As Nurse Ryan entered the room, he saw the client choking and unable to speak. Which intervention should the nurse implement first for the client?
A. Calling for help immediately.
B. Leaving the client alone to clear his throat.
C. Telling the client to adequately humidify the room.
D. Trying to determine what the client is choking on.
Correct Answer: A. Calling for help immediately.
Because the client cannot speak, a total airway obstruction has occurred. The client is in acute distress and requires emergency treatment. All adults can and should receive the Heimlich maneuver while they are conscious. If the Heimlich cannot be performed due to body habitus or pregnancy, the American Heart Association recommends a supine patient with force again applied just above the umbilicus in a cephalad posterior vector.
Option B: Leaving the client alone to clear the throat would be appropriate for a client with partial airway obstruction, as evidenced by choking but with an ability to speak. If the adult loses consciousness, it is imperative to check for a pulse and begin cardiopulmonary resuscitation if a pulse is not detected.
Option C: Adequate humidification is appropriate for the client with recurrent epistaxis or nasal congestion. Choking or foreign body airway obstruction occurs when a foreign body such as food, coins, or toys partially or completely obstruct the passage of air from the upper airway into the trachea. Choking affects either the very young or the elderly.
Option D: It does not matter what the client is choking on. It can be determined once the appropriate treatment has been done. Advanced airway techniques are now indicated, and you may be able to visualize the foreign body under direct laryngoscopy.
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