05 Suctioning

Question 1

Whats important to remember in regards to a suctioning order?

Answer 1

All orders are prn. If not listed as prn in the orders, you should call the Dr.

Question 2

How will a chest x ray appear in a patient who has built up secretions?

Answer 2

The x ray will appear more gray/white.

**Remember that air appears black on x ray

Question 3

Aspiration includes both choking and what?

Answer 3

Suctioning is considered a form of aspiration

Question 4

What should you do if you have an order to suction a pt who has a PEEP of 15?

Answer 4

Since PEEP is above 10, you need to make sure you are using a closed system to suction them while protecting their PEEP

Question 5

What are the two absolute contraindications for suctioning?

Answer 5

Epiglottitis and Croup

Question 6

Set suction pressures for adult/child/infant

Answer 6

infant is -80 to -100 mmHg
Child is -100 to -120
Adult is -120 to -150

Question 7

When do you empty the secretions container that collects the secretions?

Answer 7

Do not wait for it to get all the way full….it can over flow into the wall vacuum system (Very costly to fix).

Question 8

What type of catheter can only be used in the oral cavity?

Answer 8

Yonker aka Tonsil Tip

Question 9

Which catheter would you want to use if you were to suction the left main stem bronchi?

Answer 9

Coude (directional)

Question 10

When suctioning, at what point do you occlude the thumb control?

Answer 10

You occlude the hole once you have advanced the catheter as far as needed. (occlude when pulling out)

Question 11

What system is used for suctioning patients that are on high PEEP levels?

Answer 11

Ballard system (closed-system)

Question 12

What is a common ECG arrhythmia that you would see with suctioning?

Answer 12

Tachycardia. You could also see PVC due to hypoxia.

Question 13

How can bradycardia be a result of suctioning?

Answer 13

If you hit the vagal nerve, they will go bradycardic and you should hyperoxygenate them

Question 14

What are the three ECG rhythms that can be associated with suctioning?

Answer 14

PVC and tachycardia (due to hypoxia), bradycardia/hypotension (vagal nerve stimulation)

Question 15

How do you troubleshoot suction set up when the pressure is lower than it should be? what about if it is INCREASED?

Answer 15

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.

Question 16

Artificial airways have measurement marking in what increment?

Answer 16

mm

Question 17

Suction catheters come in what type of sizes?

Answer 17

French sizes

Question 18

What is the most commonly used suction catheter size?

Answer 18

14

Question 19

When estimating the proper size of suction catheter to use, which measurement is used?

Answer 19

You take the INNER diameter, multiply by 2. Then choose one size smaller.

Question 20

How often are in closed suction systems swapped out for new ones?

Answer 20

q 24-72 hours (depends on facility policy)

Question 21

Important thing to keep in mind for the boards’ exam regarding catheter size

Answer 21

suction catheter size must never be more than one half the internal diameter of the tracheal tube

Question 22

Purpose of suctioning

Answer 22

To maintain a patent airway by removing secretions, blood, foreign substances and facilitate pulmonary hygiene in people who have a weak cough

Question 23

What are the three most common substances for use with lavage and suctioning

Answer 23

Normal Saline, mucomyst, and sodium bicarbonate 2%.

Question 24

Which solution will you use when obtaining a sputum specimen?

Answer 24

You can only use normal saline

Question 25

How quickly do you need to suction after instilling lavage?

Answer 25

Immediately. You should not instill the solution until you are 100% ready to go.

Question 26

How long do you limit suctioning to?

Answer 26

You want to be less than 15 seconds from when the catheter is introduced