Page 2425 - Saunders Comprehensive Review For NCLEX-RN

inflation, which creates a seal and
allows complete mechanical control of
respiration.
l. Monitor cuff pressures at least every 8
hours per agency procedure to ensure
that they do not exceed 20 mm Hg (an
aneroid pressure manometer is used to
measure cuff pressures); minimal leak
and occlusive techniques are used for
cuff inflation to check cuff pressures.

A resuscitation (Ambu) bag needs to be

kept at the bedside of a client with an endotracheal
tube or a tracheostomy tube at all times.
5. Minimal leak technique
a. This is used for cuff inflation and
checking cuff pressures for cuffs
without pressure relief valves.
b. Inflate the cuff until a seal is
established; no harsh sound should be
heard through a stethoscope placed
over the trachea when the client
breathes in, but a slight air leak on
peak inspiration is present and can be
heard.
c. The client cannot make verbal sounds,
and no air is felt coming out of the
client’s mouth.
6. Occlusive technique
a. This is used for cuff inflation and
checking cuff pressures for cuffs with
pressure relief valves.
b. Provides an adequate seal in the trachea
at the lowest possible cuff pressure.
c. Uses same procedure as minimal leak
technique, without an air leak.

7. Extubation

a. Hyperoxygenate the client and suction
the endotracheal tube and the oral
cavity.
b. Place the client in a semi-Fowler’s
position.
c. Deflate the cuff; have the client inhale
and, at peak inspiration, remove the
tube, suctioning the airway through

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