A client who experienced respiratory distress had a tracheostomy performed 2 hours ago. The nurse must use which of these approaches when caring for the tracheostomy?
a. clean technique
b. sterile technique
c. clean technique to remove the cannula and sterile technique to suction it
d. client self-care technique
B
During the acute phase after a tracheostomy has been performed, all care must be performed using sterile technique.
You might also like to view...
What assessment findings should lead the nurse to suspect Down syndrome in a newborn?
a. Hypertonia and dark skin b. Low-set ears and a simian crease c. Inner epicanthal folds and a high, domed forehead d. Long, thin fingers and excessive hair
The nurse is caring for a patient receiving hemodialysis treatments and who has an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this patient?
A) Using a stethoscope for auscultating the fistula is contraindicated. B) The patient feels best immediately after the dialysis treatment. C) Taking a blood pressure reading on the affected arm can cause clotting of the fistula. D) The patient shouldn't feel pain during initiation of dialysis.
A committee of musculoskeletal care nurses has been meeting to formulate policy changes regarding the proper method for providing pin site care to best minimize the client's risk for infection
Based on the current research findings, the nurses come to the conclusion that: 1. Chlorhexidine 2 mg/mL solution is the cleanser of choice. 2. The critical period for infection control measures is up to 48 hours out from pin insertion. 3. Pins located in areas of considerable soft tissue are at least risk for infection. 4. Hydrogen peroxide is an acceptable choice of skin cleanser.
A nurse is teaching a patient about self breast examination. What would the nurse emphasize? (Mark all that apply.)
A) Inspection B) Pain C) Timing D) Palpation E) Pallor