A nurse is teaching a client who has COPD about purse-lipped breathing. Which of the following statements should the nurse make?

A. This helps prevent air leaks and maintains the closed drainage system's function.
B. Looping the tubing on the client's is incorrect as it can lead to inaccurate drainage and measurement of the fluid.
C. Placing the drainage system above the level of the client's heart is incorrect as it can lead to inaccurate drainage and measurement of the fluid.
D. Routine stripping of the chest tube is also not recommended as it can cause trauma to the pleura and potentially lead to complications.

A. Lubricating the suction catheter tip with sterile saline is generally not recommended. The catheter tip is usually not lubricated before suctioning. Instead, suctioning should be performed using a dry, sterile catheter to prevent introducing any substances into the airway that could cause irritation or infection.
B. Hyperoxygenating the patient with 100% oxygen before suctioning is a crucial step. This helps to prevent hypoxia during the suctioning procedure, as suctioning can temporarily reduce the oxygen levels in the blood. By providing 100% oxygen for 30 to 60 seconds, the nurse ensures that the patient has an adequate oxygen reserve and reduces the risk of oxygen desaturation during suctioning.
C. Performing chest physiotherapy is not a routine pre-suctioning action and is generally done as part of a separate management strategy for clearing secretions. Chest physiotherapy involves techniques such as percussion, vibration, and postural drainage to help mobilize secretions from the lungs.
D. Instilling normal saline into the airway before suctioning (known as “normal saline lavage”) is not recommended. This practice can actually cause harm, such as increasing the risk of infection, causing bronchospasm, and diluting secretions which may then become more difficult to suction.