The nurse suctions the patient's endotracheal tube, and the patient becomes hypoxic. Which is the priority nursing intervention to increase patient oxygenation?

Question

a. Assess breath sounds.
b. Discontinue suctioning.
c. Instruct the patient to cough.
d. Ventilate the patient manually.

Answer 1

D
If the patient becomes hypoxic, the nurse ventilates him or her manually with supplemental oxy-gen to increase oxygenation. The nurse implements measures to oxygenate the patient quickly to avoid adverse and potentially life-threatening complications, including arrhythmias and cardi-opulmonary arrest. He or she assesses the patient after providing supplemental oxygen and before seeking assistance because the hypoxia is most likely transient. The nurse discontinues suctioning to stop the decline in patient oxygen saturation; however, this action alone does not increase oxygenation. Instructing the patient to cough is a reasonable response to hypoxia, especially if the patient has pulmonary secretions; however, manual ventilation provides supplemental oxygen in addition to ventilation to increase patient oxygenation.