A nurse is performing nasopharyngeal suctioning for an adult client. Which of the following techniques should the nurse use?

Insert the catheter 10 cm (4 in..

Apply suction while inserting the catheter.

Apply intermittent suction for 30 seconds.

Wait 1 min between suctioning attempts.

Answer and Explanation

The Correct Answer is D

A.   In adults insert catheter approximately 16 cm (6.5 inches); in older children, 8– 12 cm (3–5 inches); in infants and young children, 4–7.5 cm (1.5–3 inches). Rule of thumb is to insert catheter distance from tip of nose (or mouth) to angle of mandible.
B.   Suction should not be applied while inserting the catheter, as it could cause trauma to the mucosa and increase discomfort. Suction should only be applied while withdrawing the catheter, and it should be done intermittently to avoid injury and reduce the risk of hypoxia.
C.   Suctioning should not exceed 10-15 seconds at a time to prevent hypoxia and other complications. Prolonged suctioning can lead to oxygen depletion and potential respiratory distress in the client.
D.   Waiting at least 1 minute between suctioning attempts allows the client to recover and helps maintain adequate oxygenation. This pause is essential to prevent hypoxia and to ensure the client has time to breathe normally before the next suctioning attempt.

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Correct Answer is D

Explanation

A. Incorrect. Tingling of the scalp is not a common adverse reaction following electroconvulsive therapy (ECT.
B. Incorrect. Voice alteration is not a common adverse reaction following ECT.
C. Incorrect. Neck pain is not a common adverse reaction following ECT.
D. Correct. Temporary memory loss is a common adverse reaction following ECT. Some clients may experience confusion and memory deficits immediately after the procedure, but these effects are typically temporary and resolve as the client recovers from the treatment.

A. Cause of the client's death B. Last set of the client's vital signs C. Copy of the client's advance directives D. Location of the identification tag on the client's body

Correct Answer is D

Explanation

A. Incorrect. The cause of death is an important piece of information but is typically included in the official death certificate rather than in routine postmortem documentation.
B. Incorrect. While vital signs are important during the client's care, the last set of vital signs is not usually a primary focus of postmortem documentation.
C. Incorrect. Advance directives are relevant to the client's care during life but are not typically included in postmortem documentation.
D. Correct. Documentation of the location of the identification tag on the client's body is important for accurate identification and tracking during the postmortem process.

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A nurse is performing nasopharyngeal suctioning for an adult client. Which of the following techniques should the nurse use?

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Naxlex Comprehensive Predictor Exams

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