Communication can be challenging for patients with tracheostomy, as they are unable to speak in the usual way. However, there are a number of communication strategies that can be used to promote effective interaction and communication between nurses and patients with tracheostomy.

Non-verbal communication

Non-verbal communication is an important way for patients with tracheostomy to communicate. Nurses can help to promote non-verbal communication by:

• Making eye contact
• Using facial expressions and gestures
• Touching the patient’s arm or shoulder gently
• Providing a quiet and comfortable environment

Verbal communication

There are a number of ways that patients with tracheostomy can communicate verbally, including:

• Speaking valves: These devices allow patients to speak by blocking the flow of air through the tracheostomy tube.
• Electrolarynxes: These devices produce a sound that is transmitted to the patient’s mouth, allowing them to speak.
• Writing: Patients with tracheostomy can also communicate by writing or typing.

Nurses can help to promote verbal communication by:

• Encouraging patients to use their preferred method of verbal communication
• Providing patients with writing materials or a tablet
• Listening patiently and attentively to patients’ communication

Other communication strategies

There are a number of other communication strategies that can be used with patients with tracheostomy, such as:

• Communication boards: These boards contain pictures or words that patients can point to to communicate.
• Picture cards: These cards can be used to represent common words and phrases.
• Sign language: Sign language can be used to communicate with patients who are unable to speak or write.

Nurses can help to promote these communication strategies by:

• Providing patients with communication boards or picture cards
• Learning basic sign language
• Encouraging patients’ families and friends to learn basic sign language

2. Caring for a patient with MRSA

a) What is MRSA?

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that is resistant to many antibiotics. MRSA can cause a variety of infections, including skin infections, pneumonia, and bloodstream infections. MRSA is spread through contact with contaminated skin or surfaces.

b) Precautions required when providing care to a patient with MRSA

When providing care to a patient with MRSA, it is important to take precautions to prevent the spread of the infection. These precautions include:

• Wearing gloves, a gown, and a mask
• Washing your hands thoroughly before and after caring for the patient
• Cleaning and disinfecting all equipment and surfaces that come into contact with the patient
• Avoiding contact with the patient’s skin wounds
• Placing the patient in a private room, if possible

c) Topics to include in patient and family education

When educating patients and families about MRSA, it is important to cover the following topics:

• What is MRSA?
• How is MRSA spread?
• How to prevent the spread of MRSA
• The signs and symptoms of MRSA infection
• When to seek medical attention for a possible MRSA infection

3. Assessment cues and nursing interventions for infiltration and extravasation of an intravenous (IV) catheter

Infiltration

Infiltration is the unintentional leakage of fluid from an IV catheter into the surrounding tissue. Assessment cues for infiltration include:

• Swelling around the IV site
• Pain or tenderness around the IV site
• Coolness around the IV site
• Blanching of the skin around the IV site

Nursing interventions for infiltration include:

• Stopping the infusion of fluid
• Removing the IV catheter
• Applying a warm compress to the IV site
• Elevating the affected limb
• Administering analgesics as needed

Extravasation

Extravasation is the unintentional leakage of vesicant medication from an IV catheter into the surrounding tissue. Vesicant medications are medications that can cause severe tissue damage, such as chemotherapy drugs and antibiotics. Assessment cues for extravasation include:

• Swelling around the IV site
• Pain or tenderness around the IV site
• Redness and blistering of the skin around the IV site
• Leakage of fluid from the IV site

Nursing interventions for extravasation include:

• Stopping the infusion of medication
• Removing the IV catheter
• Elevating the affected limb
• Applying a cold compress to the IV site
• Administering analgesics as needed
• Administering an antidote to the vesicant medication, if available

If you have any further questions or concerns, please do not hesitate to ask.