The nurse is using a closed suction device. Which patient will be ...

[imowrer]

The nurse is using a closed suction device. Which patient will be most appropriate for this suctioning method?
 
  a. A 5-year-old with excessive drooling from epiglottitis
  b. A 5-year-old with an asthma attack following severe allergies
  c. A 24-year-old with a right pneumothorax following a motor vehicle accident
  d. A 24-year-old with acute respiratory distress syndrome requiring mechanical ventilation

Question 2

The nurse is suctioning a patient with a tracheostomy tube. Which action will the nurse take?
 
  a. Set suction regulator at 150 to 200 mm Hg.
  b. Limit the length of suctioning to 10 seconds.
  c. Apply suction while gently rotating and inserting the catheter.
  d. Liberally lubricate the end of the suction catheter with a water-soluble solution.

[Meganchabluk]

Answer to Question 1

ANS: D
Closed suctioning is most often used on patients who require invasive mechanical ventilation to support their respiratory efforts because it permits continuous delivery of oxygen while suction is performed and reduces the risk of oxygen desaturation. In this case, the acute respiratory distress syndrome requires mechanical ventilation. In the presence of epiglottitis, croup, laryngospasm, or irritable airway, the entrance of a suction catheter via the nasal route causes intractable coughing, hypoxemia, and severe bronchospasm, necessitating emergency intubation or tracheostomy. The 5-year-old child with asthma would benefit from an inhaler. A chest tube is needed for the pneumothorax.

Answer to Question 2

ANS: B
Suctioning passes should be limited to 10 seconds to avoid hypoxemia. Suction for a tracheostomy should be set at 100 to 150 mm Hg. Excessive lubrication can clog the catheter or occlude the airway; lubricant is not necessary for oropharyngeal or artificial airway (tracheostomy) suctioning. Suction should never be applied on insertion.