The nurse admits a client who received a tracheostomy today. Which should the nurse implement for tracheostomy care without assistance?

Question

1. Cleanse the inside of the outer cannula with saline solution.
2. Rinse inner cannula with hydrogen peroxide and saline solution.
3. Suction oropharynx after thoroughly cleaning the tracheostomy.
4. Remove the old tracheostomy ties prior to applying new ones.

Answer 1

2
2. The nurse removes the inner cannula of the tracheostomy tube, cleans it in hydro-gen peroxide, and rinses it in normal saline solution before reinserting it into the outer cannula. Cleaning removes surface debris to maintain patency and to reduce the transmission of microorganisms into the lower respiratory tract because the tra-cheostomy bypasses a normal, protecting, filtering mechanism of the respiratory sys-tem.
1. The nurse cleans the outside of the outer cannula at the stoma.
3. The nurse suctions the oropharynx before tracheostomy care to prevent client coughing during the procedure because secretions accumulate on the cuff. The nurse wants to remove the secretions to prevent coughing and to prevent client aspiration of secretions during accidental dislodgement of the tracheostomy.
4. The nurse applies new tracheostomy ties before removing the old ties when work-ing unassisted. With assistance, the nurse instructs the nurse assistant to hold the tra-cheostomy in place while the nurse removes the old tie and replaces it with fresh twill tape.