Asthma and COPD Q 8 - Gyan Darpan : Learning Portal
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Sunday 24 April 2022

Asthma and COPD Q 8

A nurse is suctioning fluids from a client through an endotracheal tube. During the suctioning procedure, the nurse notes on the monitor that the heart rate decreases. Which of the following is the most appropriate nursing intervention?
     A. Continue to suction.
     B. Ensure that the suction is limited to 15 seconds.
     C. Stop the procedure and reoxygenate the client.
     D. Notify the physician immediately.

Correct Answer: C. Stop the procedure and reoxygenated the client

During suctioning, the nurse should monitor the client closely for side effects, including hypoxemia, cardiac irregularities such as a decrease in HR resulting from vagal stimulation, mucosal trauma, hypotension, and paroxysmal coughing. If side effects develop, especially cardiac irregularities, this procedure is stopped and the client is reoxygenated.

Option A: Suction gently and intermittently, use proper catheter size and technique. Clears airway and pool of secretions without injury to the trachea, prolonged suctioning causes vagal stimulation and bradycardia and high pressure may damage the mucosa of the trachea.
Option B: Brief, 10-second suction duration is usually recommended to avoid mucosal damage and prolonged hypoxia. Hypoxia can be profound from occlusion, interruption of oxygen supply, and prolonged suctioning.
Option D: Monitor arterial blood gasses and oxygen saturation. Pulse oximetry is a useful tool to detect early changes in oxygen saturation. Oxygen saturation should be kept at 90% or greater. Increasing PaCo2 and decreasing PaO2 are signs of hypoxemia and respiratory acidosis.

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