Select all the appropriate steps a nurse should take during tracheostomy care.

Choice A rationale:

This choice is not the most relevant information for the patient with a tracheostomy regarding communication methods. Effective oral communication with the tube in place may be challenging, and other options should be explored.

Choice B rationale:

While electronic devices can be helpful for communication, they may not be the most practical option for a patient with a tracheostomy, especially during emergencies when devices may not be readily available.

Choice C rationale:

This choice is somewhat relevant but not the most appropriate. While written communication is an option, it may not be the primary method used with a tracheostomy.

Choice D rationale:

This is the correct choice. Teaching the patient how to use speaking valves to facilitate speech with the tracheostomy tube in place can significantly improve communication. Speaking valves allow airflow during inhalation and redirect exhaled air through the vocal cords, enabling speech while maintaining a closed respiratory system during exhalation. This is a valuable communication method for patients with tracheostomies.

Choice A rationale:

Placing the patient in a prone position (Choice A) would not be suitable for suctioning a tracheostomy tube as it may impede breathing and proper access to the tracheostomy site.

Choice B rationale:

Placing the patient in a supine position (Choice B) is not the optimal position for tracheostomy suctioning. Semi-Fowler's position is preferred as it allows better lung expansion and facilitates the suctioning procedure.

Choice D rationale:

Placing the patient in Trendelenburg position (Choice D) is not appropriate for tracheostomy suctioning. Trendelenburg position is typically used for certain cardiovascular conditions and not for tracheostomy care.