NURSING RESPONSIBILITIES AND MANAGEMENT FOR TRACHEOSTOMY

Nursing Responsibilities Rationale

Pre-operative Care
Check the doctors order for tracheostomy To verify and to avoid error.

surgery.
Inform the patient and significant others about the To increase awareness about the

procedure and its rationale, the reasons why it is procedure and to gain cooperation.

ordered, how it will be done and the stinging

sensation that may be felt.

Secure for an operative consent To protect the client and health
professional from legal action.

Notify OR and anesthesiologist For preparation.

Instruct the client to have NPO post-midnight This is ordered to prevent vomiting

before the procedure. and aspiration of food particles and

fluids in case the patients level of

consciousness is altered.
Accomplish the pre-op checklist To prepare the client for surgical
procedure
Prepare client psychologically To promote client peace of mind and
lessen anxiety felt

Give preoperative teaching to the client such as To help client anticipate her next
how to perform deep breathing and coughing activity after surgery
exercises, active ROM, and early ambulation.
Post-operative Care
Secure patient with side rails and stay with the Secure patient with side rails and stay
client with the client
Monitor vital signs every 15 minutes for the 1 st For immediate management
hour after operation until stable.

Administer medications as ordered. To alleviate post op pain and control

infections.
Observe for profuse bleeding at the operative site For immediate management of any
deviation that may occur

After the vital signs are stable, position patient to To facilitate ventilation, promote
semi fowlers position. drainage, minimize edema, and
prevent strain on the suture lines.
The newly made opening must be kept patent by To provide adequate airway.
proper suctioning of secretions.
If the patient will go home with tracheostomy To gain cooperation and to prevent
tube, instruct the patient and family about proper further infection and complication.
suctioning and daily care including techniques to
prevent infection.