A client with a tracheostomy is at risk of developing tracheomalacia. Which statement by the client indicates a need for further education?

Choice A rationale:

A cuffed tracheostomy tube is most suitable for a patient who requires mechanical ventilation or has a high risk of aspiration. The cuff is inflated to create a seal between the trachea and the tube, preventing aspiration of oral secretions or gastric contents into the airway. This is crucial for patients on mechanical ventilation to ensure effective ventilation and prevent complications like ventilator-associated pneumonia.

Choice B rationale:

Uncuffed tracheostomy tubes do not have an inflatable cuff, making them unsuitable for patients who require mechanical ventilation or have a high risk of aspiration. They are more appropriate for patients who can protect their own airway and have minimal risk of aspiration.

Choice C rationale:

Fenestrated tracheostomy tubes have an opening or fenestration on the tube that allows airflow through the upper airway, bypassing the tracheostomy tube. These tubes are used for patients who are weaning off mechanical ventilation and require speech therapy. They are not the most suitable choice for patients who need mechanical ventilation or have a high aspiration risk.

Choice D rationale:

Double-lumen tracheostomy tubes have two separate tubes, which can be used for independent lung ventilation in certain situations. They are not specifically designed for patients requiring mechanical ventilation or with a high risk of aspiration.

Choice E rationale:

Metal tracheostomy tubes are not commonly used for patients requiring mechanical ventilation or with a high risk of aspiration. Metal tubes may be used in certain cases, but they are not the most suitable choice for this patient population.

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.