What are the responsibilities of a nurse to the patient with a tracheostomy tube?
This information will help you care for your tracheostomy. Show
About Your TracheaYour trachea (windpipe) is part of your respiratory system. It’s about 4½ inches (11 centimeters) long and is at the front of your neck (see Figure 1). It runs from your larynx (voice box) to your lungs. Figure 1. Placement of the tracheostomy tube When you breathe, air travels from your nose or mouth into your larynx, through your trachea, and into your lungs. This path is called your airway. Back to topAbout Your TracheostomyA tracheostomy is a surgical opening in your trachea. It makes breathing easier and protects your airway from being blocked. You may need a tracheostomy if:
Your tracheostomy may be temporary or permanent. Your doctor will talk with you about how long you’ll need it. About your tracheostomy tubeA tracheostomy tube is a hollow tube that’s put in your tracheostomy to keep it from closing. Once you have a tracheostomy, you’ll need to wear a tracheostomy tube all the time. A tracheostomy tube has 3 parts (see Figure 2):
Figure 2. Inner and outer cannulas Communicating with a tracheostomyWhile you have a tracheostomy, you won’t be able to speak like usual. Many people can speak by covering the opening in their tracheostomy tube with a finger. Your nurse will teach you how to do this. They’ll also give you a pen and paper to help you communicate. Protect your airway at all times while you have a tracheostomy.
It’s also important to use a humidifier while you have a tracheostomy, especially at night. This will help keep your secretions loose so they don’t clog your tracheostomy tube. Caring for Your TracheostomyWhile you’re in the hospital, your nurse will teach you how to care for your tracheostomy. You’ll learn how to:
If you’re discharged from the hospital with your tracheostomy, you’ll care for it at home. You’ll get the supplies you need before you’re discharged from the hospital. You may also have a nurse visit you at home to help. Your healthcare team will plan these things with you. You can use the following instructions to help you remember how to care for your tracheostomy. How to suction your tracheostomy tubeYour nurse will tell you how often to do this.
Repeat these steps if you feel you have more secretions that need to be cleared out. If you need to repeat the suctioning more than 2 or 3 times, rest for a few minutes before starting again. Once you’re done:
While you’re at home, change the suction catheter once a week or more often if it’s dirty or clogged. If you’re in the hospital, use a new one each time. Clean the suction machine’s canister with soap and water as needed. How to change the inner cannula and clean your skin around your tracheostomyRemove and inspect your inner cannula regularly, at least 3 times a day. Change it 2 times per day: once in the morning and once at night. If you see secretions building up inside, change it sooner. Try not to change your inner cannula more than 2 times per day. If you do, you might run out. If you regularly need to change your inner cannula more often than 2 times per day, call your healthcare team to tell them.
If you’ll have your tracheostomy for a longer time, your healthcare provider will change your whole tracheostomy tube (inner cannula, outer cannula, and tracheostomy ties) during your office visits. Don’t remove your tracheostomy tube’s outer cannula on your own. You may not be able to put it back into your trachea. Don’t change your tracheostomy ties until your doctor tells you it’s safe to do so. How to moisturize the air you breatheUse a humidifier to moisten the air you breathe. If you want or need more moisture, you can place a moist piece of gauze in front of your tracheostomy tube. This will help filter, moisturize, and warm the air you breathe in.
Removing Your Tracheostomy TubeYour doctor will remove your tracheostomy tube when you no longer need it. You won’t feel any pain when it’s taken out. You won’t need to have surgery, and the opening will close on its own. You won’t need stitches. Before your tracheostomy tube is removed, you’ll put a cap over your inner cannula. The cap will block your tracheostomy so you breathe normally. You’ll leave the cap in place for at least 24 hours. If you’re able to breathe normally with it in place, your doctor will remove your tracheostomy tube and put a dressing (bandage) over your tracheostomy site.
Important Points
What is the priority in nursing a patient with a tracheostomy?Nursing care plan goals and objectives for a client who had undergone tracheostomy include maintaining a patent airway through proper suctioning of secretions, providing an alternative means of communication, providing information on tracheostomy care, and preventing the occurrence of infection.
When suctioning a patient with a tracheostomy tube the nurse should?Tips on Tracheostomy Suctioning
Always wear gloves when suctioning so that germs and infections are not transferred. Never suction for lengths of time longer than 5 or 10 seconds. Use saline solution in the trach to loosen secretions and make the suction process easier.
Which actions will the nurse include when doing tracheostomy care select all that apply?Guide the catheter into the tracheostomy tube using a sterile-gloved hand. 2. Prepare by turning suction on to between 80 and 120 mm Hg pressure. 3.. Verify that an inner cannula is in place.. Change the tracheostomy tube every week.. Clean the tracheostomy once a day.. Verify that a low-pressure cuff is in place.. |