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19 Cards in this Set

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Weaning pt from a trach. include?
Gradual decrease in tube size
Who is responsible for this process?
MD. nurse practitioner, respiratory advanced-practice nurse
What criteria have to met by pat to qualify to be weaned?
Manage secretions
Do not need mechanical ventilation
How will pt receive oygen while while weanining is taking place?
Will be allowed to breath through a tube and through upper airways
How is the process of weaning done. List steps.
First, cuff is deflated, tube is Changed to an uncuffed size. If tolerated,the size is gradually decreased. Small tube(fenestra) tube is placed ,the tube is capped, all air pass through upper air wy and fenestra, none through tube.
What assessmnt is required for weaning.
Pt tolerate more than 24 hours of capping. Assess for adequate airflow around the tube when it is capped
What other device isused for the transition from tracheostomy to natural breathing?
Tracheostomy buttom
How does the tracheostomy button work?
The button maintains stoma patency and assista spotaneous breathing.
* They mus fit properly to work
What are two types of Tracheosomy button?
Kstner tube and Olympic
What are the disadvantage of the tracheostomy buttom
Possibility of decannulation, the tube candislodge from the trahea but remain in the neck tissues
Discharge plans for trach pt.
Able to provide tracheostomy care, nutritional care,suctioning,metods of communication
When doe education begin for the trach patient?
Before surgery, most self care is taght it the hospital
How to determing taching method effetive?
Review airway care, including cleanng, and inspecting for s/s of infection. Teach clean suction techique
What intsructions should be given to the patient?
Use shower shield over trach when bathing;cover airway with cotton or foam to protect during the day.
Addtional instructions:
Covering the permanent open filters the air entering the stoma, keep humidity in the airway , and enhances appearance
Additional instructions:
Inrease humidity at home;istill NS into artificial airway 10 to 15 times aday,as prescribed. Continue usingmethod of communication used in hospital and wear medicl alert bracelet(cannot speak)
Speech and commucation for a pt. with a trach.
Pt can peak with a cuffless trach; not with a cuff
* Use a writing table, magic slate, communication flah cards, cmmucation board with pictures and letters,hand signals, or computer
Speech ad communication:
Move pt. closr by nurses station,mark the central call ligt system to indicate that he/she cannot speak
What is a major stressor for the pt wth trach.
The inability to speak helping communication is a important nursing function.