Suction
The mechanical removal of secretions from the airway or wound to maintain patency and prevent aspiration or infection.
NCLEX items test your sequence and your stop rules. Expect “select the correct order” or “which action needs follow-up” stems: classic wrong answers are applying suction while inserting (apply suction only on withdrawal, with intermittent port occlusion while rotating the catheter), exceeding roughly 100–150 mmHg wall pressure for adults — keep it under 150 (some banks still teach the older 80–120 range) — and routinely instilling normal saline before a pass. Current guidance does not recommend saline lavage because it lowers oxygenation and can wash endotracheal-tube biofilm into the lower airway. Advance only until resistance or a cough, withdraw about a centimeter, then suction out.
Watch the confusable cluster: suction removes secretions, a catheter drains a hollow space (a urinary catheter is the CAUTI item, not airway). Monitoring guides when to abort a pass; endoscopy is a sterile scoped airway rather than open clearing. Sequence with one catheter clean-to-dirty: the sterile trachea first, the contaminated mouth last — never return a mouth-soiled catheter to the trachea. Memory hook: “Sterile down, clean up.”
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