Saunders Respiratory Practice

When suctioning through a tracheostomy tube, what should the nurse do if the client begins to cough and wheeze?

1. Continue suctioning to clear the airway

2. Disconnect the suction source from the catheter

3. Administer a bronchodilator

4. Check the position of the tracheostomy tube

The correct answer is: Disconnect the suction source from the catheter

When a client begins to cough and wheeze during suctioning through a tracheostomy tube, the appropriate action is to disconnect the suction source from the catheter. This is essential because coughing and wheezing indicate that the client is experiencing respiratory distress or irritation, which may be worsened by continuous suctioning. Discontinuing suctioning allows the client to breathe more easily and reduces the likelihood of further irritation to the airway. Furthermore, it is crucial to monitor the client's response and assess their airway and lung sounds after disconnecting to determine if further intervention is needed. While the other options may provide some level of support, they could potentially exacerbate the situation. For example, continuing suctioning could result in further airway irritation, while administering a bronchodilator might not be appropriate if the immediate priority is to alleviate the distress caused by the suctioning. Checking the position of the tracheostomy tube may be relevant but is typically done after addressing the immediate symptoms of coughing and wheezing. In summary, disconnecting the suction source is the safest first step in response to signs of respiratory distress during the procedure.