A nurse is preparing to perform endotracheal suctioning for a client. Which of the following are appropriate guidelines for the nurse to follow? Select all that apply.

A. Apply suction while withdrawing the catheter
B. Perform suctioning on a routine basis, every 2-3 hours
C. Maintain medical asepsis during suctioning
D. Use a new catheter for each suctioning attempt
E. Limit suctioning to 2-3 attempts

When performing endotracheal suctioning, the nurse should apply suction while withdrawing the catheter, use a new catheter each time, and limit attempts to 2-3 to avoid airway trauma and hypoxia. Maintaining medical asepsis is vital to prevent infections.

Explanation:

The appropriate guidelines for a nurse preparing to perform endotracheal suctioning include: Applying suction while withdrawing the catheter, which helps to remove secretions efficiently while minimizing mucosal damage. Use a new catheter for each suctioning attempt to maintain medical asepsis and reduce the risk of infection. Lastly, Limit suctioning to 2-3 attempts, as excessive suctioning can lead to hypoxia and trauma to the airways. It is not recommended to perform suctioning on a routine basis (Q2-3 hours) without assessing the need, as this can cause unnecessary harm to the patient.

It's crucial to maintain medical asepsis during endotracheal suctioning to prevent infections such as bloodstream infections, which can be caused by organisms like Staphylococcus. Following a sterile technique and using checklists to avoid missing steps can enhance patient safety, much like strategies used in intensive care units for inserting central intravenous lines.

ppriyagpt0 ppriyagpt0 · Answer 2 · 2023-11-20T20:52:29-05:00

Final answer:

When performing endotracheal suctioning, a nurse should apply suction while withdrawing the catheter, maintain medical asepsis, use a new catheter for each attempt, and limit suctioning to 2-3 attempts to ensure safety and prevent infection.

Explanation:

When a nurse is preparing to perform endotracheal suctioning for a client, several appropriate guidelines should be followed to ensure patient safety and procedure efficacy. The guidelines that the nurse should follow include:

Apply suction while withdrawing the catheter: Suction should only be applied while gently withdrawing the catheter to avoid trauma to the tracheal mucosa.
Maintain medical asepsis during suctioning: It is crucial to prevent infections by maintaining aseptic technique throughout the suctioning process.
Use a new catheter for each suctioning attempt: This reduces the risk of infection and ensures that each suctioning procedure is carried out with a sterile catheter.
Limit suctioning to 2-3 attempts: To minimize oxygen desaturation and potential damage to the airways, suctioning should be limited to a few necessary attempts.

It's important to note that suctioning should not be performed on a routine basis, such as every 2-3 hours, but rather as clinically indicated based on the patient's assessment.