Discuss ONE of the following: 1. Describe how the nurse provides tracheostomy teaching to the patient and family.

Include what needs to be taught, the approach for teaching each component and how the nurse will verify the teaching.

Before the nurse start the teaching, nurse should access the knowledge of the patient what he already knows about tracheotomy. Identify the patients preferred language. Arranged an interpreter if necessary. Nurse should also provide written instructions for the better understating. Nurse should show the pictures of tracheotomy and three parts of tubes; outer cannula with flange (neck plate), inner cannula, and an obturator. Teach the patient it is normal to feel some pain and discomfort for about a week after the procedure. Teach the patient that immediately after the tracheostomy, he may not able to speak, but he can communicate by writing, later he can use electronic speaking device. Use tracheostomy cover to protect airway from outside dust, air insect, etc. Do not go into areas where there is a lot of dust, fumes, or smoke Teach the patient and family how to take care of stoma. Cleaned the stoma at least once a day. Rinse the area with Q-tip soaked in sterile water or saline to prevent redness, irritations, swelling or bleeding. Pay attention to the type and amount of mucus through your stoma. Report if the patient notice any changes. Use a humidifier to moisten the air. Teach the family that surgery may be a different experience physically and emotionally. It is often helpful to talk to your doctor or nurse about your feelings and concerns. At the end, evaluate their knowledge about tracheostomy. Ask the questions such as how to clean stoma, why the patient has to pay attention to mucus and why should he use humidifier? Based on the information provided by family and patient, the nurse can judge if the goal has been met. Otherwise, nurse should continue the teaching until they have successfully learned.

References: 1) Norris, C. (2011). Upper Respiratory Problems. In K. Geen (Ed.), Medical Surgical Nursing: Assessment and Management of Clinical Problems. (pp. 501544).St Louis, MO: Mosby Elsevier. 2) 2) Gulanick, M., & Myers, J. L. (2011) Nursing Care Plans: Diagnosis, Interventions, and Outcomes. (8th Ed.) Philadelphia, PA: Elsevier Mosby.