Mr. Kent, 42 years old, had a cuffed tracheostomy tube placed 4 weeks ago. This morning, his doctor made an order for him to begin eating by mouth, with the tracheostomy in place. To prevent aspiration, the nurse will: Select all that apply:
Explanation
Answer - A, C, D, E - (A) By raising the head of the bed, gravity helps the client swallow and helps prevent aspiration; (C) the cuff should initially be deflated to assess gag and swallowing ability; (D) the client’s airway should be patent and secretions removed before deflating the cuff; and (E) assessing the client’s gag and swallowing ability is crucial before starting the client on PO food and fluids. Choice B is incorrect because there is no reason to increase FiO2. Choice F is incorrect because it is not necessary to replace the tracheostomy ties before the client eats, unless they are noted to soiled or loose.
