An alert patient with a long-term need for a tracheostomy tube ...

[savannahhooper]

An alert patient with a long-term need for a tracheostomy tube (because of recurrent aspiration) is having difficulty communicating with the intensive care unit staff.
 
  Which of the following would you recommend to help this patient communicate better?
  1. Use a letter, phrase, or picture board.
  2. Consider switching to a fenestrated tracheostomy tube.
  3. Consider a talking tracheostomy tube.
  a. 1 and 2 only
  b. 1 and 3 only
  c. 2 and 3 only
  d. 1, 2, and 3

Question 2

Tracheal airways increase the incidence of pulmonary infections for which of the following rea-sons?
 
  1. Lower levels of humidification
  2. Increased aspiration of pharyngeal material
  3. Contaminated equipment or solutions
  4. Ineffective clearance through cough
  a. 1 and 3 only
  b. 1, 2, and 3 only
  c. 3 and 4 only
  d. 2, 3, and 4 only

[reversalruiz]

Answer to Question 1

ANS: B
A better solution is a letter, phrase, or picture board. These devices allow patients to communi-cate by simple pointing. Large and simple drawings are particularly important for patients who cannot clearly see print. For conscious patients with a long-term tracheostomy and ventilator de-pendent, communication can be enhanced with a talking tracheostomy tube (Figure 36-29).

Answer to Question 2

ANS: D
As indicated in Box 36-7, there are several reasons why tracheal tubes increase the incidence of pulmonary infection.

[savannahhooper]

Excellent

[yeungji]

TYSM