The nurse observes the student nurse suctioning a patient with a tracheostomy. Which action by the student nurse requires the nurse to intervene? (Select all that apply.)

1. The student preoxygenates the patient before beginning suctioning.
2. The student suctions the patient for 30 seconds during each suctioning attempt.
3. The student uses tap water to clear the catheter tubing between suction attempts.
4. The student applies intermittent suction when withdrawing the suction catheter from the airway.
5. The student places the thumb over the suction control vent when advancing the catheter into the patient's airway.

Among the student nurse's actions, suctioning the patient for 30 seconds, using tap water to clear the catheter, and placing the thumb over the suction control vent when advancing the catheter must be corrected. These actions can cause patient complications.

Explanation:

The actions by the student nurse that require the observing nurse to intervene are: 1. The student suctions the patient for 30 seconds during each suctioning attempt. 2. The student uses tap water to clear the catheter tubing between suction attempts. 3. The student places the thumb over the suction control vent when advancing the catheter into the patient's airway.

The suctioning process should not exceed 15 seconds as prolonged suction can cause hypoxia. Sterile solution, not tap water, should be used to prevent infection. Placing the thumb over the suction control vent when advancing the catheter can create excessive negative pressure that can damage the tracheal mucosa.

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