A nurse is performing tracheostomy care for a patient with a tracheostomy tube (TT). Which action should the nurse include in the procedure?

Choice A rationale:

Limiting the suctioning time to 15 seconds may still be too long for some patients, increasing the risk of hypoxia and other complications related to prolonged suctioning. The optimal suctioning time should be shorter to minimize adverse effects.

Choice B rationale:

Limiting the suctioning time to 20 seconds is longer than the recommended duration. Prolonged suctioning can cause hypoxia, increased intracranial pressure, and other adverse effects, making it crucial to keep the time as short as possible.

Choice C rationale:

Suctioning time should generally be limited to 10 seconds to reduce the risk of complications while effectively clearing the patient's airway. This duration allows for adequate removal of secretions without causing significant disturbances to the patient's oxygenation and hemodynamic stability.

Choice D rationale:

Limiting the suctioning time to 5 seconds is too short to effectively clear secretions from the airway, especially in patients with excessive or tenacious secretions. Sufficient time is needed to ensure proper removal of respiratory secretions and maintain the patient's airway patency.

Choice A rationale:

Cleaning the inner cannula once a week is insufficient to maintain proper hygiene for a patient with a tracheostomy tube. The inner cannula should be cleaned more frequently, as directed by the healthcare provider, to prevent the accumulation of secretions and potential respiratory complications.

Choice B rationale:

Deflating the cuff before cleaning the tracheostomy tube is not recommended because it may lead to aspiration of secretions or loss of the airway seal. The cuff should only be deflated when it is necessary to remove or change the tracheostomy tube.

Choice C rationale:

Using cotton-tipped applicators to clean the stoma is not the recommended method for tracheostomy care. Sterile tracheostomy care kits usually include specialized brushes or swabs designed for this purpose, ensuring effective and safe cleaning of the stoma without the risk of shedding fibers or causing injury.

Choice D rationale:

Changing the tracheostomy ties every 24 hours is the appropriate action. Regular changing of the ties helps prevent complications such as skin breakdown, ensures a secure fit of the tracheostomy tube, and reduces the risk of infection.