is on mechanical ventilation or is at risk for aspiration
What happens if a tracheostomy cuff pressure is too high?
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Tracheal capillaries are compressed limiting blood flow and predisposing the patient to tracheal necrosis
Why do some patients have their tracheal cuffs periodically deflated?
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To remove secretions that build up above the cuff
A cuff should be inflated during ________ and deflated during _________.
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INflated during INspiration Deflated during expiration
What should be done prior to deflating a tracheostomy cuff?
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-ask the patient to cough up whatever secretions they can -suction the tube and the patient's mouth -remove as they exhale
When should a cuffless tracheostomy tube be used?
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If a patient can protect the airway from aspiration and doesn't require mechanical ventilation
T/F The first tracheostomy tube change can only be done by the physician.
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True, they usually change it around 7 days after insertion
T/F After a tracheostomy tube has been inserted, the nurse should keep another one bedside that is the same size in case an emergency reinsertion is required.
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True
  
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