A fifty-year-old client has a tracheostomy and requires tracheal suctioning. The first intervention in completing this procedure would be to:
A. Change the tracheostomy dressing.
B. Provide humidity with a trach mask.
C. Apply oral or nasal suction.
D. Deflate the tracheal cuff.
Correct Answer: C. Apply oral or nasal suction.
Before deflating the tracheal cuff, the nurse will apply oral or nasal suction to the airway to prevent secretions from falling into the lung. Dressing change and humidity do not relate to suctioning. Airway suctioning is a procedure routinely done in most care settings, including acute care, sub-acute care, long-term care, and home settings. Suctioning is performed when the patient is unable to effectively move secretions from the respiratory tract.
Option A: Airways suctioning is indicated for multiple reasons. Most commonly suctioning is done for the removal of secretions from the respiratory tract, but sometimes also for removal of blood or other materials like meconium in specific cases. Airway suctioning is also performed for diagnostic purposes.
Option B: Suctioning of the lower airways should be done in a sterile manner with single-use gloves and suction catheters to prevent contamination and secondary infection. After preparation with appropriate equipment at the bedside and monitoring continuous heart rate and oxygen saturation (as available), the patient should be suctioned with appropriately sized equipment for their airway.
Option D: After preparation with appropriate equipment at the bedside and monitoring continuous heart rate and oxygen saturation (as available), the patient should be suctioned with appropriately sized equipment for their airway.
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