The nurse must suction a 6-month-old infant with a tracheostomy. ...

[michelleunicorn]

The nurse must suction a 6-month-old infant with a tracheostomy. What intervention should be included?
 
  a. Encourage the child to cough to raise the secretions before suctioning.
  b. Perform each pass of the suction catheter for no longer than 5 seconds.
  c. Allow the child to rest after every five times the suction catheter is passed.
  d. Select a catheter with a diameter three quarters of the diameter of the tracheostomy tube.

Question 2

What nursing consideration is most important in the care of a child on a mechanical ventilator?
 
  a. Humidification is not necessary.
  b. Respiratory assessment is done by the ventilator.
  c. Positioning the child for comfort and optimum ventilation is necessary.
  d. Support and reassurance are not as important because the child is unconscious.

[princessflame2016]

Answer to Question 1

ANS: B
Suctioning should require no longer than 5 seconds per pass. Otherwise, the airway may be occluded for too long. An infant would be unable to cooperate with instructions to cough up secretions. The child is allowed to rest for 30 to 60 seconds after each aspiration to allow oxygen tension to return to normal. Then the process is repeated until the trachea is clear. The catheter should have a diameter one half the size of the tracheostomy tube. If it is too large, it might block the child's airway.

Answer to Question 2

ANS: C
The ventilator will do the work of breathing, but the nurse must position the child with attention to achieving optimum gas exchange. The reason for mechanical ventilation and the child's comfort are part of the assessment. Mechanical ventilation is usually achieved by intubation or tracheostomy. These routes bypass the humidification that occurs in the upper airway. The ventilator provides some information about the work of breathing, but patient assessment must be done by the nurse. Support and reassurance are always important for both the child and family. Opioids and anxiolytics are often used to decrease the child's anxiety. Careful assessment is indicated.

[michelleunicorn]

Thank you

[princessflame2016]

No problemo