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

What is the recommended management for a suspected tracheoinnominate artery fistula?

1. Increase cuff pressure

2. Immediate surgical intervention

3. Administer anticoagulants

4. Use topical hemostatic agents

The correct answer is: Increase cuff pressure

In cases of a suspected tracheoinnominate artery fistula, the appropriate management is immediate surgical intervention. This condition arises when there is an abnormal connection between the trachea and the innominate artery, often presenting with massive, life-threatening hemorrhage. Immediate surgical intervention is crucial because the risk of exsanguination is high, and prompt action can save the patient's life. Other management strategies, such as increasing cuff pressure, would not address the underlying problem and may only exacerbate the situation or delay necessary surgical treatment. Administering anticoagulants would be contraindicated, as this could lead to increased bleeding and worsen the patient's condition. Topical hemostatic agents are generally not sufficient for managing a fistula of this nature because the issue involves a significant vascular structure and requires comprehensive surgical repair. Hence, the focus should be on securing timely surgical intervention to address the fistula.