05 Suctioning Flashcards
Whats important to remember in regards to a suctioning order?
All orders are prn. If not listed as prn in the orders, you should call the Dr.
How will a chest x ray appear in a patient who has built up secretions?
The x ray will appear more gray/white.
**Remember that air appears black on x ray
Aspiration includes both choking and what?
Suctioning is considered a form of aspiration
What should you do if you have an order to suction a pt who has a PEEP of 15?
Since PEEP is above 10, you need to make sure you are using a closed system to suction them while protecting their PEEP
What are the two absolute contraindications for suctioning?
Epiglottitis and Croup
Set suction pressures for adult/child/infant
infant is -80 to -100 mmHg
Child is -100 to -120
Adult is -120 to -150
When do you empty the secretions container that collects the secretions?
Do not wait for it to get all the way full….it can over flow into the wall vacuum system (Very costly to fix).
What type of catheter can only be used in the oral cavity?
Yonker aka Tonsil Tip
Which catheter would you want to use if you were to suction the left main stem bronchi?
Coude (directional)
When suctioning, at what point do you occlude the thumb control?
You occlude the hole once you have advanced the catheter as far as needed. (occlude when pulling out)
What system is used for suctioning patients that are on high PEEP levels?
Ballard system (closed-system)
What is a common ECG arrhythmia that you would see with suctioning?
Tachycardia. You could also see PVC due to hypoxia.
How can bradycardia be a result of suctioning?
If you hit the vagal nerve, they will go bradycardic and you should hyperoxygenate them
What are the three ECG rhythms that can be associated with suctioning?
PVC and tachycardia (due to hypoxia), bradycardia/hypotension (vagal nerve stimulation)
How do you troubleshoot suction set up when the pressure is lower than it should be? what about if it is INCREASED?
If it is reading lower, the problem is almost always going to be a leak. If it is reading higher than it should be, the problem is probably due to an obstruction in the catheter tubing.
Artificial airways have measurement marking in what increment?
mm
Suction catheters come in what type of sizes?
French sizes
What is the most commonly used suction catheter size?
14
When estimating the proper size of suction catheter to use, which measurement is used?
You take the INNER diameter, multiply by 2. Then choose one size smaller.
How often are in closed suction systems swapped out for new ones?
q 24-72 hours (depends on facility policy)
Important thing to keep in mind for the boards’ exam regarding catheter size
suction catheter size must never be more than one half the internal diameter of the tracheal tube
Purpose of suctioning
To maintain a patent airway by removing secretions, blood, foreign substances and facilitate pulmonary hygiene in people who have a weak cough
What are the three most common substances for use with lavage and suctioning
Normal Saline, mucomyst, and sodium bicarbonate 2%.
Which solution will you use when obtaining a sputum specimen?
You can only use normal saline
How quickly do you need to suction after instilling lavage?
Immediately. You should not instill the solution until you are 100% ready to go.
How long do you limit suctioning to?
You want to be less than 15 seconds from when the catheter is introduced
