Question

The nurse performs nasotracheal suctioning of a patient. The nurse finds that the patient gags and becomes nauseated upon insertion of the catheter into the trachea. Which response should the nurse take?

1) Ask the patient to swallow and repeat the insertion of catheter.
2) Turn the patient's head to left and suction the left bronchus.
3) Perform suction during insertion to make insertion easy.
4) Gently remove the catheter and wait until the patient breathes normally.

Answer 1

The nurse should gently remove the nasal-tracheal catheter and wait for the patient's normal breathing to resume before considering another attempt, ensuring patient safety and comfort.

Step-by-step explanation:

When the nurse finds that a patient gags and becomes nauseated upon insertion of the catheter into the trachea for nasotracheal suctioning, the appropriate response is to gently remove the catheter and wait until the patient breathes normally. This approach minimizes the risk of aspiration and further discomfort for the patient. In the meantime, the nurse should monitor the patient's vital signs and provide reassurance. It is crucial to avoid performing suction during insertion, as this can exacerbate the gag reflex and increase the risk of vomiting and aspiration. Once the patient’s breathing has stabilized, the nurse may attempt reinsertion, with measures in place to reduce the risk of gagging, such as having the patient take deep breaths or using a topical anesthetic to numb the throat if appropriate and ordered by a physician.