In caring for a client with a cuffed endotracheal tube, what action should the nurse take to prevent a tracheoesophageal fistula?

Maintaining cuff pressure is critical in the care of a client with a cuffed endotracheal tube to prevent the development of a tracheoesophageal fistula. A cuffed tube is designed to provide a seal within the trachea to ensure effective ventilation and to minimize the risk of aspiration.

Properly maintaining the cuff pressure ensures that the cuff effectively isolates the airway from the esophagus, thereby preventing pressure necrosis of the trachea and surrounding tissues. If the cuff pressure is either too low or too high, it can lead to complications. For example, excessive pressure can cause ischemia and erosion of the tracheal wall into the esophagus, resulting in a tracheoesophageal fistula.

Regular monitoring and adjustment of cuff pressure, usually to a level that is safe (typically around 20-30 cm H2O), allows for adequate ventilation while also minimizing the risk of damaging surrounding structures. This action is essential for overall airway management and preventing serious complications in patients who are intubated for extended periods.

The other options may play roles in general patient care but do not specifically address the prevention of tracheoesophageal fistula as effectively as maintaining appropriate cuff pressure does. For instance, frequent suctioning