American Association of Critical-Care Nurses (AACN) Certification Practice Test

What should the cuff pressure be adjusted for in tracheostomy care?

1. To reduce the risk of infection

2. To prevent erosion of the trachea

3. To facilitate suctioning

4. To manage hypoxia

The correct answer is: To prevent erosion of the trachea

The adjustment of cuff pressure during tracheostomy care is primarily aimed at preventing erosion or injury to the tracheal wall. The cuff, when inflated, exerts pressure on the trachea to create a seal that prevents aspiration and allows for the delivery of positive pressure ventilation if required. However, if the cuff pressure is too high, it can lead to ischemia and erosion of the tracheal tissue. This risk underscores the importance of continuously monitoring and adjusting cuff pressure to maintain it within the recommended range, typically between 20 and 30 mmHg, ensuring that it is sufficient to prevent air leakage while avoiding excessive pressure that could cause damage to the trachea. In contrast, while infection risk, suctioning facilitation, and managing hypoxia are important considerations in tracheostomy care, they are not the primary reasons for adjusting cuff pressure. Inappropriate cuff pressure does not directly manage hypoxia, nor does it primarily aim to reduce the risk of infection, although adequate cuff management may indirectly contribute to these factors by ensuring proper ventilation and secretion management.