Evidence based Knowledge

[Dressagern]

So I am trying to find evidence for 2 exam questions I do not agree on from my last exam.

The first question was a priority question. If you walked into a COPD patients room and they were SOB what would you do first? I went with the ABC and prioritized raising the head of the bed to help facilitate in a better position for breathing and airway clearance

The correct answer was facilitate with Purse lip breathing..

I do not agree on this.... as I agree that PRL is important but not a priority action...if given those two choices! I am allowed to question the answer but need evidence based knowledge...so as anyone seen info on this...I have looked everywhere and haven't.

The second is with suctioning..the question asked what would you do before and after suctioning a client ( it did not state that client had any trach tube ). So I would answer you would assess the clients airway and breath sounds before suctioning and after as you do not want to do any unnecessary suctioning as that can cause bronchiospasms, and you would want to asses after to see if you suctioning was successful... So again I am looking for evidence based knowledge...as I was told you would hyper-oxygenate any person before suctioning...I am only finding you would hyper-oxygenate a person with a trach tube? Also again wouldn't your priority action be to asses lung sounds to see if suctioning is necessary?? thanks for any help!

[SopranoKris, MSN, RN, NP]

Hyper-oxygenation before suction is definitely correct. That was on our lecture exam and skills evaluation. Not sure what text book you use, but if you are using Medical-Surgical Nursing, Volume 7 by Ignatavicius, it states this on page 574 in the Best Practice for Patient Safety & Quality - Suctioning Artificial Airway, Chart 30-2. And also middle of page 575 in the Suctioning section.

COPD, pg 618 lists priority intervention as breathing techniques (diaphragmatic or purse-lipped breathing), followed by positioning in an upright position to alleviate dyspnea & conserve energy.

[nurseprnRN, BSN, RN]

Anytime you are going to suck air out of somebody's chest (and of course you are if you stick a suction cath down there, no matter what route you take), you should preoxygenate. You may or may not cause bronchospasm (check that spelling too) but it's the oxygenation that's important here.

Pursed-lip breathing (note spelling): Pursed lip breathing: MedlinePlus Medical Encyclopedia