A client with a tracheostomy is at risk of developing tracheomalacia. Which statement by the client indicates a need for further education?
"I should inform the nurse if I notice any food particles in my tracheal secretions.".
"I may need a larger tracheostomy tube to prevent an air leak at the stoma.".
"I should try to minimize the time the cuff is inflated to prevent tracheal dilation.".
"I will monitor the cuff pressure and air volumes closely for any changes.".
Correct Answer : B,C
Choice A rationale:
This statement is correct. The client should inform the nurse if they notice any food particles in their tracheal secretions as it could indicate aspiration and require immediate attention.
Choice B rationale:
This statement indicates a need for further education. A larger tracheostomy tube to prevent an air leak at the stoma is not an appropriate intervention for tracheomalacia. Tracheomalacia is the weakening of the tracheal cartilage, and a larger tube would not address this underlying issue.
Choice C rationale:
This statement is also incorrect. Minimizing the time the cuff is inflated may be beneficial to prevent tracheal stenosis but would not prevent tracheomalacia, which is a different condition altogether.
Choice D rationale:
This statement is correct. Monitoring cuff pressure and air volumes closely is essential to prevent complications and ensure appropriate cuff inflation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice C rationale:
A fenestrated tracheostomy tube would be the most appropriate choice for a client who is ready to wean from mechanical ventilation and also requires speech therapy. The fenestration in the tube allows the patient to breathe through the upper airway, facilitating the weaning process, and enabling speech by allowing air to pass over the vocal cords. This type of tube is commonly used for patients who have progressed in their recovery and are transitioning to breathing independently.
Choice A rationale:
A cuffed tracheostomy tube with an inflated cuff is more suitable for patients requiring mechanical ventilation or those at high risk of aspiration, rather than a patient who is ready to wean from ventilation.
Choice B rationale:
Uncuffed tracheostomy tubes may be appropriate for patients who can protect their airway and are weaning from mechanical ventilation. However, they would not be the most appropriate choice when speech therapy is also required.
Choice D rationale:
Double-lumen tracheostomy tubes are not typically used for weaning from mechanical ventilation or speech therapy needs. They are employed in specialized situations for independent lung ventilation.
Choice E rationale:
Plastic tracheostomy tubes are commonly used in clinical practice and may be suitable for a patient ready to wean from mechanical ventilation and requiring speech therapy. However, the fenestrated tube is a more specific choice for this scenario.
Correct Answer is B
Explanation
Choice A rationale:
A neonate with a tracheostomy tube would require lower suction pressure compared to an adult. Neonates have smaller and more delicate airways, making them more susceptible to damage from high suction pressures. Using lower suction pressures is essential to ensure the safety and well-being of the neonate.
Choice B rationale:
An adult with a tracheostomy tube may require higher suction pressure compared to other age groups. Adults generally have larger airways and more significant secretion production. Adequate suction pressure is necessary to effectively remove secretions and maintain airway patency.
Choice C rationale:
A child with a tracheostomy tube would typically require lower suction pressure than an adult. Children have smaller airways than adults, and using high suction pressures could cause harm and discomfort.
Choice D rationale:
An infant with a tracheostomy tube would require lower suction pressure compared to an adult. Infants have smaller airways and are more sensitive to changes in pressure. Using higher suction pressure could cause trauma to the delicate tissues in their airways.
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