1. Place the following steps in the suctioning procedure for a patient with a tracheostomy in proper order (1–7). All options must be used
A. ____ Connect oxygen source to manual resuscitation bag.
B. ____ Connect catheter to suction tubing, and turn on suction to level specified by institution policy.
C. ____ Pour saline into sterile container.
D. ____ Suction small amount of saline into catheter.
E. ____ Use thumb to stop suction, and insert catheter through tracheostomy tube until patient coughs or resistance is met.
F. ____ Oxygenate patient with three ventilations using a manual resuscitation bag connected to an oxygen source.
G. ____ Slowly withdraw catheter, suctioning intermittently while rotating it.
ANS:
A. ANS: 2
B. ANS: 1
C. ANS: 3
D. ANS: 4
E. ANS: 6
F. ANS: 5
G. ANS: 7
(1) Gather equipment: sterile suction catheter, sterile gloves, sterile container (may be found in a single "cath and glove" kit), sterile water or saline, suction machine with tubing, manual resuscitation bag. (2) Explain procedure to patient. (3) Connect catheter to suction tubing, keeping catheter inside sterile sleeve. Turn on suction to level specified by institution policy (usually 80 to 120 mm Hg for wall suction). Connect oxygen source to manual resuscitation bag. (4) Pour saline into sterile container. (5) Put on sterile gloves. Keep dominant hand sterile at all times. (6) Suction small amount of saline into catheter. (7) Oxygenate patient with three ventilations using a manual resuscitation bag connected to an oxygen source, using the nonsterile hand. If the patient is mechanically ventilated, use manual sigh. (8) With thumb control uncovered to stop suction, insert suction catheter through tracheostomy tube until patient coughs or resistance is met. (9) Slowly withdraw catheter, suctioning intermittently while rotating it. The entire procedure should take no more than 15 seconds. (10) Allow patient to rest.
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