The nurse is caring for a client being weaned from the ventilator, and wants to improve the client's ability to communicate. Which item should the nurse request an order for from the health care provider?
1. Cuffed tracheostomy tube
2. Uncuffed tracheostomy tube
3. Fenestrated tracheostomy tube
4. Obturator
3
Rationale 1: The cuffed tracheostomy would need to be deflated in order for the fenestrated tube to function.
Rationale 2: An uncuffed tube does not improve communication.
Rationale 3: The fenestrated tracheostomy tube allows clients to speak, and could be safely used on the client who is being weaned from the ventilator.
Rationale 4: An obturator is used to make the tracheostomy tube more rigid during insertion, and must be removed as soon as the tube is in place, because it occludes the airway.
Global Rationale: The fenestrated tracheostomy tube allows clients to speak, and could be safely used on the client who is being weaned from the ventilator. The cuffed tracheostomy would need to be deflated in order for the fenestrated tube to function. An uncuffed tube does not improve communication. An obturator is used to make the tracheostomy tube more rigid during insertion, and must be removed as soon as the tube is in place, because it occludes the airway.
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