An unlicensed assistive personnel (UAP) was feeding a client with ...

[magmichele12]

An unlicensed assistive personnel (UAP) was feeding a client with a tracheostomy. Later that evening, the UAP reports that the client had a coughing spell during the meal. What action by the nurse takes priority?
 
  a. Assess the client's lung sounds.
  b. Assign a different UAP to the client.
  c. Report the UAP to the manager.
  d. Request thicker liquids for meals.

Question 2

A client has a tracheostomy tube in place. When the nurse suctions the client, food particles are noted. What action by the nurse is best?
 
  a. Elevate the head of the client's bed.
  b. Measure and compare cuff pressures.
  c. Place the client on NPO status.
  d. Request that the client have a swallow study.

[krakiolit]

Answer to Question 1

ANS: A
The priority is to check the client's oxygenation because he or she may have aspirated. Once the client has been assessed, the nurse can consult with the registered dietitian about appropriately thickened liquids. The UAP should have reported the incident immediately, but addressing that issue is not the immediate priority.

Answer to Question 2

ANS: B
Constant pressure from the tracheostomy tube cuff can cause tracheomalacia, leading to dilation of the tracheal passage. This can be manifested by food particles seen in secretions or by noting that larger and larger amounts of pressure are needed to keep the tracheostomy cuff inflated. The nurse should measure the pressures and compare them to previous ones to detect a trend. Elevating the head of the bed, placing the client on NPO status, and requesting a swallow study will not correct this situation.