Question

The student nurse is observing the staff nurse perform routine tracheostomy care. Which of the following actions, if made by the staff nurse, would be inappropriate?

A) The nurse removes the soiled tracheostomy ties, cleans the flange, and applies new tracheostomy ties, securing them tightly behind the patient's neck.
B) The nurse oxygenates the patient, suctions the tracheostomy tube, and removes the soiled tracheostomy dressing before removing gloves.
C) The nurse cleans around the tracheostomy faceplate and stoma with hydrogen peroxide, then rinses with normal saline-saturated gauze and cotton-tipped applicators.
D) The nurse removes the inner cannula and places it in a sterile basin of hydrogen peroxide to soak.

Answer 1

Securing the tracheostomy ties tightly behind the patient's neck is the inappropriate action, as it could harm the patient. The correct method is to secure the ties snugly while allowing room for one to two fingers.

Step-by-step explanation:

When observing the staff nurse perform routine tracheostomy care, it is critical to identify any inappropriate actions. In this scenario, the inappropriate action would be option A). The nurse should not secure the tracheostomy ties tightly behind the patient's neck as this can lead to discomfort, restricted airflow, and potentially harm the patient. Instead, the ties should be snug enough to allow for one to two fingers to fit under the tie, ensuring proper fit and patient safety. Options B, C, and D describe appropriate steps in tracheostomy care that involve suctioning the tube, cleaning the area with proper solutions and maintaining inner cannula hygiene.