Urgent reponse needed!

[Physiofit]

what your action would be to the scenario below:

The nurses have referred Mr X to you. He has a diagnosis of left lower lobe pneumonia. On assessment he is short of breath with a respiratory rate of 40. He is slumped in bed with sats of 95% on 9 litres of oxygen via nasal specs. You have already established that he has a very weak, ineffective cough and coarse crackles throughout with tactile fremitus. You decide that suctioning is an appropriate treatment but you have not done suctioning before.

Thanks

physiofit

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[hasanj]

Hi,
for me I will not think in suctioning first,his rr 40 ?
with nasal patient will not recive more than 34% oxygen on 6 l/m,puting patient on 9 l/m will drying the res. tract.
I will working on his ex. by stronging it . that will maks him has good cough up.
I will put the patient on oxgygen mask to give him more oxygen (reducing his RR)

[Latrobe2000]

I think you'd probably look at suctioning lastly especially if he's got RR of 40 suggesting hes in some sort of resp failure.
Good if you know what his ABGS are. Firstly I would use positioning and mobilise the patient unless there were any other contraindications. Yes, he shouldn't be on NP on such a high flow of O2 (9Lit). If he needs those levels of o2 to maintain his sats then you may need to look at an aquapak-ie provides humidified 02.. Best to look at as much info as you can, identifty main problems and treat within any contraindications..

[beenish]

i would NOT suction this patient with a resp rate of 40.... also with copious amounts of secretions you get from pneumonia you are likely to need to do it a good few times regularly which in my opinion is distressing for an awake patient.
i think i would contact the medics to consider ventilatory support...