Certified Pediatric Nurse (CPN)

What represents appropriate care for a child with a tracheostomy needing suctioning?

1. Measure the catheter against the extra trach tube before suctioning

2. Instil 2-3 drops of sterile saline into the trach

3. Insert the catheter until resistance is met before withdrawing

4. Have two additional trach tubes at the bedside

The correct answer is: Measure the catheter against the extra trach tube before suctioning

Measuring the catheter against the extra trach tube before suctioning is an essential practice as it helps determine the appropriate length to insert the catheter into the tracheostomy tube. This practice is crucial to avoid causing trauma to the airway or pushing the catheter too far, which could lead to complications such as inducing a cough reflex or damaging the mucosa of the airways. By measuring, the nurse knows how far to insert the catheter to effectively clear secretions without causing harm. The other practices mentioned, such as instilling saline into the trach or inserting the catheter until resistance is met, may not align with current evidence-based practices for suctioning a tracheostomy. Additionally, while having extra trach tubes at the bedside is a good safety measure, it does not directly relate to the procedure of suctioning. Hence, measuring the catheter length is the most appropriate action to ensure safe and effective suctioning in a child with a tracheostomy.