A nurse is contributing to the plan of care of a 14-month-old toddler who is 24 h postoperative following a cleft palate repair. Which of the following interventions should the nurse include in the plan?

A. Applying suction for 20 seconds:

Suctioning for 20 seconds is within the recommended duration for endotracheal suctioning in children. It allows adequate time for removing secretions without causing excessive trauma to the airway.

B. Introducing the catheter without suction:

This action is incorrect. When performing endotracheal suctioning, the catheter should be introduced into the endotracheal tube while applying suction. Introducing the catheter without suction may not effectively remove secretions and can lead to ineffective suctioning.

C. Rotating the catheter between the thumb and forefinger while suctioning:

Rotating the catheter between the thumb and forefinger while suctioning helps to prevent the catheter from sticking to the airway walls and facilitates the removal of secretions. This action is appropriate and helps ensure effective suctioning.

D. Allowing the child to rest for 30 to 60 seconds between suctioning passes:

Allowing the child to rest between suctioning passes helps minimize hypoxia and discomfort during the procedure. This action is appropriate and ensures that the child has adequate time to recover before the next suctioning pass.

A. Allow the child to see and touch IV tubing and supplies.

Allowing the child to see and touch the IV tubing and supplies can help familiarize them with the equipment and reduce anxiety. However, there may be a more appropriate action to take first.

B. Explain to the child's parents what role they will have during the procedure.

While it's important to involve the child's parents and inform them of their role during the procedure, the priority should be to prepare the child for the insertion itself.

C. Describe the procedure using visual aids.

Using visual aids can be helpful in explaining the procedure to the child and providing a clear understanding of what will happen. However, there may be a more appropriate action to take first.

D. Ask the child what he knows about the procedure.

This is the correct answer. Asking the child what they already know about the procedure allows the nurse to assess their understanding and address any misconceptions or concerns they may have. It also helps the nurse tailor their explanation to the child's level of understanding and provide information that is relevant and meaningful to them.