NORCET 2 - 2021 (shif…: Identify the following instrument that denote in image?

NORCET 2 - 2021 (shift-1)

Medical & Surgical Nursing

Medium

Appeared in: NORCET 2 - 2021 (shift-1)

Explanation

The instrument in the image is a Tracheostomy tube, identified by its characteristic features designed for insertion into a surgical airway (stoma) in the neck.
The presence of a flange (neck plate) is a key differentiator. This part rests on the patient's neck and is used to secure the tube with ties.
The tube has a short, curved cannula, which is distinct from the longer, more flexible endotracheal tube.
An inflatable cuff is visible around the distal end, and its corresponding pilot balloon is also present. This indicates it is a cuffed tube used to seal the airway for ventilation and prevent aspiration.

Option A: An Endotracheal (ET) tube is much longer and is inserted through the mouth or nose, passing through the vocal cords. It does not have a large neck flange like the device shown.
Option C: A Laryngeal Mask Airway (LMA) is a supraglottic airway device. It features a large, soft, inflatable mask at the distal end that seals around the larynx, but it does not enter the trachea itself.
Option D: A Guedel tube, or oropharyngeal airway, is a simple, uncuffed, rigid plastic device designed to keep the tongue from obstructing the pharynx. It lacks a cuff, pilot balloon, and flange.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of Airway Management Devices as background academic context rather than a clinical decision trigger.
A cuffed tracheostomy tube is essential for patients requiring mechanical ventilation as it seals the airway, ensuring delivered breaths go to the lungs and preventing aspiration of oral or gastric secretions.
Nurses must monitor the cuff pressure regularly (typically every 8 hours) to keep it within a safe range (usually 20-30 cm H2O) to prevent tracheal wall injury, such as ischemia, necrosis, or tracheoesophageal fistula.
What if the pilot balloon was cut or damaged? The cuff would deflate, leading to an air leak, loss of ventilation, and increased aspiration risk. The entire tracheostomy tube would need to be replaced immediately.

How to Approach the Question

First, carefully observe the image provided, paying close attention to the key features of the medical device.
Identify the main components: What is its shape? Does it have a cuff, a flange, or any connectors? In this case, note the neck plate, curved tube, and pilot balloon.
Systematically evaluate each option against your visual analysis.
Option A (ET Tube): Recall that ET tubes are long and lack a neck flange. This doesn't match.
Option B (Tracheostomy tube): Recall that these have a neck flange, a short curve, and often a cuff. This matches the image perfectly.
Option C (LMA): Recall that LMAs have a large mask at the end. This doesn't match.

Concept Tested & Keywords

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E6 Nursing Fundamentals Taylor p. 736-738

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 115-117