Your patient had a tracheostomy placed a few days ago. You walk into their room to complete your assessment. Which of the following observations would be the MOST concerning to you?

 

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Correct

- The oxygen tubing providing humidified oxygen is in the patient's hand, at their side

- The obturator is at the bedside

- The trach ties are slightly soiled

- The previous nurse left some trach care supplies, and you note they used hydrogen peroxide

Rationale

Humidified oxygen should be continually provided to the patient to prevent a mucous plug from forming. An obturators should be at the bedside, hydrogen peroxide is an appropriate cleaning agent, and the slightly soiled trach ties can be changed with the next trach care. Replacing the humidified oxygen back so it is flowing into the tracheostomy and not at the patient's side is the priority.

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