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Upper Respiratory ProblemsMedical Surgical Nursing

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Question Answer
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
How soon after a tracheostomy should the tapes be changed?
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No sooner than 24 hours after the procedure
T/F If a tracheostomy tube is displaced, the nurse should immediately attempt to replace it.
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True
A replacement tracheostomy tube is lubricated with saline poured over the tip and inserted in the stoma at a _____ degree angle.
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45 degree
What should a nurse do if his patient is experiencing mild dyspnea after the patient's tracheostomy tube has become dislodged and cannot be replaced?
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Elevate the bed to a semi-Fowler's position until assistance arrives
What should a nurse do if his patient is experiencing severe dyspnea after the patient's tracheostomy tube has become dislodged and cannot be replaced?
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Cover the stoma with a sterile dressing and ventilate the patient with a bag mask until help arrives Note: this shouldn't be done if the patient has had a total laryngectomy and has had a complete separation between the trachea and upper airway
How often should a tracheostomy tube be changed after the first tube change?
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Once a month
Why do patients get humidifed air immediately after a tracheostomy?
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To compensate for the loss of the upper airway warming and mositurizing secretions
T/F When performing tracheostomy care, you should wear gloves and goggles.
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True
Where should tracheal retention sutures be taped after cleaning the stoma during trach care?
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Above and below the stoma
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How much room should be between tracheal ties and the patient's skin?
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Enough room for one finger to slide in between
How often, at a minimum, should trach care be performed?
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At least three times a day, and as needed for secretions
T/F You should not cut gauze to fit if used for collecting drainage around a tracheostomy tube.
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True, the frayed threads may be inhaled or wrap around the tube
Why should tracheostomy tube dressings be changed frequently?
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Wet dressings promote infection and stoma irritation
How does an inflated tracheostomy cuff increase the risk of developing a swallowing dysfunction?
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It interferes with normal function of the muscles that are used to swallow
The risk for aspiration for a client with a tracheostomy should be assessed with the cuff inflated or deflated?
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Deflated
T/F Neither of the methods used to assess for aspiration risk in patients with tracheostomies is 100% accurate.
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True (blue dye test is subjective, the glucose test gets false positives from blood tinged mucus )
Trachebronchial secretions are tested for the presence of glucose to gauge the aspiration risk of a patient with a tracheostomy. The results indicate a high glucose content. Is this a normal finding?
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No, usually mucus has low glucose content. It can be a false positive if the mucus is blood tinged
What is the optimal patient bed positioning to alleviate dyspnea?
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Elevate the head of the bed to 30-40 degrees
What are the main reasons for wanting a patient's airway free of secretions?
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TO maintain a patent airway and to prevent aspiration
What interventions can be used for a patient who is unable to speak due to a tracheostomy?
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Encourage written and nonverbal comunication techniques with others, listen attentively, use a picture board
  
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