The nurse is preparing to extubate a client. Arrange in order of priority the actions that the nurse should take to perform this procedure.

Rationale: Explaining the procedure to the client first helps minimize fear. Equipment should be set up before performing the procedure. Hyperoxygenation should be performed before suctioning to avoid dropping the client’s oxygen saturation levels. Deflating the tube cuff aids in removal and prevents injury to client. Coughing helps clear any remaining secretions. The nurse should apply oxygen to the client and ensure it is in place before teaching. The client should demonstrate use of incentive spirometer to verify proper technique and lower risk of respiratory complications.

hyperoxygenate the client

1. explain the procedure to the client
2. immediately instruct the client to cough
3. apply oxygen by nasal cannula or face mask
4. thoroughly suction the ET tube and the oral cavity
5. teach the client how to use an incentive spirometer every 2 hours
6. rapidly deflate the ET tube cuff and remove tube at peak inspiration
7. set up the prescribed oxygen delivery system and bring in equipment for emergency reintubation