1. The client/caregiver can state the purpose of oral or nasal suctioning.
    1. To mechanically remove secretions from the client’s airway via the nose (nasopharynx), mouth (oropharynx), or trachea
    2. To maintain an open and patent airway
  2. The caregiver can discuss/demonstrate how to prepare for suctioning.
    1. Show proper hand washing before and after suctioning.
    2. Explain purpose of the procedure, and include the method to be used.
    3. Gather equipment, including suctioning machine, suction catheters, sterile saline solution, and disposable gloves.
    4. Review signs and symptoms that indicate the need for suctioning, such as
      • Congested-sounding cough
      • Coarse wheezing that can be heard by the client or caregiver
      • Visible secretions
    5. Discuss that suctioning can be repeated as needed, but it is important to try deep breaths and to allow 20 to 30 seconds between suctioning attempts.
  3. The client/caregiver can demonstrate how to suction.
    1. Position client.
      1. The client should be in a semi-Fowler’s position.
      2. The unconscious client should be placed in the lateral position facing you.
    2. Turn on the suction machine and adjust to the appropriate pressure level.
    3. Open the suction catheter kit, and pour saline touching only the outside surface.
    4. Put on sterile gloves. The dominant hand that handles the catheter must remain sterile.
    5. Attach catheter to the suction tubing and moisten the catheter with saline.
    6. Place finger over Y tube to check suction.
    7. Gently insert a catheter with the suction off.
    8. Place catheter along the base of the nostril to trachea for nasopharynx suctioning.
    9. Insert catheter alongside the mouth towards the trachea for oropharynx suctioning.
    10. Do not suction until the catheter is fully inserted.
    11. Apply suction and gently rotate the catheter as it is withdrawn, limiting suctioning to 10 to 15 seconds.
    12. Flush tubing with sterile water after suctioning.
    13. Apply oxygen or instruct the client to take deep slow breaths after suctioning.
    14. Note the characteristics of sputum and the client’s response to suctioning.
    15. Use each catheter only once.
    16. Offer oral care and clean suction equipment.
  4. The client/caregiver can state measures to care for equipment.
    1. Keep adequate supplies on hand.
    2. Empty collection bottle after each suctioning.
  5. The client/caregiver can list general care measures.
    1. Signs and symptoms that should be reported to the physician or nurse are
      • Restlessness, anxiety, confusion, or difficulty concentrating
      • Bluish fingernails or lips
      • Palpitations
      • Fever
      • Changes in color, consistency, amount, and odor of secretions
    2. Keep follow-up appointments with a physician.
    3. Take medications as ordered.

Resources

Home health agency
Medical supply company
Respiratory therapist

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Inc.Canobbio, M. M. (2006). Mosby’s handbook of patient teaching. St. Louis: Mosby Inc.Taylor, C., Lillis, C., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott, Williams & Wilkins.Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott

Credits

Client Teaching Guides for Home Health Care, 2nd ed.© 2008 Jones and Bartlett Publishers, Inc.www.jbpub.com

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