Answer :
The correct procedure for suctioning a tracheostomy tube that was placed 3 days ago is to limit each suction pass to 10-15 seconds. This means the correct answer is:
C) Limit each suction pass to 10-15 seconds.
Here's why this is the appropriate process:
- Limiting each suction pass to a short period of time, such as 10-15 seconds, helps to minimize the risk of hypoxia (a lack of sufficient oxygen in the body's tissues). Suctioning removes not only secretions but also air from the airways, which can lead to low oxygen levels if done for too long.
- Inserting the suction catheter until resistance is met is not the best practice because it can cause trauma to the tracheal mucosa at the end of the tracheostomy tube. Instead, the catheter should be inserted to a predetermined length, which is usually a few centimeters beyond the end of the tracheostomy tube.
- Applying continuous suction while inserting the catheter is also not correct. Suction should only be applied while withdrawing the catheter, not while inserting it, to minimize damage to the tracheal lining.
- Hyperoxygenating the client is indeed an important step before suctioning, as it helps to ensure that the client's oxygen levels remain stable during the brief period when suctioning may interfere with ventilation. Providing 100% oxygen for about 30 seconds to a minute before and after suctioning is a common practice. However, limiting the suction pass time is a direct instruction relating to the act of suctioning, making it the best choice for this question.
Taking all of this into account, while hyperoxygenation is also a good practice, C is the most appropriate response as it most directly addresses the protocol for the duration of the actual suctioning process.
