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NR 324 ADULT HEALTH Week 2 Lab Prep

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John Marsh
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Chamberlain College of Nursing

NR 324 ADULT HEALTH

NR 324 Week 2 Lab Prep

Week 2- Lab Prep
1. Discuss 4 indications for a tracheostomy.
 Obstruction of the upper airway – i.e., foreign body, trauma, infection, facial
fractures.
 Impaired respiratory function – i.e., head trauma leading to unconsciousness.
 To assist weaning from ventilator support in patients in intensive care.
 To help clear secretions in the upper airway.
2. Your textbook discusses 4 types of tracheostomies. Please explain the characteristics
of each of the 4 types.
 Tracheostomy tube with cuff and pilot balloon- When properly inflated, lowpressure,
high-volume cuff distributes cuff pressure over large area, minimizing
pressure on tracheal wall.
 Fenestrated tracheostomy tube (Shiley, Portex) with cuff, inner cannula, and
decannulation plug- When non-fenestrated inner cannula is removed, cuff
deflated, and decannulation plug inserted, air flows around tube, through
fenestration in outer cannula, and up over vocal cords. Patient can then speak. A
fenestrated inner cannula can be used to facilitate cleaning.
 Speaking tracheostomy tube (Portex, National) with cuff, two external tubings-
Has two tubings, one leading to cuff and second to opening above the cuff. When
port is connected to air source, air flows out of opening and up over the vocal
cords, allowing speech with cuff inflated.
 Tracheostomy tube (Bivona Fome-Cuf) with foam-filled cuff- Cuff is filled with
plastic foam. Before insertion, cuff is deflated. After insertion, cuff can fill
passively with air. Pilot tubing is not capped, and no cuff pressure monitoring is
required.’

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NR 324 ADULT HEALTH Week 2 Lab Prep

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