A patient who will require long-term mechanical ventilation has had a tracheostomy for 2 weeks. The nurse is concerned that stoma erosion is occurring. Which nursing assessment would support the nurse's concern?
1. Secretions are present at the stoma opening.
2. Granulation tissue is noted at the stoma site.
3. The patient has developed a dry cough.
4. The skin at the stoma opening is flaky.
Answer: 1
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