A nurse is collecting data from a client who is taking enoxaparin.
The client reports starting the use of dietary supplements.
The nurse should report the use of which of the following supplements to the provider?

Choice A rationale

Instilling saline into the tubing is not recommended as it increases infection risks and does not clear secretions effectively. It is contraindicated in tracheostomy care and can harm the patient’s respiratory system.

Choice B rationale

Checking the cuff pressure is essential to prevent complications like tracheal injury or air leaks. However, it does not directly alleviate restlessness or crackles in the lungs caused by secretions.

Choice C rationale

Performing suctioning removes secretions from the tracheostomy tube and airways, improving oxygenation and reducing lung crackles. It is the most effective immediate intervention for this scenario.

Choice D rationale

Increasing humidification prevents secretion thickening but does not address accumulated secretions already causing crackles and respiratory distress.

Choice A rationale

Obtaining a radial pulse is not the next priority for managing a bleeding site in hemophilia. Hemophilia is characterized by clotting factor deficiencies, so the priority is to stop bleeding first. Assessing a pulse does not address active bleeding and can delay essential interventions, such as applying pressure to control hemorrhage.

Choice B rationale

Reinforcing the dressing does not actively address ongoing bleeding in a hemophilia client. Adding more material over the wound may conceal continued bleeding but does not provide the hemostatic effect required to stop it. Direct pressure is necessary for clot formation, which is hindered in hemophilia.

Choice C rationale

Maintaining direct pressure is crucial as it compresses blood vessels, promoting clot formation at the bleeding site. Hemophilia impairs the intrinsic clotting pathway; therefore, mechanical compression compensates for clotting factor deficiencies until further interventions, such as clotting factor infusion, are possible.

Choice D rationale

Checking whether the bleeding has stopped is important, but it should only occur after applying adequate pressure to the site. Hemophilia requires prompt mechanical hemostasis, and delaying pressure to assess cessation risks prolonged bleeding and increased blood loss.