ARTICLE
TITLE

Nursing care of the patients with tracheostomyTrakeostomili hastalarda hemsirelik bakimi

SUMMARY

One of the primary responsibility of nursing care is maintaining and evaluating airway patency in patients. Nurses’ knowledge is have vital importance about the complications and care, when providing airway patency with an artificial way (via endotracheal tube or tracheostomy cannula). As the origin of the word ‘tracheotomy’ comes from the Greek and refers to the cut-off trachea. Tracheotomy is making an opening between 3. and 4. cartilage rings on the front wall of trakea to maintain airway and it is one of the oldest life- saving surgical procedures. Indications for tracheotomy operation, prolonged intubation and mechanical ventilation can be listed firstly. Tracheostomy complications may occur in the weeks or months/years later following the opening of the tracheostomy. Nurses have responsibilities follow-up of prevention complications after the tracheostomy procedure. Tracheostomy nursing care of consist of; adequate and balanced nutrition, aspiration, cleaning of inner cannula, adjustment of cuff pressure (if the cannula has cuff system), prevention of peristomal skin problems and communication process. ÖzetHastalarda hava yolu açikligini sürdürmek ve degerlendirmek hemsirelik bakiminda öncelikli sorumluluklardan biridir. Hava yolu açikligi yapay bir yol olusturularak saglandiginda (endotrakeal tüp veya trakeostomü kanülü ile) hemsirelerin bu islemlerin indikasyonlarina, komplikasyonlarina ve bakimina dair tüm bilgilere sahip olmasi yasamsal öneme sahiptir. Trakeotomi kavrami, köken olarak Yunanca'dan gelmektedir ve kelime olarak 'trakeanin kesilmesi'ni ifade eder. Trakeotomi, hava yolu açikligini saglamak amaciyla trakeanin ön duvarinda 3. ve 4. kikirdak halka hizasinda açiklik olusmasi için yapilan islem olarak tanimlanir ve hayat kurtarici olarak bilinen yöntemlerden en eskisi olarak kabul edilir. Trakeotomi isleminin endikasyonlari arasinda uzamis entübasyon ve mekanik ventilasyon ilk siralarda yer alir. Trakeostomi komplikasyonlari, trakeostominin açilmasini takip eden haftalar içinde ya da aylar/yillar sonra ortaya çikabilir.  Trakeostomi isleminden sonra hastalarin takibinde ve özellikle komplikasyonlarin önlenmesinde hemsirelerin sorumluluklari bulunmaktadir. Trakesotomili hastada hemsirelik bakimi; hastalarin yeterli ve dengeli beslenmesini, trakeostomi aspirasyonunu, iç kanül temizligini, eger kanül kaf sistemine sahipse kaf basincinin ayarlanmasini, peristomal cilt problemlerinin önlenmesini ve iletisim sürecini kapsar.

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