Which statement by a patient with a new tracheostomy indicates a need for further teaching?

Correct Answer: C

Rationale: Rationale for Choice C (correct answer): Suctioning a tracheostomy every 2 hours is excessive and can lead to mucosal trauma, infection, and compromised airway. Suctioning should be done only when necessary to maintain airway patency. Cleaning around the stoma, replacing soiled ties, and humidifying the air are all important aspects of tracheostomy care. Suctioning every 2 hours is not routine practice and can be harmful.

Correct Answer: A

Rationale: The correct answer is A: Perform tracheal suctioning. When a patient with a tracheostomy is unable to clear secretions, suctioning is necessary to remove the accumulated secretions and maintain a clear airway. This prevents potential complications such as airway obstruction and respiratory distress. Administering a mucolytic (B) may help loosen secretions but does not address the immediate need for clearing them. Encouraging the patient to cough forcefully (C) may not be effective if the secretions are too thick or if the patient is unable to cough effectively. Increasing fluid intake (D) may help in thinning secretions but will not address the immediate need for clearing them.

Correct Answer: B

Rationale: The correct answer is B: Increase the patient's fluid intake. Thick pulmonary secretions can be effectively thinned out by increasing hydration, making it easier for the patient to clear the secretions through coughing and expectoration. This intervention helps to improve lung function and prevent complications such as respiratory infections. Postural drainage and percussion (Choice A) are interventions for mobilizing secretions in specific lung segments but may not address the underlying issue of thick secretions. Administering bronchodilators (Choice C) is appropriate for conditions like asthma or COPD but not directly for thick secretions. Encouraging the use of a peak flow meter (Choice D) is helpful for monitoring lung function but does not directly address the thickness of pulmonary secretions.

Correct Answer: B

Rationale: The correct first action is to assess oxygen saturation (Choice B) to determine the patient's respiratory status. This step is crucial in identifying if the patient is hypoxic, which could be life-threatening. Encouraging deep breathing (Choice A) may worsen dyspnea if there is an underlying respiratory compromise. Notifying the healthcare provider (Choice C) should come after assessing the oxygen saturation. Positioning the patient in high Fowler's (Choice D) may provide comfort but does not address the immediate need to assess oxygen saturation for appropriate intervention.

Correct Answer: A

Rationale: The correct answer is A: Oxygen saturation of 85% on room air. A low oxygen saturation level indicates hypoxemia, which can be life-threatening in patients with COPD. Immediate intervention is needed to improve oxygenation. Option B is related to barrel chest, common in COPD but not an immediate concern. Option C indicates an infection which may require treatment but not immediate intervention. Option D is within normal range and does not indicate an urgent need for intervention.