NUR 333 ABSN > Tracheostomy > Flashcards

Tracheostomy Flashcards

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1
Q

Artificial airways can be ____ or ____

A

Emergent; non emergent

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2
Q

An emergent artificial airway is also called:

A

Non-planned

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3
Q

A non-emergent artificial airway is also called:

A

Planned

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4
Q

Example of planned artificial airways:

A

Someone had surgery for a tumor removal

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5
Q

Example of non planned artificial airway:

A

Respiratory distress

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6
Q

Endotracheal tubes are inserted via the

A

Mouth

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7
Q

Percutaneous tubes are inserted via

A

Trachea→ bypass the mouth and nose

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8
Q

Endotracheal (ET) tubes are used for someone _____

A

Being ventilated on a ventilator

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9
Q

Percutaneous tubes can be used for someone ____

A

Ventilated OR not ventilated

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10
Q

What is a stoma?

A

Surgically made opening

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11
Q

Tracheostomy tubes can be

A

Metal or plastic

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12
Q

When we remove a temporary trash, it is called _____

A

Decannulation

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13
Q

T/f: trach tubes can be permanent or temporary

A

True

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14
Q

Indications of a tracheostomy

A

Acute airway obstruction
Airway protection
Facilitate removal of secretions
Prolonged intubation

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15
Q

Prolonged intubation is considered:

A

7-10 days

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16
Q

Advantages of trachs:

A

Less damage to airway
More comfortable
Allowed to eat
Mobility is improved
Help come off ventilator

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17
Q

Mobility is improved with trachs because

A

Tube is more secure than oxygen mask

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18
Q

The two types of trachs are:

A

Shiley
Jackson

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19
Q

The Shiley is a ____ trach

A

Plastic

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20
Q

The Jackson is a ____ trach

A

Metal

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21
Q

Aspects of the Shirley trach:

A

Disposable inner cannula
Cuff *
Obturator

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22
Q

Aspects of the Jackson trach:

A

Reusable inner cannula
No cuff
Obturator

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23
Q

Purpose of obturator

A

Insert a trach → think guidewire

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24
Q

The Shiley trach is also referred to as:

A

Cuffed trach

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25
The purpose of the cuff is to _\_\_\_\_
Create a snug fit in trachea
26
The cuff on the trach helps to _\_\_\_\_
Prevent aspiration Help ventilator give stronger breaths
27
If a pt is on the ventilator, the cuff needs to be _\_\_\_\_
Inflated → don't want air leaking around it
28
On a med-surg floor, cuffs are usually _\_\_\_\_
Not inflated
29
Indications for inflated cuff
Patient is mechanically ventilated Specifically ordered by physician
30
When the cuff is inflated, it can become _\_\_\_\_ and cause _\_\_\_\_
Overinflated; damage
31
If you need to deflate the cuff, you should 1. _\_\_\_\_ , then 2. _\_\_\_\_ and lastly 3. _\_\_\_\_
1. Suction the mouth (oropharynx); 2. Deflate cuff; 3. Suction trachea after
32
Dangers of a prolonged or over-inflation of cuff
Increased mucosal pressure → ischemia; softening cartilage; mucosal erosion Fistula could also be created → tracheaesophageal fistula
33
What device can allow patients to speak with trach?
Passy-muir valve
34
When a passy-muir valve is being used, the cuff is _\_\_\_\_
Deflated
35
Contraindications of utilizing passy-muir valve:
Pt is in any kind of respiratory distress Pt is anxious
36
Utilizing a passy Muir valve requires _\_\_\_\_
OK from MD
37
When does tube dislodgement and accidental decannulation usually occur?
Pt is coughing Transition times
38
During assessment, you should ensure that the _\_\_\_\_ are intact to avoid decannulation
Ties
39
Things you should keep at bedside:
Obturator Extra trachs→ one smaller in size than what pt has, one same size as pt currently has Humidification Suction Extra inner cannula
40
Steps to reinsert a decannulated trach:
1. Keep obturator at bedside AAT 2. Insert obturator into outer cannula 3. Extend neck and open tissue; insert outer cannula/ obturator 4. Remove obturator immediately 5. Check bilateral breath sounds * assess pt* 6. Secure trach
41
Suctioning a trach is a _\_\_\_\_ procedure
Sterile
42
Nursing problems associated with pts who have tracks:
Ineffective airway clearance Impaired verbal communication Risk for infection Impaired swallowing Body image disturbance Anxiety
43
We also may want to consider _\_\_\_\_ as a nursing problem it it is a new trach
Pain→ new trachs can be tender & painful
44
What is the usual size of both Shiley and Jackson trachs?
6 or 8
45
What aspects are included in a trach assessment?
Kind of trach Size of trach Cuff inflated or deflated Pt complaining of discomfort or not Is pt oxygenating appropriately? Respiratory assessment → what does pt sound like? -
46
How often is trach care usually done?
q 12 hours
47
We suction pts to prevent _\_\_\_\_
Hypoxemia
48
Define hypoxemia
Abnormally low concentration of oxygen in the blood
49
By preventing hypoxemia, we lead to prevent the prevention of _\_\_\_\_
Hypoxia
50
Define hypoxia
Deficiency in the amount of oxygen reaching tissues
51
If a trach tube has a hole in the tube, it is considered to be a _\_\_\_\_
Fenestrated tube
52
When is a fenestrated tube indicated?
Pt trying to wean off the ventilator May be able to speak Let air flow in and out of vocal cords
53
If a trach tube doesn't have a hole in it, it is considered to be a _\_\_\_\_
Non- fenestrated tube
54
When is a non- fenestrated tube indicated?
Very very ill pts are ventilated → need all of the forced air
55
Cuffed trachs are indicated for pts who _\_\_\_\_
Pts who need to have aspiration precautions Ventilator pts Potential to aspirate
56
Uncuffed trachs are indicated for pts who are _\_\_\_\_
Not on ventilator No issue w/swallowing Can cough & speak normally
57
Shirley trachs are meant for _\_\_\_\_ use
Temporary
58
Jackson trachs are meant for _\_\_\_\_ use
Long term/permanent
59
Things that need to be kept at bedside:
Obturator Oxygen + humidification Flow meter Xmas tree Suction Extra trachs Ambu bag w/ adapter Spare inner cannula
60
When caring for a pt w/ a trach it is important to establish _\_\_\_\_
Some form of communication
61
Communication forms when caring for a patient w/ tract:
Hand signals Picture boards Pad & paper
62
Patients with trachs still need _\_\_\_\_
Oral care → toothettes! They can still swish & spit
63
64
When putting lip moisturizer on a pt w/ a trach, you need to make sure the moisturizer is _\_\_\_\_
Water soluble
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