When providing discharge instructions for the family and patient with a tracheostomy, which statement indicates the caregiver understands the instructions?
1. "He cannot resume normal activities as long as he has the tracheostomy in place."
2. "I will clean the site under the tracheostomy plate with half-strength hydrogen peroxide at least twice daily."
3. "I can suction the trachea as often as necessary to decrease secretions coming from the tube."
4. "When he is ready for decannulation, I will bring him back in to have the stoma sutured closed."
2
Rationale 1: The goal for patients discharged with a tracheostomy is to resume activities as normally as possible.
Rationale 2: Cleaning the site around the tube and under the plate will help keep secretions from irritating the skin in and around the stoma.
Rationale 3: Suctioning the trachea should be done only when absolutely necessary to prevent tracheal irritation and mucosal breakdown.
Rationale 4: The stoma is allowed to close naturally when the patient is ready for decannulation; it is never sutured closed.
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