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NLN Community-based Home Health Nursing Core RN Sample Test

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A 20-year-old patient is admitted to the hospital with respiratory failure. He’s intubated, given oxygen, and is coughing with copious secretions in his lungs. What should be done first?

Correct Answer:

suction the lungs

in the case of a 20-year-old patient admitted to the hospital with respiratory failure, who is intubated and presenting with copious lung secretions, the immediate action should be to suction the lungs. this step is crucial because it directly addresses the patient's ability to breathe, which is compromised by the excess secretions obstructing the airways. clearing these secretions will help stabilize the patient’s respiratory status and improve oxygenation, which is critical in preventing further complications associated with respiratory failure.

other actions such as calling his family, checking his heart rate and blood pressure, or calling for assistance in restraining the patient, while important in the broader scope of patient care, are secondary at this juncture. the urgent need is to ensure that the airways are clear. once this is achieved and the patient's immediate breathing needs are stabilized, healthcare providers can then proceed to monitor vital signs like heart rate and blood pressure, which will give further insights into the patient's overall cardiovascular status and potential needs for additional interventions.

similarly, while informing the family about the patient’s condition is an essential aspect of holistic care and supports the patient’s emotional and psychological well-being, it does not precede the critical need for maintaining patent airways. furthermore, unless the patient is exhibiting behavior that poses a risk to himself or others, restraint should not be prioritized over respiratory management.

in summary, the first and foremost action in managing a patient with respiratory failure and significant pulmonary secretions is to perform suctioning. this ensures that the airways are clear, thus facilitating better gas exchange and improving the patient’s immediate survival prospects. subsequent steps can then be taken in a more controlled and less emergent manner, once the primary life-threatening issue has been addressed.