24 Questions
What should the nurse do if a client with a tracheostomy tube in place has food particles noted during suctioning?
Measure and compare cuff pressures
Why would a nurse need to palpate the skin of the upper chest of a client with subcutaneous emphysema?
To detect air leaks around the tracheostomy
What can air leaking into the tissues surrounding a tracheostomy lead to?
Emphysema
If a client with a tracheostomy is unstable, what action should the nurse take?
Call the Rapid Response Team
What could be a consequence of constant pressure from a tracheostomy tube cuff?
Tracheomalacia
Why is it essential for the nurse to monitor cuff pressures in a client with a tracheostomy tube?
To monitor for tracheomalacia
What is the most appropriate action for a student to take when tying a tracheostomy tie?
Tying the knot at the side of the client's neck
Which action by a student when suctioning a tracheostomy demonstrates the need for more teaching?
Applying suction while inserting the catheter
Which action is appropriate for cleansing a tracheostomy site?
Using half-strength peroxide for cleansing
When should a nurse suction a client with a tracheostomy?
Suctioning should be performed only when secretions are present
What is the purpose of preoxygenating a client prior to suctioning a tracheostomy?
To reduce the risk of the client experiencing respiratory distress during the suctioning procedure
What is the recommended duration for suctioning a client's tracheostomy?
Suctioning should be performed for 10 to 15 seconds each time
What is the priority action for the nurse when a client with a tracheostomy experiences a coughing spell during a meal?
Assess the client's lung sounds
What should be considered by the nurse after assessing a client who experienced a coughing spell during a meal?
Consult with the registered dietitian regarding thickened liquids
What should an unlicensed assistive personnel (UAP) have done immediately after a client with a tracheostomy experienced a coughing spell during a meal?
Reported the incident immediately
What action should the nurse take if a UAP fails to report a client's coughing spell during a meal?
Educate the UAP on reporting procedures
After addressing a client's immediate oxygenation needs post-coughing spell, what should be the nurse's next step?
Consult with other healthcare team members as needed
What is a key aspect that a student nurse providing tracheostomy care should ensure when changing ties?
Securing the device properly during tie changes
What action should the nurse take if the client with a tracheostomy begins to hemorrhage?
Notify the provider and apply pressure at the bleeding site
What is the recommended nursing action if a client has a tracheainnominate artery fistula?
Prepare the client for surgery
What is a crucial nursing intervention for a client with a new tracheostomy experiencing Impaired Self-Esteem?
Promote social activities like joining a book club outside the home
Why does the nurse ask someone else to notify the provider when a client may have a tracheainnominate artery fistula?
To ensure accurate information is relayed to the provider
Which finding would be most concerning in a client with a new tracheostomy?
Family members assisting with stoma care
How should a nurse respond if a client with a new tracheostomy experiences skin irritation around the stoma?
Increase the frequency of stoma care
Test your knowledge on assessing a client with a tracheostomy for subcutaneous emphysema. Learn when to palpate the skin of the upper chest and when to call the Rapid Response Team. Understand the importance of assessing oxygen saturation and indicators of oxygenation.
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