A nurse is preparing to suction a patient via the nasotracheal route. Which conditions should the nurse recognize as contraindications to nasotracheal suctioning? (Select all that apply.)
a. Motor vehicle accident with acute head injuries
b. History of hemophilia
c. Epiglottitis or croup
d. Environmental allergies with sinus drainage
A, B, C
Contraindications to nasotracheal suctioning include facial or neck trauma/surgery, acute head injuries, bleeding disorders, nasal bleeding, epiglottitis or croup, laryngospasm, irritable airway, and gastric surgery. These conditions are contraindications because the passage of a catheter through the nasal route causes additional trauma, increases nasal bleeding, or causes severe bleeding in the presence of bleeding disorders. In the presence of epiglottitis, croup, laryngospasm, or irritable airway, the entrance of a suction catheter via the nasal route causes intractable coughing, hypoxemia, and severe bronchospasm; this may necessitate emergency intubation or tracheostomy. Allergies with sinus drainage will increase the volume of secretions in the pharynx and may require suctioning.
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