Scribd
Upload
34 views

Quiz A

This document provides instructions for close thoracostomy tubing, oro/nasal suctioning, and endotracheal tubing. It outlines the steps to collect fluid samples from thoracostomy tubing and perform safe oral and nasal suctioning. The document also lists assessments and care considerations for patients with endotracheal tubes, including securing the tube, monitoring cuff pressure, oral care, positioning, and providing nutrition via enteral feeding tubes.

Uploaded by

MARIA CHARMIN M. MEJIA
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
34 views

Quiz A

This document provides instructions for close thoracostomy tubing, oro/nasal suctioning, and endotracheal tubing. It outlines the steps to collect fluid samples from thoracostomy tubing and perform safe oral and nasal suctioning. The document also lists assessments and care considerations for patients with endotracheal tubes, including securing the tube, monitoring cuff pressure, oral care, positioning, and providing nutrition via enteral feeding tubes.

Uploaded by

MARIA CHARMIN M. MEJIA
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 2

MARIA CHARMIN M.

MEJIA

BSNII-RUBY

Close Thoracostomy Tubing

1. Wait for the fluid to collect in a loop of the tubing


2. Perform hand hygiene, then don gloves & eye protection
3. Clean the sampling port, or for smaller sampling volumes you can use the patient tube, with an
alcohol wipe and leave to dry for 20 seconds
4. Clamp the tubing above where the fluid has collected
5. Connect a 10ml lock syringe to the sampling port and aspirate the fluid out of the tubing. If
using the patient tube clamp the tubing then use a 20 gauge needle with syringe to aspirate
specimen.
6. Place fluid in sterile specimen container
7. Once the syringe is disconnected remove all clamps and kinks
8. Perform hand hygiene

Oro/ Nasal Suctioning


 Avoid oral suctioning on patients with recent head and neck surgeries.
 Use clean technique for oral suctioning.
 Know which patients are at risk for aspiration and are unable to clear secretions because
of an impaired cough reflex. Keep supplies readily available at the bedside and ensure
suction is functioning in the event oral suctioning is required immediately.
 Know appropriate suctioning limits and the risks of applying excessive pressure or
inadequate pressure.
 Avoid mouth sutures, sensitive tissues, and any tubes located in the mouth or nares.
 Avoid stimulating the gag reflex.
 Always perform a pre- and post-respiratory assessment to monitor patient for
improvement.
 Consider other possible causes of respiratory distress, such as pneumothorax,
pulmonary edema, or equipment malfunction.
 If an abnormal side effect occurs (e.g., increased difficulty in breathing, hypoxia,
discomfort, worsening vital signs, or bloody sputum), notify appropriate health care
provider.

Endotracheal Tubing
 Ensure that the required oxygen support indicated for the patient is provided.
 Assess the client’s respiratory status at least every 2 hours or frequently as indicated.
Note the lung sounds and presence of secretions.
 Ensure that adequate humidity is provided to avoid feeling of dryness in the oropharynx.
 Suction secretions orally to prevent aspiration. This also decreases the risk for infection.
 Assess nasal and oral mucosa for redness and irritation.
 Secure the endotracheal tube with tape or ET holder to prevent movement or deviation
of the tube in the trachea.
 Place the patient in a side-lying position or semi fowler’s if not contraindicated to avoid
aspiration. Reposition patient every 2 hours. This will allow the lungs to expand better
and prevent secretions stagnation.
 Ensure the ET for placement. Note lip line marking and compare it with the desired
placement (18cm, 20cm, and 22cm).
 Closely monitor cuff pressure, maintaining a pressure of 20 to 25 mmHg to minimize the
risk of tracheal necrosis.
 Move the oral endotracheal tube to the opposite of the mouth every 8 hours or
depending on the protocol of the hospital. This is to prevent irritation to the oral
mucosa.
 Provide oral care at least every 4 hours using an antibacterial or antiseptic solution. Use
a bite block to avoid patient from biting down. Frequent oral care in intubated patients
will decrease the risk of ventilator-acquired pneumonia.
 Use a bite block to avoid patient from biting down.
 Turn patient’s head to the side to reduce the risk for aspiration.
 Communicate frequently with the client. Give patient means to communicate using a
whiteboard or communication board.
 Nutritional Consideration (Smeltzer, S., et. al, 2010)
 Oral feeding is contraindicated. Enteral feeding is the route for nutritional support. The
most common route for enteral feeding is through a nasogastric tube.
 Do steps in preventing aspiration during feeding. Check the placing of the nasogastric
tube. Place patient in high Fowler’s position.
 Ensure patient’s comfort during suctioning and other procedure that involves
manipulating the endotracheal tube.

You might also like