A nurse is reinforcing teaching with a group of adolescents about safety. Which of the following information should the nurse include in the teaching?

Answer: d. Apply suction in 3 to 4-second increments.

Rationale:

• a. Instill 2 mL of 0.9% sodium chloride prior to suctioning:While saline instillations may be used in some cases,it is not universally recommended for infants with tracheostomies and depends on the specific situation and healthcare provider's protocol.The priority in this case is to quickly clear the partial mucus occlusion to prevent respiratory distress.
• b. Select a catheter that fits snugly into the tracheostomy tube:This isincorrect.Selecting a catheter that fits tightly can damage the delicate tracheal mucosa and increase the risk of bleeding.A smaller-diameter catheter that allows for gentle passage is preferred.

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  Tracheostomy tube and different catheter sizes

• c. Use a clean technique when performing suctioning:This is absolutely essential for all suctioning procedures to minimize the risk of infection.However,it is not the specific action that addresses the immediate concern of clearing the partial mucus occlusion.
• d. Apply suction in 3 to 4-second increments:This is thecorrectapproach for suctioning an infant with a tracheostomy.Applying short,intermittent suction bursts minimizes the risk of hypoxia and tissue trauma while effectively removing secretions.

Therefore, the most important action for the nurse to take is to apply suction in short, 3-4 second bursts to effectively clear the mucus occlusion while minimizing risks to the infant.

Additional Points:

• The nurse should use sterile suction equipment and sterile technique throughout the procedure.
• The suction pressure should be set at the lowest effective level,typically 80-120 mmHg.
• The nurse should monitor the infant for signs of respiratory distress,such as increased work of breathing,retractions,and oxygen desaturation,before,during,and after suctioning.
• If the mucus occlusion is not cleared after several attempts,the nurse should seek assistance from ahealthcareprovider.

Choice A rationale:
Correct Choice. Current pregnancy is a contraindication to administering the measles, mumps, and rubella (MMR) vaccine. The MMR vaccine contains live attenuated viruses, and it is generally contraindicated during pregnancy due to the potential risk to the developing fetus. Pregnant individuals should wait until after giving birth to receive the MMR vaccine.
Choice B rationale:
Mild ear infection is not a contraindication to administering the MMR vaccine. Mild illnesses, such as mild upper respiratory infections or low-grade fevers, are not typically considered contraindications for vaccination. In fact, immunization might be recommended in these cases to ensure protection against preventable diseases.
Choice C rationale:
A family history of seizures is not a contraindication to administering the MMR vaccine. Seizures are not known to be associated with the MMR vaccine. Therefore, a family history of seizures would not preclude an individual from receiving the vaccine.
Choice D rationale:
Severe peanut allergy is not a contraindication to administering the MMR vaccine. Allergies, including severe peanut allergies, are not considered contraindications for the MMR vaccine. Only individuals with a known severe anaphylactic allergy to a vaccine component (such as gelatin or neomycin) would have a contraindication to receiving the vaccine.