A charge nurse is teaching a newly licensed nurse about health care-associated infections (HAIs). Which of the following should the nurse include in the teaching as examples of HAIS?

A. Proper oral hygiene is crucial for preventing ventilator-associated pneumonia (VAP), which is a common complication in ventilated patients. The bundle often includes instructions on how to perform mouth care to reduce the risk of bacterial colonization in the oral cavity and subsequent aspiration into the lungs.
B. Tracheostomy care, including suctioning as needed, is important to maintain airway patency and prevent complications like mucus plugging. However, specific instructions for suctioning frequency (e.g., every 2 hours) may vary based on the patient's clinical condition and the presence of secretions. It is not universally part of the ventilator care bundle but is an essential component of managing patients with tracheostomies.
C. Correct ventilator settings are critical to support adequate oxygenation and ventilation while minimizing lung injury. Nurses should be knowledgeable about how to monitor and adjust ventilator settings based on the patient's respiratory status. Education on ventilator settings may be included in

training related to mechanical ventilation management, but it is not typically part of a standardized ventilator care bundle.
D. The position of the patient can affect ventilation and respiratory mechanics. In the context of ventilator care, positioning recommendations may include elevating the head of the bed (semi-Fowler's position) to reduce the risk of aspiration and improve lung expansion. Placing the client in a supine position alone is not specific to the ventilator care bundle but may be considered based on the patient's clinical condition.

A. Keeping the client in a semi-Fowler's position (with the head of the bed elevated to 30-45 degrees) can help improve lung expansion and reduce the feeling of congestion. This position facilitates easier breathing but has no direct role in expectoration.
B. Adequate hydration helps to thin bronchial secretions, making them easier to cough up and clear from the airways. This is particularly beneficial for clients with COPD who often have thick, sticky mucus that is difficult to expectorate. Drinking sufficient water helps keep the mucus more liquid and less likely to block air passages.
C. Oxygen therapy is essential for clients with COPD to maintain adequate oxygen levels, but it does not directly address the issue of tenacious bronchial secretions. However, ensuring adequate oxygenation can indirectly support the client's ability to mobilize and expectorate secretions by improving overall respiratory function.
D. A low-salt diet is important for managing conditions like hypertension and heart failure, but it does not directly impact the client's ability to clear bronchial secretions in COPD. While overall health management is crucial, dietary changes do not play a direct role in managing respiratory secretions.