Tracheostomy And Airway Care - NCLEX-PN

Deflate cuff only if ordered/appropriate; consider speaking valve when eligible. Allows airflow over vocal cords for phonation while ensuring safety in eligible patients.

Encourage coughing and provide adequate hydration and humidification. Facilitates natural expulsion of secretions and maintains thin mucus consistency to avoid plugs.

To prevent thick secretions and mucus plugging. Compensates for bypassed upper airways, which normally warm and moisten air, to keep secretions thin.

Tracheal pain or pressure injury signs with no air leak at low volume. Excess pressure causes mucosal damage despite effective sealing, necessitating deflation or adjustment.

Inflatable cuff. Seals the trachea to protect against aspiration of secretions and enables effective delivery of ventilated air under pressure.

To maintain a patent airway via a surgical opening in the trachea. Bypasses upper airway obstructions or facilitates long-term mechanical ventilation by creating a direct tracheal access point.

Remove the valve immediately to prevent airway obstruction. Inflated cuff blocks exhalation, causing pressure buildup and potential barotrauma.

Clean with sterile technique and keep the area dry with a sterile dressing. Removes debris and bacteria while protecting the site to promote healing and prevent infection.

Maintain minimal occlusive volume/pressure to prevent leak. Ensures adequate seal for ventilation while minimizing tracheal ischemia and necrosis risks.

Hyperinflate cuff and apply direct pressure; call rapid response. Temporarily controls massive bleeding by compressing the artery while summoning emergency support.

High Fowler position ($90^\circ$) with swallowing precautions as ordered. Upright positioning uses gravity to aid swallowing and minimize reflux into the airway.

Secure with space for one finger between tie and neck. Balances secure tube placement with prevention of skin breakdown or circulatory compromise.

Increased work of breathing with decreased airflow through the tube. Indicates partial or complete blockage impeding normal ventilation through the artificial airway.

Call for help and ventilate with bag-mask; do not blindly reinsert. Immature tract risks false passage with blind reinsertion, so prioritize alternative ventilation and expert assistance.

Obturator and spare tubes (same size and one smaller), plus suction setup. Ensures immediate availability for emergencies like dislodgement or obstruction to maintain airway patency.

To guide safe insertion by providing a rounded leading edge. Reduces trauma to tracheal tissues by providing a smooth, blunt tip during tube placement.

Inner cannula (if present). Allows easy removal of secretions and debris to prevent obstruction without replacing the entire tube.

Report subcutaneous emphysema to the provider promptly. Indicates potential tracheal perforation or air leak requiring immediate medical evaluation to prevent complications.

Assess airway patency and suction the tracheostomy. Addresses potential mucus plugs or obstructions as the most immediate cause of acute distress in fresh tracheostomies.

Apply suction only on withdrawal. Prevents tracheal wall trauma and atelectasis that could occur from suction during insertion.

Preoxygenate before suctioning. Increases oxygen reserves to compensate for the temporary removal of air during suctioning.

Hemorrhage (possible tracheo-innominate fistula). Suggests arterial erosion, a life-threatening emergency needing urgent intervention.

No longer than $10$ to $15$ seconds per pass. Limits hypoxia and mucosal trauma by minimizing oxygen deprivation during the procedure.

Remove and replace the inner cannula; reassess patency. Clearing potential blockages in the removable inner component restores patency without dislodging the outer tube.