A nurse is preparing to perform open-system suctioning for a client with a tracheostomy tube. To reduce the risk of hypoxia and mucosal trauma, in which order should the nurse perform the following actions? Arrange the steps in the correct sequence from first to last.
- 1Preoxygenate the client with 100% oxygen.
- 2Insert the suction catheter without applying suction until resistance is met.
- 3Withdraw the catheter approximately 1 to 2 centimeters.
- 4Apply intermittent suction while rotating the catheter outward.
- 5Reassess the client's respiratory status and oxygen saturation.
Answer
The correct sequence is to preoxygenate, insert without suction, withdraw slightly, apply suction while rotating outward, and finally reassess.
To reduce the risk of life-threatening complications such as hypoxemia, cardiac dysrhythmias, and mucosal trauma, the nurse must adhere to a strict procedural sequence. Preoxygenation provides a critical oxygen reserve. Inserting the catheter without suction protects the airway lining. Withdrawing the catheter slightly before applying suction prevents adherence to the carina, avoiding vagal stimulation. Applying suction only during withdrawal with a rotating motion safely removes secretions. Reassessing the client verifies the procedure's success and the client's stability.
Step-by-Step Solution
Key Concept
Safe tracheostomy suctioning sequence to minimize hypoxia and mucosal trauma.
Estimated Time:1m 0s