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.)

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

For endotracheal suctioning, the nurse should apply suction while withdrawing the catheter, maintain medical asepsis, use a new catheter per attempt, and limit the suction attempts to two to three.

Explanation:

Endotracheal suctioning is a crucial procedure that must be carried out with utmost regard to aseptic principles to prevent infections. Suctioning should be based on the patient's need, not on a routine schedule. The nurse should adhere to the following guidelines: apply suction while withdrawing the catheter. This is because applying suction while advancing could cause damage to the tracheal tissue. Maintain medical asepsis during suctioning.

This involves thorough handwashing, use of sterilized equipment, and maintaining a sterile field to prevent contamination and possible introduction of infectious microbes to the patient. The nurse should also use a new catheter for each suctioning attempt to prevent any chance of cross-contamination. Lastly, limit the suctioning to two to three attempts as repeated attempts can cause trauma and lead to other complications. The guideline to perform suctioning on a routine basis every 2 to 3 hours may not be applicable as suctioning should be performed based on patient's need rather than on a set schedule.

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