An adult patient is receiving mechanical ventilatory support and is being suctioned through the endotracheal tube at a pressure of -90 mmHg. Secretions have been difficult to remove. What can be done first to increase suctioning efficiency?

A. Increase suction time
B. Decrease suction to 80 mmHg
C. Increase suction pressure to 100 mmHg
D. Increase suction catheter size

To increase the efficiency of suctioning through an endotracheal tube, the best first step would be to increase the suction pressure to 100 mmHg, as it can help remove difficult secretions more effectively.

Explanation:

The question is asking about the best approach to improve the efficiency of suctioning secretions via an endotracheal tube in a patient on mechanical ventilation. The most effective first step to achieve this could be option c. increase suction pressure to 100 mmHg.

Applying higher suction pressure can help in removing the difficult secretions. However, it should be noted that extremely high suction pressures can potentially cause damage to the respiratory tract tissues, so caution is necessary. The range between 80 to 120 mm Hg is often considered appropriate for most adults.

Other options mentioned here i.e., changing the suction duration (a), reducing the suction pressure (b) or increasing the catheter size (d) are generally not considered the first steps to improve suction efficiency, and might not lead to the desired result.

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