A physician asks you to assess the upper airway function of a ...

[imanialler]

A physician asks you to assess the upper airway function of a patient with a fenestrated trache-ostomy tube. How should this be accomplished?
 
  a. Replace the inner cannula, plug the proxi-mal opening, and inflate the cuff.
  b. Remove the inner cannula, plug the prox-imal opening, and deflate the cuff.
  c. Remove the inner cannula, plug the prox-imal opening, and inflate the cuff.
  d. Replace the inner cannula, plug the proxi-mal opening, and deflate the cuff.

Question 2

What is the most common problem with fenestrated tracheostomy tubes?
 
  a. Relative frequency of accidental extuba-tion
  b. Increased likelihood of tracheomalacia
  c. Poor positioning of the tube fenestration
  d. Inability to provide mechanical ventilation

[ngr69]

Answer to Question 1

ANS: B
Removal of the inner cannula opens the fenestration allowing air to pass into the upper airway. Capping or placing a peaking valve on the proximal opening of the tube's outer cannula, accom-panied by deflation of the cuff, allows for assessment of upper airway function.

Answer to Question 2

ANS: C
One problem associated with this type of tracheostomy tube is malposition of the fenestration, such as between the skin and stoma, or against the posterior wall of the larynx.