The nurse is preparing discharge instructions for a school-age child with a tracheostomy. On what should the nurse focus when teaching the parents about the child's care needs at home? (Select all that apply.)
A) Performing tracheostomy care
B) Comfort level with suctioning procedure
C) Eliminate the use of room freshener sprays to reduce tracheal irritation
D) Importance of encouraging independence in the child as soon as possible
E) Obtaining a spare tracheostomy tube and inserter in the event of accidental removal
A, B, C, E
Feedback:
The nurse should ensure that the parents are comfortable performing tracheostomy care and suctioning. The parents need to understand the need to eliminate sprays that could irritate the child's tracheal mucosa and to have a spare tracheostomy tube and inserter available in the event the current device is accidentally removed. The child needs to be monitored for adequate oxygenation, safety when eating, and activity tolerance. Encouraging independence might need to be postponed until the child's respiratory status stabilizes.
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