The nurse is documenting the completion of tracheostomy suctioning and tracheostomy care in a client's medical record.What should this documentation include?
(Select all that apply)
A)Lung sounds before and after suctioning
B)Characteristics of suctioned sputum
C)Integrity of the skin around the stoma
D)Side on which the tracheostomy tie knot is located
E)Flow rate of oxygen

Question

Quizplus · Accepted Answer

The documentation of tracheostomy suctioning and care should include lung sounds before and after suctioning to assess the effectiveness of the procedure and any changes in the patient's respiratory status. Characteristics of suctioned sputum (such as color, consistency, and amount) provide important information about the patient's respiratory health and potential infections. The integrity of the skin around the stoma is crucial to monitor for any signs of infection or breakdown. The flow rate of oxygen is also important to document, as it indicates the level of respiratory support the patient is receiving. The side on which the tracheostomy tie knot is located is not clinically significant for documentation purposes.

The Nurse Is Documenting the Completion of Tracheostomy Suctioning and Tracheostomy