Podcast
Questions and Answers
What is the main purpose of performing a tracheostomy?
What is the main purpose of performing a tracheostomy?
- To provide long-term airway management (correct)
- To enhance vocalization capabilities
- To increase lung capacity
- To prevent blood flow to the lungs
Which part of the tracheostomy tube is primarily responsible for maintaining the airway open?
Which part of the tracheostomy tube is primarily responsible for maintaining the airway open?
- Neck plate
- Outer cannula (correct)
- Inner cannula
- Obturator
What is the function of the obturator in a tracheostomy procedure?
What is the function of the obturator in a tracheostomy procedure?
- To assist in inserting the tracheostomy tube (correct)
- To secure the inner cannula in place
- To ensure comfort during the procedure
- To prevent mucus accumulation
Which of the following statements is incorrect regarding the cleaning of a tracheostomy?
Which of the following statements is incorrect regarding the cleaning of a tracheostomy?
How does a tracheostomy help in airway clearance?
How does a tracheostomy help in airway clearance?
What is a common occurrence for patients with new tracheostomy tubes within the first few days post-procedure?
What is a common occurrence for patients with new tracheostomy tubes within the first few days post-procedure?
What is one characteristic of pediatric tracheostomy tubes smaller than size 4?
What is one characteristic of pediatric tracheostomy tubes smaller than size 4?
Why are older adults more prone to skin breakdown with tracheostomy care?
Why are older adults more prone to skin breakdown with tracheostomy care?
What does Central Venous Pressure (CVP) reflect?
What does Central Venous Pressure (CVP) reflect?
Which of the following is a direct measurement obtained using a central venous catheter?
Which of the following is a direct measurement obtained using a central venous catheter?
What is a common insertion site for a central venous catheter due to its high success rate?
What is a common insertion site for a central venous catheter due to its high success rate?
Which of the following indicates that central venous pressure can be monitored?
Which of the following indicates that central venous pressure can be monitored?
When are routine tracheostomy tube changes typically performed after a tract has formed?
When are routine tracheostomy tube changes typically performed after a tract has formed?
What is a necessary item for closed continuous irrigation in addition to irrigation tubing?
What is a necessary item for closed continuous irrigation in addition to irrigation tubing?
Which item is used to temporarily occlude the catheter during irrigation?
Which item is used to temporarily occlude the catheter during irrigation?
If the irrigating solution does not flow freely during intermittent irrigation, which action should be taken first?
If the irrigating solution does not flow freely during intermittent irrigation, which action should be taken first?
What must be used to access a needleless port during irrigation?
What must be used to access a needleless port during irrigation?
What should be inspected in the drainage tubing if there is less output than the infused irrigation solution?
What should be inspected in the drainage tubing if there is less output than the infused irrigation solution?
Which option is NOT typically included in an open intermittent irrigation setup?
Which option is NOT typically included in an open intermittent irrigation setup?
In closed intermittent irrigation, what could indicate the need for further assessment?
In closed intermittent irrigation, what could indicate the need for further assessment?
What item is essential for both closed intermittent and continuous irrigation setups?
What item is essential for both closed intermittent and continuous irrigation setups?
What is one advantage of using brushless scrubbing for surgical hand hygiene?
What is one advantage of using brushless scrubbing for surgical hand hygiene?
Why is using a brush for surgical hand scrub discouraged?
Why is using a brush for surgical hand scrub discouraged?
What area of the sterile gown is considered sterile?
What area of the sterile gown is considered sterile?
When should a nurse don a sterile gown in relation to other protective gear?
When should a nurse don a sterile gown in relation to other protective gear?
What is the primary purpose of wearing a sterile gown?
What is the primary purpose of wearing a sterile gown?
In what type of situations would nurses wear sterile gowns?
In what type of situations would nurses wear sterile gowns?
What is a reason the circulating nurse typically does not wear a sterile gown?
What is a reason the circulating nurse typically does not wear a sterile gown?
Which areas of a sterile gown are not considered sterile?
Which areas of a sterile gown are not considered sterile?
Which type of compounds are primarily bacteriostatic and fungistatic?
Which type of compounds are primarily bacteriostatic and fungistatic?
What is the recommended scrub time according to AORN?
What is the recommended scrub time according to AORN?
Which compound is noted for having resistance against most strains of pseudomonas?
Which compound is noted for having resistance against most strains of pseudomonas?
What does AORN state about the use of a scrub brush for surgical hand scrubs?
What does AORN state about the use of a scrub brush for surgical hand scrubs?
Which QAC is commonly used as an antiseptic?
Which QAC is commonly used as an antiseptic?
Chloroxylenol has what characteristic compared to chlorhexidine?
Chloroxylenol has what characteristic compared to chlorhexidine?
Based on CDC recommendations, what is said about traditional 10-minute scrubs?
Based on CDC recommendations, what is said about traditional 10-minute scrubs?
Which compound has only fair activity against mycobacterium tuberculosis?
Which compound has only fair activity against mycobacterium tuberculosis?
Study Notes
Tracheostomy Overview
- A tracheostomy involves inserting a 51- to 76-mm (2- to 3-inch) tube into the trachea through the neck.
- It is essential for maintaining a patent airway in patients needing long-term management due to obstruction or extended intubation.
- Purposes include clearing mucus, preventing infection, promoting healing, enhancing comfort, and preventing displacement.
Parts of Tracheostomy Tube
- Outer Cannula: Encases the trachea; features a flange for securing around the neck.
- Inner Cannula: Fits within the outer tube, removable for cleaning, and has a locking mechanism to prevent displacement.
- Obturator: A guide for inserting the tube, ensuring smooth placement.
Patient Considerations
- Pediatric Patients: Shorter necks complicate stoma cleaning; tubes smaller than size 4 typically lack an inner cannula.
- Gerontologic Considerations: Older patients may have fragile skin, increasing risks of breakdown due to secretions or pressure.
Central Venous Pressure (CVP)
- CVP measures blood pressure in the thoracic vena cava and right atrium, indicating blood return and heart pumping ability.
- Acquired through a central venous catheter inserted into large veins.
CVP Indications
- Assessing right ventricular function, systemic fluid status, and rapid infusions.
- Administering hypertonic solutions and serial venous blood assessments.
Insertion Sites for CVP
- Internal Jugular Veins: Preferred for high success rates and lower complication risks.
Equipments for CVP Procedures
- Requires sterile solutions, gloves, irrigation syringes, and clamps to regulate flow rates.
Unexpected Outcomes in Irrigation
- Inspect for clots, sediment, and kinks.
- Notify healthcare providers if solutions do not return or if pain or distention occurs.
Quaternary Ammonium Compounds (QACs)
- Composed of nitrogen linked to four alkyl groups, effective as antiseptics, particularly alkyl benzalkonium chlorides.
- Primarily bacteriostatic but can be microbicidal at high concentrations.
Antiseptic Agents
- Triclosan: Inhibits various bacteria; however, resistance exists in some strains.
- Chloroxylenol: Less effective than chlorhexidine; not classified safe and effective by FDA due to insufficient data.
AORN and CDC Recommendations
- Scrub times of 3-4 minutes achieve acceptable germ reduction, eliminating the need for traditional 10-minute scrubs.
- Brushless scrubbing is advised to minimize skin damage.
Surgical Hand Scrubbing
- AORN discourages the use of brushes as it increases skin cell shedding and creates areas for bacterial growth.
- Only use brushes for nails and visibly soiled areas.
Gowning Protocol
- Sterile gowns shield against contamination in sterile fields.
- Gowns should be donned after masks and caps, and only specific areas of the gown are sterile.
Purpose of Sterile Gown
- To exclude skin contaminants and protect against cross-contamination during procedures.
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Description
This quiz covers the fundamental aspects of tracheostomy, including its purpose, maintenance of airway patency, and management of secretions. It is essential for healthcare professionals dealing with long-term airway management and patient care.
