Podcast
Questions and Answers
What is the name of the part of the pharynx located behind the mouth?
What is the name of the part of the pharynx located behind the mouth?
Oropharynx
When is suctioning used?
When is suctioning used?
When coughing does not adequately clear respiratory secretions and secretions are interfering with oxygenation.
Which of the following are types of suctioning? (Select all that apply)
Which of the following are types of suctioning? (Select all that apply)
LPNs can suction the nasal passages beyond the point where they normally narrow without additional education and an order.
LPNs can suction the nasal passages beyond the point where they normally narrow without additional education and an order.
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LPNs can carry out nasopharyngeal swabs after successfully completing additional education.
LPNs can carry out nasopharyngeal swabs after successfully completing additional education.
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LPNs can insert nasogastric tubes.
LPNs can insert nasogastric tubes.
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LPNs can provide tracheostomy care to clients who have well-established tracheostomies after successfully completing additional education and with an order.
LPNs can provide tracheostomy care to clients who have well-established tracheostomies after successfully completing additional education and with an order.
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What are some specific signs that a client might need suctioning?
What are some specific signs that a client might need suctioning?
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What assessments would you perform prior to suctioning?
What assessments would you perform prior to suctioning?
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How often would you suction a patient?
How often would you suction a patient?
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What should you monitor during suctioning?
What should you monitor during suctioning?
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What are some of the equipment needed for suctioning?
What are some of the equipment needed for suctioning?
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What should you do before suctioning?
What should you do before suctioning?
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What are the steps for performing oropharyngeal suctioning?
What are the steps for performing oropharyngeal suctioning?
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What should you do if SpO2 drops or respiratory distress develops during nasopharyngeal suctioning?
What should you do if SpO2 drops or respiratory distress develops during nasopharyngeal suctioning?
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What are the two main sections of the pharynx?
What are the two main sections of the pharynx?
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When would suctioning be used?
When would suctioning be used?
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Which of the following types of suctioning requires a sterile procedure?
Which of the following types of suctioning requires a sterile procedure?
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LPNs can perform which of the following procedures?
LPNs can perform which of the following procedures?
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According to the slides, what are some signs that a client might need suctioning?
According to the slides, what are some signs that a client might need suctioning?
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What are the two main types of suctioning?
What are the two main types of suctioning?
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What should be done before suctioning a client?
What should be done before suctioning a client?
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What equipment is used for suctioning?
What equipment is used for suctioning?
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How do you prep the suction catheter before performing oropharyngeal suctioning?
How do you prep the suction catheter before performing oropharyngeal suctioning?
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What is the recommended catheter insertion depth for adults during nasopharyngeal suctioning?
What is the recommended catheter insertion depth for adults during nasopharyngeal suctioning?
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How long do you apply suction for on the catheter during nasopharyngeal suctioning?
How long do you apply suction for on the catheter during nasopharyngeal suctioning?
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It is important to rotate the catheter back-and-forth between your thumb and forefinger while slowly withdrawing it after nasopharyngeal suctioning.
It is important to rotate the catheter back-and-forth between your thumb and forefinger while slowly withdrawing it after nasopharyngeal suctioning.
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What should be done to the suction catheter after nasopharyngeal suctioning?
What should be done to the suction catheter after nasopharyngeal suctioning?
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It is okay to leave the nasal cannula on during oropharyngeal suctioning.
It is okay to leave the nasal cannula on during oropharyngeal suctioning.
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When is it important to reapply the nasal cannula or mask during suctioning?
When is it important to reapply the nasal cannula or mask during suctioning?
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Study Notes
Suctioning Overview
- Suctioning is a procedure used to remove secretions from the respiratory tract when a client cannot clear them through coughing.
- This procedure is necessary when secretions interfere with oxygenation.
- Oropharyngeal/nasopharyngeal suctioning treats the back of the throat.
- Orotracheal/nasotracheal suctioning involves insertion into the trachea.
- Tracheostomy or endotracheal suctioning requires sterile technique.
Pharyngeal Anatomy
- The oropharynx lies behind the mouth, extending from the soft palate to the hyoid bone. It contains the tonsils.
- The nasopharynx is positioned behind the nose, reaching to the soft palate.
Suctioning - When It's Used
- Suctioning is used when a client's cough is ineffective in clearing respiratory secretions that impede oxygenation.
- Conditions requiring suctioning include secretions in the mouth, abnormal respiratory rate, or adventitious breath sounds (e.g., gurgling, drooling).
- Secretions in the oropharyngeal or nasopharyngeal area or within an artificial airway are all reasons to consider suctioning.
LPN Scope of Practice Guidelines - Restrictions
- LPNs are restricted from inserting nasogastric (NG), orogastric (OG) tubes, and nasopharyngeal washes.
- LPNs can perform suctioning of the nasal passages beyond the point of normal narrowing (after completing additional education and receiving a physician order).
- LPNs can perform nasopharyngeal swabs (after completing additional education).
- LPNs can manage well-established tracheostomy care (after completing additional education).
Suctioning Equipment
- Sterile suction catheter
- Water-soluble lubricant
- Gloves
- Suction regulator/container
- Bowl
- Face shield
- Towel
- Water
Procedure for Suctioning
- Assess the client's need for suctioning.
- Use either wall or portable suction.
- Set the suction regulator to 100-150 mmHg (adults), 7-15 mmHg (portable).
- Apply sterile gloves and a protective mask.
- Fill a sterile bowl with 100mL of sterile normal saline.
- Connect the suction catheter or Yankauer (tonsil suction) to the tubing.
- May leave nasal cannula in place (remove masks if SpO2 drops or respiratory distress develops).
Oropharyngeal Suctioning
- Lubricate the suction catheter with water.
- Insert the catheter or Yankauer into the client's mouth.
- With suction applied, move the catheter around the mouth, pharynx, and gum line until secretions are cleared.
- Encourage the client to cough.
- Repeat if needed.
- Remove secretions from the catheter with suction water or saline; clean and dry the catheter for reuse.
- Replace oxygen (O2) if required.
Nasopharyngeal Suctioning
- Apply sterile gloves.
- Attach the suction tubing (with the non-sterile hand).
- Suction a small amount of normal saline from the bowl.
- Lubricate the catheter.
- Insert the catheter into the nostril during inhalation.
- Advance the catheter to the back of the pharynx without applying suction.
- Gently withdraw the catheter while rotating it.
- Rinse the catheter and dry it for reuse.
- Turn the suction off.
- In adults, insert the catheter about 20 cm from the tip of the nose to the base of the earlobe.
- Apply intermittent suction for up to 10 seconds, releasing the thumb from the catheter valve after each suction.
- Slowly withdraw the catheter, rotating it back and forth, between the thumb and forefinger.
- Rinse the catheter and store it in a clean, dry area for reuse.
Assessment Questions
- How do you determine if a client needs suctioning?
- What are the signs indicative of suctioning needs?
- Which assessment tools should be used prior to suctioning?
- How often should suctioning be performed?
- What parameters should be monitored during suctioning?
Assessment Answers
- Inability to clear secretions through coughing, abnormal respiratory rate, adventitious sounds (gurgling, drooling), nasal secretions are all signs that a client needs suctioning.
- Vital signs (VS), pulse oximetry, and a lung assessment are completed first.
- Suctioning isn't a routine procedure.
- Monitor the color, pulse oximetry, pulse rate, and respiratory rate (RR), and presence of/change in sounds during suctioning.
Videos
- Oropharyngeal Suctioning (non-sterile): https://www.youtube.com/watch?v=7XyfHY9iSWY
- Nasopharyngeal Suctioning (sterile): https://www.youtube.com/watch?v=TwNSNodYfEw&feature=related
References
- Potter, P., & Perry, A. (2019). Canadian fundamentals of nursing. (6th ed.). Elsevier.
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Description
This quiz covers the essential procedures and techniques of suctioning, including its necessity when clients cannot clear secretions effectively. It also examines the anatomy involved and the conditions that warrant the use of suctioning in respiratory care.
