bedbound-patient
Instructed patient caregiver clean technique includes tracheostomy care: hand washing, using gloves is optional, re-using a trach tube and/or inner cannula that has been properly cleaned, using prepared sterile water and normal saline, re-using the same trach ties if they are properly cleaned, re-using suction catheters if they are properly cleaned ( up to 8 hrs or 3/per day )
Instructed patient caregiver that It is normal to feel some pain and discomfort for about a week after the tracheostomy procedure. If you have difficulty breathing and it is not relieved by your usual method of clearing secretions. when secretions become thick, if crusting occurs or mucus plugs are present. Your physician may recommend increasing.
Instructed patient Contact your healthcare provider or physician immediately: ff you have an irregular heart rate, your fluids or using cool mist humidification. If you have any other problems or concerns. If you feel increased pain or discomfort.
Instructed patient it’s important to routinely clean catheters to prevent infections. Wash your hands well before and after you handle your catheter. Clean the skin around the catheter twice a day using soap and water.
Instructed patient when to call the doctor the stoma is swollen and is more than a 1/2 inch (1 cm) larger than normal. The stoma is pulling in, below the skin level. The stoma is bleeding more than normal.
Instructed patient Be sure to treat any skin redness or skin changes right away, when the problem is still small. Do not allow the sore area to become larger or more irritated before asking your doctor about it.
Instructed patient To care for your skin:Wash your skin with warm water and dry it well before you attach the pouch. Avoid skin care products that contain alcohol. These can make your skin too dry.
Instructed patient about the skin around your stoma should look like it did before surgery. The best way to protect their skin is by: using a bag or pouch with the correct size opening, so waste does not leak, taking good care of the skin around your stoma.
Instructed patient assess bowel sounds in all 4 quadrants, assess effluent from ostomy. Empty pouch when 1/3-1/2 full, assess abdomen, report any abnormal findings immediately.
SN used hand cleaner, donned gloves. Drainage bag from old catheter has clear yellow with sediments urine. SN donned sterile gloves, cleaned the perineum around the urinary meatus with chlorhexidine swabs. Flush Foley with 50 cc NS and immediately drained clear yellow urine. Then connected Foley to new drainage bag, then statlock placed on right thigh to secure catheter. Adult diaper put on patient. All items used for procedure disposed of in plastic bag, tied shut and put in household trash.