Tracheostomy Care Practice Questions with Answers and NCLEX® Review

Introduction to Tracheostomy Care & Suctioning

The tracheostomy is an opening in the neck that allows air to pass into and out of the lungs. A tube is inserted into this opening to provide air passage.

Tracheostomy suctioning involves removing mucus or other substances that have been collected in the trachea that can cause obstruction in conditions such as pneumonia.

Tracheostomy suctioning is used for clients who need emergency relief from excess secretions in the airway. Tracheotomy tubes are placed in the client’s throat and connected to an external suction source, such as a vacuum pump or a reservoir bag containing saline water.

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It is important for nurses to be able to competently perform tracheostomy care and suctioning on clients who have been placed on a ventilator or intubated. Nursing care includes suctioning the client, cleaning the skin around the stoma, dressing changes, suctioning providing oral hygiene, and assessing for complications. 

This also includes maintaining equipment that helps administer oxygen to these clients, such as oxygen masks, and nasal cannulas. As a nurse, you must be aware of potential complications that may occur during these procedures, such as bleeding and infection.

Risks of Tracheostomy Suctioning

Tracheostomy suctioning is a common nursing procedure that has both risks and benefits.

One of the biggest risks of tracheostomy suctioning is the possibility of airway obstruction. This can be caused by mucus, secretions, or even blood clots in the trachea. If this happens, the client could lose consciousness or even die.

Another risk associated with tracheostomy suctioning is infection. This results from inadequate cleaning and suctioning, decreased airflow, damage to the trachea during surgery, and inappropriate management of the tracheostomy. 

In addition to causing pain and discomfort for clients, this will also lead to complications such as pneumonia and respiratory failure. This is due to a lack of oxygen reaching the lungs because of blockages caused by scarring from surgery scars pressing against them.

Tracheostomy Suctioning (How-To)

Tracheostomy suctioning is an important skill to have as a nurse to help care for clients with respiratory emergencies. This process can be difficult and uncomfortable for clients, so it’s important to help your clients feel as comfortable as possible during this procedure.

Here are the steps to perform tracheostomy suctioning: 

1. Ensure that your client has a tracheostomy tube. Check the tube for signs of infection, and replace it if necessary.
2. Get supplies together.
3. Wash your hands thoroughly.
4. Put on your sterile gloves and eye shield (or mask) until you’ve finished the procedure.
5. Locate the tracheostomy site on your client’s neck. It will be located between their collarbone and Adam’s apple.
6. With your dominant hand, hold up one side of the skin flaps on either side of the tracheostomy site so that they are pulled back away from your client’s neck so that you can see inside their throat. 
7. With your other hand, use a catheter tip syringe (or whatever other suctioning device you have) to gently squeeze out any secretions or mucus from inside their throat until nothing comes out. 
8. Gently wash the area around their tracheostomy tube with cool water. Then apply antibiotic ointment to any possible cuts or abrasions in that area.
9. Remove the catheter tip syringe and replace it with a new one for continued suctioning as needed.
10. Have your client sit up in bed facing forward with their head turned slightly away from you and place a pillow behind them, so they’re leaning back slightly on it. 

Tracheostomy Care Nursing Interventions

• Clean and dress the affected wound area.
• Change the trach tube as needed.
• Monitor the ETT and its insertion site.
• Educate clients and family members about how to care for the tracheostomy.

Tracheostomy Care Conclusion

Tracheostomy is a surgical procedure that creates a new opening in the trachea, or windpipe. It’s used for people who can’t breathe through their mouth and nose because of chronic obstructive pulmonary disease (COPD), severe asthma, trauma, or other conditions.

Tracheostomy suctioning is performed to prevent the build-up of secretions in the trachea and lungs. It involves clearing away mucus with a suction catheter that has been inserted into the tracheostomy tube.

The procedure is typically performed every four hours while the client is awake and every two hours while they’re asleep. Suctioning can also be done on an as needed (PRN) basis.

Sources

https://www.hopkinsmedicine.org/tracheostomy/living/suctioning.html 

https://my.clevelandclinic.org/health/articles/4673-tracheal-suction-guidelines