Lady_Luck

Thanks for the encouragement, it did make me feel better. I'm still a little confused, though, about a couple things. As far as the mucous plug, if the patient had one I think it would be in a bronchus. The catheter might be too small to suction out the plug, but it might be able to remove part of it. However, if the goal is to get to the bronchus, then I don't understand the difference between going in nasally and going in orally...because if I went in nasally, the suction catheter would pass through the nasopharynx and then go into the oropharynx. So it would still remove secretions from the back of the throat. As far as the BBG tip, it can be removed so that I can insert the suction catheter. He has a yonker so that I can suction the oral cavity, and that will probably be enough but if he did end up getting a mucous plug I'd like to be able to suction deeper than that. It's home health care and he lives out in the country, so if he coded from a mucous plug, I wouldn't have all the equipment I needed and it would take a long time for the ambulance to get there. So I'm mainly concerned about being in a situation where I need to use deep suctioning. If I needed to go past the oropharynx, would oral suctioning still work better than nasal suctioning? He is mentally handicapped and deaf, so I wouldn't be able to instruct him on coughing, and I'm scared that if I tried deep suctioning through the oral cavity he would fight the catheter and it would be more difficult than oral suctioning.

I have a random question for everyone. Have you guys heard of LPN's who obtain their MSN without having to get their BSN first? I'm an LPN with three years of experience (mostly med/surg), and in December I will have a bachelor's in science (with a double major in Biology and Psychology). I'd like to obtain my MSN and apply to medical school afterwards. I've already taken the prerequisites for medical school, I just have the MCAT left. But before I go on to medical school, I would like to work in nursing for a few more years. So I'd like to obtain my MSN, but if I still have to do the LPN-to RN-to BSN transition, then it might be a better idea to just apply to med school and skip trying to get my MSN first. Do you guys know if the 3 years of experience I have would help at all when it comes to trying to get my MSN? I've looked at MSN admission programs, but this is not a common question and I couldn't find any info on it anywhere.

Does anyone have any tips on suctioning for a 3 y/o patient? I am new to pediatrics (most of my experience is med/surg), and I have a patient who has a history of mucous plugs and uses a vibra-vest and periodic suctioning (due to partial paralysis). I work in home health, so I work with this patient every week. They usually suction only his nares with a BBG nasal aspirator tip (or a "mushroom tip"). He has orders for PRN suctioning. The mother would like me to do this orally, and the nurse I did orientation with agreed with the mother. However, I don't see any benefits to suctioning orally as opposed to nasally (without the BBG adaptor). I think that trying to suction a 3 y/o orally would just be even more traumatizing, and more difficult. The nurse who was in charge of my orientation did not seem to know very much about suctioning, so I could really benefit from some advice from other Peds nurses. I am very comfortable with suctioning in adults, but not with children. Any advice?