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A client who has had a laryngectomy and tracheostomy frequently expectorates copious amounts of purulent secretions. When changing the ties of the tracheostomy tube, which action is most important for the nurse to take?

A.

Secure tracheostomy ties by making knots close to the tube.

B.

Remove ties to secure a disposable, soft foam collar with hook and loop fastener.

C.

Leave the old ties in place until the new ones are secure.

D.

Place knots of the ties laterally to prevent irritation and pressure.

Answer and Explanation

The Correct Answer is C

Choice A rationale

 

Securing tracheostomy ties by making knots close to the tube can cause irritation and pressure on the skin.

 

Choice B rationale

 

Removing ties to secure a disposable, soft foam collar with hook and loop fastener is not the most important action when changing the ties of the tracheostomy tube.

 

Choice C rationale

 

Leaving the old ties in place until the new ones are secure is the most important action to prevent accidental dislodgement of the tracheostomy tube.

 

Choice D rationale

 

Placing knots of the ties laterally to prevent irritation and pressure is important but not the most critical action when changing the ties of the tracheostomy tube.


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View Related questions

Correct Answer is C

Explanation

Choice A rationale

Increasing the frequency of dressing changes may not be necessary and could potentially disrupt the healing process. The type of dressing used is more important for managing the wound.

Choice B rationale

Leaving the dressing off until consulting with the healthcare provider is not recommended as it can expose the wound to infection and delay healing.

Choice C rationale

Applying a hydrocolloidal gel dressing is appropriate for a stage 3 pressure injury with significant granulation. Hydrocolloidal dressings provide a moist environment that promotes healing and protects the wound from contamination.

Choice D rationale

Replacing the gauze with a transparent dressing may not provide the necessary moisture and protection for a stage 3 pressure injury. Hydrocolloidal dressings are more suitable for this type of wound.

Correct Answer is C

Explanation

Choice A rationale

Advising the client that it is too late to receive an influenza vaccination once symptoms occur is correct, but it does not address the client’s question about oseltamivir.

Choice B rationale

Explaining that antibiotics are not useful in treating viral infections is correct, but it does not address the client’s question about oseltamivir.

Choice C rationale

Referring the client to the healthcare provider to obtain a medication prescription is the most appropriate response. Oseltamivir is an antiviral medication that can be effective if started within 48 hours of symptom onset.

Choice D rationale

Instructing the client that over-the-counter medications are sufficient to manage influenza symptoms is not appropriate, as oseltamivir can help reduce the severity and duration of the illness if taken early.

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