Question

a hargesh y c Crca Thining C w B aosoem oe defa Whe ee top Your Patient: ng sa M.D. age 65, admitted to your floor 3 days ago, after surgical insertion of n tracheoatomy tube. Prior to surgery, diagnosis was Acute upper airway obstruction, Has saline lock to left forearm. Currently, Oxygen is flowing via his tracheostomy at 40% , with Pulse oximeter Readings consistently in the low 90's, He quickly becomes short of breath, when his Oxygen is interrupted during suctioning. During your shift, you need to suction M.C. as needed, and provide routine tracheostomy care. In addition, you will need to transport him with portable oxygen to Radiology for his AP & Lateral chest X-ray. Current Orders: AP & Lateral chest X-ray Pulse oximetry every shift and PRN Oxygen via trach Venturi mask at 40% Tracheostomy care every shift and PRN Tracheal suctioning PRN Medication or IV lock, flush every shift Morphine Sulfate 2 to 6 mg, IV q2h PRN for pain Questions: uhes How would you determine with M.D.needs to be suctioned? expected outcomes when suctioning and providing tracheostomy care? What are How would you determine when M.D. needs to have Tracheostomy care? When transporting M.D. to the radiology department, what precautions should you implement to ensure his safety?

Answer 1

The following things can determine when MD needs suctioning

• When there is mucus or secretion in the trach opening
• Patient is agitative,aggressive,different facial grimace
• Rattling or coarse crakle on auscultstion indicates secretion
• When patient is unable to breath
• Patient unable to cough
• A decrease initial volume
• A fall in oxygen saturation
• Respiratory distress

The expected outcome when doing a suctioning and tracheostomy care are

• a fall in oxygen saturation
• Patient turning aggressive or uncooperative
• Dislodgement are possible
• Chance of injury and bleeding

The need of tracheostomy care can be determined When

• It is soiled ,contaminated ,or wet with secretion
• once a day in the morning during morning care

The precautions which has to be done in this case are

• Continious supply of oxygen ,when shifting to radiology department connect with the metal resistant oxygen cylinder available in the department
• Connect the patient to monitor (to assess The TPR,BP,SPo2 continuously)
• Remove any metals from the patient body