A nurse is planning to change a client’s tracheostomy ties. Which of the following actions should the nurse take?
A.
Use a quick-release knot to secure the ties.
B.
Cut the old ties after the new ties are secured.
C.
Allow space for three fingers under the ties when securing.
D.
Extend the client’s neck while securing the ties
The Correct Answer and Explanation is:
The correct answer is B. Cut the old ties after the new ties are secured.
Explanation:
When changing a client’s tracheostomy ties, the primary goal is to ensure that the tracheostomy tube remains securely in place throughout the procedure, reducing the risk of accidental dislodgement and maintaining the patient’s airway.
1. Cut the old ties after the new ties are secured (B): This is the recommended practice when changing tracheostomy ties. First, the nurse should secure the new ties before cutting the old ones. This approach ensures that the tracheostomy tube is consistently held in place during the entire process, minimizing the risk of accidental displacement. By having the new ties in place before removing the old ones, the stability of the tracheostomy tube is maintained, which is crucial for the patient’s safety.
2. Use a quick-release knot to secure the ties (A): While quick-release knots can be useful in certain situations, they are not typically recommended for securing tracheostomy ties. Traditional secure knots are preferred because they provide a more reliable and stable hold. Quick-release knots may be more prone to becoming loose over time, which could compromise the security of the tracheostomy tube.
3. Allow space for three fingers under the ties when securing (C): This practice is generally used when securing other types of bandages or dressings, but it is not recommended for tracheostomy ties. For tracheostomy ties, it is important to ensure that the ties are snug enough to prevent movement but not so tight that they cause discomfort or impede circulation. The appropriate snugness is usually determined by assessing the fit based on the individual patient’s anatomy and comfort, rather than a strict measurement like three fingers.
4. Extend the client’s neck while securing the ties (D): Extending the client’s neck may not be ideal and could potentially increase discomfort or strain. It is generally better to keep the client’s neck in a neutral position to avoid any unnecessary stress or injury. Maintaining a neutral position helps in properly aligning the tracheostomy tube and ensures that the ties are applied correctly without causing any undue pressure.
In summary, the best practice for changing tracheostomy ties is to secure the new ties first before cutting the old ones, ensuring that the tracheostomy tube remains stable and the patient’s airway is protected throughout the procedure.