The nurse is caring for a client with a permanent tracheostomy who is able to eat. Which is the correct action by the nurse in managing this tube?

  1. if the tube must be capped, place the cap before deflating the cuff
  2. inflate the cuff and remove the inner cannula before capping the tube
  3. inflate the cuff (if the tube is not capped) for meals and 1 hour afterward to prevent aspiration
  4. deflate the cuff (if the tube is not capped) for meals and 1 hour afterward to prevent aspiration
Number 3 is correct.
Rationale: Inflating the cuff (if the tube is not capped) during meals and for 1 hour afterward prevents aspiration. The client should sit up for all meals. When capping the tube, the cuff is first deflated and the inner cannula removed prior to capping in order to avoid blocking the airway. The cuff is not inflated prior to capping. The cuff must be inflated for meals.