Question 1

tracheostomy is

Accepted Answer

a type of artificial airway consisting of a small, plastic tube that’s inserted through a surgically created opening, or stoma, in the anterior neck

Question 2

patients with a tracheostomy typically have a short tube that protrudes from the anterior of their neck, which is usually stabilized

Accepted Answer

with a flange and ties that encircle the neck

Question 3

Many tracheostomy tubes have an outer cannula, which keeps the airway patent, and an

Accepted Answer

inner cannula, which can be disposable or non-disposable and is removed for cleaning.

Question 4

tubes can be cuffed,

Accepted Answer

- meaning there is a balloon that can be inflated to provide a leak-proof connection
- short term use because they occlude upper trachea and phaynx
- pressure can compress tracheal capillaries causing necrosis

Question 5

uncuffed tubes

Accepted Answer

- no balloon (less risk to surrounding tissue)
- long term use

Question 6

tubes can also be fenestrated

Accepted Answer

with a hole in dorsal surface or unfenestrated

Question 7

When patients have a cuffed, fenestrated tracheostomy tube, the cuff can be deflated and inner cannula removed. This allows air

Accepted Answer

to pass from their lungs through the opening in the tube, enabling them to breathe spontaneously and speak.

Question 8

a Passey-Muir valve, or PMV, is a one-way valve placed on the end of their tracheostomy, that allows them to

Accepted Answer

speak by redirecting exhaled air through the vocal cords, rather than back through the tube.

Question 9

With a Passey-Muir valve in place, the cuff should be fully deflated, or patient will not be

Accepted Answer

able to fully exhale.

Question 10

To promote oxygenation with a tracheostomy, make sure your patient is

Accepted Answer

receiving humidified air. Humidification not only warms and moisturizes secretions, but it helps thin secretions and decreases the formation of mucus plugs.

Question 11

if your patient’s tracheostomy tube requires suctioning, be sure to always use

Accepted Answer

-sterile technique
- observe the amount, color, and clarity of secretions, as well as how well they tolerate suctioning

Question 12

perform tracheostomy care to

Accepted Answer

prevent infection and promote comfort

Question 13

assess the tracheostomy site and confirm patency of the tracheostomy every shift, observing the site for any

Accepted Answer

redness, inflammation, edema, ulceration, or signs of infection. Notify the health care provider immediately if any of these signs are present

Question 14

To perform tracheostomy care, perform sterile dressing change by:

Accepted Answer

- remove the old dressing / ties
- clean around the stoma with NS
- apply a sterile pre-cut dressing around the tracheostomy site
- secure the trach ties.
(due to the risk of tube dislodgement have another staff member in the room to assist)

Question 15

For patient who has a non-disposable inner cannula, remove the cannula using sterile technique and

Accepted Answer

cleanse it with sterile saline, then reinsert the cannula

Question 16

Because an inflated tracheostomy cuff exerts pressure on the tracheal mucosa, cuff pressure should be

Accepted Answer

measured at least every 8 hours with a cuff manometer

Question 17

a replacement tube of equal size and one size smaller should always be kept at the bedside, in case the original tube is

Accepted Answer

unable to be re-inserted.

Question 18

If dislodgement of trachea tube occurs

Accepted Answer

stay at the bedside, immediately call for help. While waiting for help, assess your patient’s ability to breathe and their LOC. If respiratory distress is present, and if it’s within the facility policy, you can insert a new tracheostomy tube.

Question 19

If a dislodged trachea tube cannot be replaced, you should immediately place the patient in

Accepted Answer

a semi-Fowler position to decrease dyspnea and the stoma should be covered with a sterile dressing. Then you should initiate bag-valve mask ventilation over their nose and mouth until help arrives.

Question 20

When caring for a patient with a tracheostomy, emergency equipment should always be kept at the bedside, including a

Accepted Answer

bag valve mask, suctioning equipment, obturator, and a replacement tube in an equal and smaller size.

Question 21

avoid suctioning a tracheostomy in the first few hours after the procedure because

Accepted Answer

it can be painful and cause bleeding.

Question 22

The inner cannula of a tracheostomy tube allows

Accepted Answer

for frequent cleaning without the need to change the entire tracheostomy tube, minimizing patient discomfort and it helps prevent the main tube from becoming blocked with secretions or debris.

Question 23

humidified air

Accepted Answer

warms and moisturizes secretions
thins secretions
decreases formation of mucous plugs

Question 24

to complete sterile dressing changes (use two nurses)

Accepted Answer

1. remove old dressing and ties
2. clean around stoma with NS
3. apply sterile pre-cut dressing
4. secure ties
(for disposable)
5. remove inner cannula (if disposable)
6 insert new one using sterile technique

(for non-disposable)
5. remove inner cannula using sterile technique
6. cleanse w/sterile saline
7. insert cannula using sterile technique

112-T2 Osmosis

112-T2 Osmosis Videos - Tracheostomy

"Know" box contains:
Time elapsed:
Retries: