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31 Cards in this Set
- Front
- Back
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TRACHEOSTOMY: SUCTIONING & PROVIDING CARE – NOTES/ POSSIBLE TQ
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X
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Suction typically set at?
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80-120 mmMg
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When inserting a trach tube, what is the location called where the trach. branches off to the bronchi?
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Carina
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Define: Hypoxia
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↓ in oxygen to the tissue
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Early signs of hypoxia?
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mental status change & restlessness
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Other signs of hypoxia?
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- dyspnea
-↑ BP -dysrhythmias -diaphoresis -tachycardia -tachypnea -cyanosis – late sign |
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Put Hypoxia, Cyanosis & Hypoxemia in order of manifestation?
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Hypoxemia (↓ O2 in blood) → Hypoxia (↓ O2 in tissues) → Cyanosis
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Best way to see amount of O2 in blood?
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ABG (arterial blood gas)
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What do the probes on a Pulse Oximetry sense? Why is this important?
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hemoglobin molecules – need good blood perfusion for a reading.
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Things to do if getting a low O2 reading?
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sit up, cough, deep breath, change location of meter (check cap refill on site)
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Interventions for Prevention of Respiratory Complications?
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-Cough & Deep breathing
-Incentive Spirometer -Turning & Ambulation -proper positioning -patient education |
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Pt teaching on using an incentive spirometer?
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- inhale slowly (like through a straw)
- keep it between the arrows - hold breath 3-5 seconds (keeps alveoli open – prevents atelectasis) - remove mouth from spirometer & exhale slowly through pursed lips |
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Teaching deep breathing exercises:
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- pt upright
- pt put hand over ribs (women) or abdomen (men) - exhale completely - inhale slowly & deeply through nose - hold breath 3-5 seconds - exhale through pursed lips over 7 – 10 seconds - repeat 3 – 10 times every 1-2 hours |
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Types of Oxygen Therapy equipment?
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- Nasal cannula (high-flow NC)
- Face Masks - face tent -simple mask -venturi mask (venti mask) - partial re-breather mask (PRB) - non re-breather mask (NRB) - trach collar |
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Difference between a partial re-breather and a non-rebreather?
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PRB has one valve missing while a NRB has 2 valves.
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What % or O2 is Room Air (RA)?
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21%
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Which type of face mask is best for COPD pts?
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Venturi Mask – so they don’t over oxygenate and stop breathing.
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What might lethargy be a sign of in relation to O2 or CO2 levels?
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↑ CO2 levels
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Precautions with O2 therapy?
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-no smoking
- inspect electrical equipment around O2 source - no wool blankets (can cause a spark) - routine inspections of O2 equipment - Pts w/ COPD should not receive high O2 flow rates |
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Ways to manage secretions?
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- sit forward
- proper coughing: - after deep breathing, cough twice (from the diaphragm) during exhalation - chest physiotherapy (cup hands & percuss chest – esp. w/ CF kids) - suction (Oropharengeal, nasopharengeal, & nasotracheal) |
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Why might someone need an artificial Oropharangeal airway?
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- after surgery until gain consciousness or if tongue clear of the airway
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Why might you use a Nasal airway?
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can suction frequently w/o trauma to nasal passageway (because it stays in place)
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Position for Oropharyngeal suctioning?
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semi-fowlers
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How many times can you repeat suctioning on a tracheostomy?
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up to 3 times, if needed
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How long to wait between suction attempts on a trach.?
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30 – 60 seconds
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Why must use 4 x 4 in kit designed w/ cut out notch, instead of cutting one ourselves?
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cutting one ourselves creates frayed edges w/ fibers that can cause infection if inhaled.
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Precautions to take in case trach becomes dislodged?
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- spare trach and obturator at bedside at all times
- one smaller trach and one same size trach |
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What would be noticed during assessment if pt had subcutaneous emphysema?
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crepitus
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Is there a time when crepitus might be expected?
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with a chest tube
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What would cause subcutaneous emphysema?
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misplaced trach
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Precautions to prevent infection?
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- oral care
- VAP protocol (ventilati on assessment pneumonia) - HOB > 30 degrees |
