Question

Discuss correct procedures for postural drainage and tracheostomy care.

Answer 1

Ans:- postural drainage :- postural drainage is the drainage of secretions by gravity from various lung segments by the application of specific positions.

Name of the specific positions are as follows:- 1. High fowler's for the bilateral segment.

2. Sitting on side of bed supine with head elevated for right upper lobe of anterior segment.

3. Supine with head elevated for left upper lobe anterior segment.

4. Side lying with right side of chest elevated on pillows for right upper lobe posterior segment.

5. Side lying with left side of chest elevated on pillows for left upper lobe of posterior segment.

6. Three fourth supine position with dependent lung in trendelenburg's position for right middle lobe of anterior segment.

7. Prone with thorax and abdomen elevated for right middle lobe of posterior segment.

8. Supine in trendelenburg's for both lower lobes of anterior segments.

9. Right side lying in trendelenburg's position for left lower lobe lateral segment.

10. Left side lying in trendelenburg's position for right lower lobe of lateral segment..

11. Prone with right side of chest elevated in trendelenburg's position for right lower posterior segment.

12. Prone in trendelenburg's position both lower lobes posterior segments..

Procedure for postural drainage steps are as follows:-

1. Before postural drainage, the client may be given bronchodilators or nebulization therapy to loosen secretions.

2. postural drainage treatment are scheduled two or three times daily, depending on the degree of lung congestion.

3. The best time includes before breakfast, before lunch, in the late afternoon, and before bed time.

4. Just after meal it should avoid because at this time postural drainage can be tiring and can induce vomiting.

5. Help the patient assume the appropriate position, based on the lung field that requires drainage.

6. The lower lobes require drainage most frequently because the upper loves drain by gravity.

7. After positioning client should leave for 10-15 mints in that position if it is tolerable.

8. Perform percussion and vibration by keeping client in position.

9. The sequence for the therapy is as follows:- positioning, percussion, vibration, and removal of secretions by coughing or suction...

Tracheostomy :- A tracheostomy is an artificial opening made in the trachea into which a tube is inserted to establish and maintain a patient air way and the care that is given to maintain this opening and prevent it from infection is called tracheostomy care..

Procedure of tracheostomy care is as follows:- 1. Gather the following steps:- a) two sterile gloves.

b) suction catheter.

c)betadine

d) sterile fine mesh gauze pads.

e) normal saline or tap water.

f) cotton tipped sawbs.

g) suction jar

h) clean washcloth.

i) towel.

J) trachea tube ties.

K) clean scissors.

l) ambu bag.

m) suction tube.

n) stethoscope.

2. Provide position to the patient flat position.

3. Assess the patient before giving care.

4. Wash hands thoroughly with soap and water.

5.wear sterile gloves.

6. Will perform suctioning if any secretions are present for 5-10 sec.

7.reomve old dressing.

8.Clean the site with normal saline and after that with betadine.

9. Apply new sterile dressing ( wet gauze piece).

10. Change the tube ties.

11. Assess the condition of patient.

12. Documentation of all the findings.