Question

The RN on the oncology unit is serving as preceptor for a senior nursing student. Which action by the student during performance of the tracheostomy care warrants intervention by the RN? ? A. Suctioning the tracheostomy prior to beginning the procedure ? B. Applying sterile gloves to perform the procedure ? C. Removing tracheostomy ties and then applying new ones ? D. Cleansing with H202 and then normal saline

Short answer

Answer: Removing tracheostomy ties and then applying new ones.

Step-by-step solution

Reviewing the Options

First, let's look at each of the provided options and discuss whether they are part of proper tracheostomy care: ? A. Suctioning the tracheostomy prior to beginning the procedure - This is an appropriate step in tracheostomy care, as it helps to clear secretions from the patient's airway. Therefore, intervention is not required. ? B. Applying sterile gloves to perform the procedure - This is also an appropriate practice in tracheostomy care, as sterile technique is essential to minimize the risk of infection during tracheostomy care procedures. No intervention required here. ? C. Removing tracheostomy ties and then applying new ones - This is the incorrect step, as securing the tracheostomy tube should be done before removing the old ties. This is to ensure that the tracheostomy tube remains in place and does not accidentally become dislodged, leading to airway loss or potential complications. This action warrants intervention by the RN. ? D. Cleansing with H202 and then normal saline - This is an appropriate practice, as it maintains a clean and moist environment for the tracheostomy site, minimizing the risk of infection. No intervention is necessary here.

Choosing the Correct Answer

Based on the analysis of the options, we can conclude that the action warranting intervention by the RN is: ? C. Removing tracheostomy ties and then applying new ones

Key concepts

Oncology Nursing

Oncology nursing is a specialized area of nursing practice focused on providing care to patients with cancer. Oncology nurses work in various settings, including hospitals, outpatient clinics, and home care, and are involved in a range of tasks from administering chemotherapy to offering emotional support to patients and their families.

Oncology nurses must have a sound understanding of the pathophysiology of cancer, as well as the various treatments available and their side effects. A key responsibility is to assess the patient's condition and work in conjunction with other healthcare professionals to develop and implement a care plan. For instance, in the context of tracheostomy care within an oncology unit, the nurse would need to be particularly vigilant about preventing infection, managing pain, and maintaining clear airways, as patients with cancer can have compromised immune systems.

Moreover, oncology nursing involves educating patients about their condition and treatment, which is integral in helping them make informed decisions about their care. This adherence to patient education underscores the collaboration between nurses and patients, a dynamic that is fundamental to quality oncology nursing.

Clinical Nursing Skills

Clinical nursing skills are the competencies that nurses require to effectively care for patients. These skills encompass a wide range of actions, from the more technical, like administering IV medications, to the more interactive, like communicating with patients about their health.

In the scenario of tracheostomy care, essential clinical nursing skills include maintaining sterility during the procedure, appropriately suctioning secretions, and safely securing the tracheostomy tube. Mastery of these skills is crucial for preventing complications such as infections, which could have serious, if not fatal, consequences for the patient.

Sterile Technique

The application of sterile gloves is mentioned in the exercise and highlights the importance of aseptic technique to prevent infection. Other aspects, such as using the correct cleansing agents and methods, are also vital components of clinical nursing skills.

Tracheostomy Management

Securely fastening tracheostomy ties is critical to ensuring the tube's stability and the patient's safety; failure to do so can lead to life-threatening situations. The exercise improvement advice focuses on this detail, illustrating the impact that adeptness in clinical nursing skills can have on patient outcomes.

Nursing Student Preceptorship

A nursing student preceptorship is an educational arrangement in which a nursing student is assigned to an experienced nurse, known as a preceptor, to gain practical experience in a clinical setting. This partnership allows for the hands-on application of theoretical knowledge and the acquisition of clinical skills under the guidance and supervision of a seasoned practitioner.

The value of a preceptorship lies in the personalized feedback and instruction students receive. In the exercise, the student's action of changing tracheostomy ties without ensuring the tube's stability first identifies a learning opportunity that the preceptor can address. By intervening, the preceptor provides crucial, real-time correction and mentoring, which reinforces safe and effective nursing practices.

A successful preceptorship requires clear communication, mutual respect, and a supportive learning environment. The ultimate goal is for the nursing student to transition from the role of learner to that of a competent, autonomous nurse capable of providing high-quality patient care.