The nurse is caring for a mechanically ventilated patient with a ...

[madam-professor]

The nurse is caring for a mechanically ventilated patient with a cuffed tracheostomy tube. Which action by the nurse would best determine if the cuff has been properly inflated?
 
  a. Use a manometer to ensure cuff pressure is at an appropriate level.
  b. Check the amount of cuff pressure ordered by the health care provider.
  c. Suction the patient first with a fenestrated inner cannula to clear secretions.
  d. Insert the decannulation plug before the nonfenestrated inner cannula is removed.

Question 2

The nurse plans to teach a patient how to manage allergic rhinitis. Which information should the nurse include in the teaching plan?
 
  a. Hand washing is the primary way to prevent spreading the condition to others.
  b. Use of oral antihistamines for 2 weeks before the allergy season may prevent reactions.
  c. Corticosteroid nasal sprays will reduce inflammation, but systemic effects limit their use.
  d. Identification and avoidance of environmental triggers are the best way to avoid symptoms.

[spencer.martell]

Answer to Question 1

ANS: A
Measurement of cuff pressure using a manometer to ensure that cuff pressure is 20 mm Hg or lower will avoid compression of the tracheal wall and capillaries. Never insert the decannulation plug in a tracheostomy tube until the cuff is deflated and the nonfenestrated inner cannula is removed. Otherwise, the patient's airway is occluded. A health care provider's order is not required to determine safe cuff pressure. A nonfenestrated inner cannula must be used to suction a patient to prevent tracheal damage occurring from the suction catheter passing through the fenestrated openings.

Answer to Question 2

ANS: D
The most important intervention is to assist the patient in identifying and avoiding potential allergens. Intranasal corticosteroids (not oral antihistamines) should be started several weeks before the allergy season. Corticosteroid nasal sprays have minimal systemic absorption. Acute viral rhinitis (the common cold) can be prevented by washing hands.

[madam-professor]

Thanks for the timely response, appreciate it

[yeungji]

TYSM