NCLEX-PN

Moreover, percussion is a technique where you use cupped hands to tap over a specific area for at least one minute while the client holds their breath. Meanwhile, vibration is performed by placing the hand on the area and applying rapid, vibrating movements while the client exhales deeply. The correct hand placement for percussion and vibration is detailed in the table below.

Lung Lobe

Lobe Section

Client Positioning

Anterior bronchus

The area directly below the collarbones on the front of the chest.

Apical bronchus

The Upper Lobe

The area spanning from the shoulder blades up to the collarbone.

Posterior bronchus

The area encompasses both sides of the shoulder blades and extends outward. The area extending from the armpit crease across to the middle of the front chest, including the right side of the chest along its side and front.

Medial and lateral bronchus

The Middle Lobe

Apical bronchus

Both sides of the lower third of the ribcage at the back.

Medial bronchus

The lower third of the ribcage on the left side at the back.

Lateral bronchus

The lower third of the ribcage on the right side at the back.

The Lingula

Posterior bronchus

The lower third of the ribcage at the back on both sides.

Superior and inferior bronchus

The area extending from the left armpit fold to the middle of the front chest.

Suctioning Performing suctioning is a critical nursing procedure to maintain airway patency and ensure effective breathing for clients with oral, nasopharyngeal, endotracheal, or tracheal airways, including artificial airways like endotracheal and tracheostomy tubes. Here's a step-by-step guide on how to perform suctioning: 1.​ Identify the Client: Ensure you have the correct client by verifying their identity using two identifiers, such as their name and date of birth. 2.​ Instruct the Client: Explain the suctioning procedure to the client and the purpose behind it. Reassure them and address any concerns they may have. 3.​ Preoxygenate the Client: Administer oxygen to the client before suctioning to ensure adequate oxygenation during the procedure. 4.​ Open the Suctioning Catheter Wrapper: Prepare the suctioning catheter and maintain sterility during the procedure. 5.​ Don a Sterile Glove: Put a sterile glove on your dominant hand, as this will be the hand used to handle the catheter.

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