NORCET 2 - 2021 (shift-1)
Child Health Nursing (Pediatrics)
Medium
A baby is admitted to the ICU on ventilator support via a 4 mm ET tube. Which suction catheter size should be used in this child?
Appeared in: NORCET 2 - 2021 (shift-1)
Explanation
- The standard clinical guideline for selecting a suction catheter is to use a size (in French gauge) that is approximately double the internal diameter of the endotracheal tube (in mm).
- For a 4 mm ETT, the calculation is 4 mm × 2 = 8 Fr.
- This sizing ensures the catheter is effective for clearing secretions while being small enough (occupying less than 50% of the ETT lumen) to prevent complications like hypoxia and mucosal trauma.
- An 8 Fr catheter is the correct and safest choice for a 4 mm ETT.
Why Other Options Were Wrong
- Option B: A 10 Fr catheter is too large for a 4 mm ETT. It would occlude more than 50% of the airway's internal diameter.
- Option C: A 12 Fr catheter is significantly oversized for a 4 mm ETT and would block a substantial portion of the airway, posing a high risk of hypoxia, atelectasis, and tracheal injury.
- Option D: A 14 Fr catheter is dangerously large for a 4 mm ETT and should never be used in this scenario. It would completely obstruct the small airway, leading to severe complications.
Related Visual
- Visual 1: Diagram: A cross-section of an endotracheal tube showing the comparison between a correctly sized suction catheter (occupying <50% of the lumen) and an oversized catheter (occupying >50%), illustrating the risk of airway occlusion.
- Visual 2: Chart: A quick-reference chart matching pediatric ETT sizes (2.5 mm to 6.0 mm) with their corresponding recommended suction catheter sizes in French gauge.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Selection of appropriate suction catheter size for a pediatric patient with an endotracheal tube as background academic context rather than a clinical decision trigger.
- Proper suction catheter sizing is a fundamental patient safety measure in neonatal and pediatric critical care to prevent iatrogenic airway trauma and acute hypoxemia.
- Using a catheter that is too large can cause immediate desaturation, bradycardia (due to vagal stimulation), and atelectasis. Repeated trauma can lead to long-term complications like tracheal stenosis.
- What if? If an 8 Fr catheter is unavailable and secretions are thick, the nurse should not select a larger size. The safest alternative is to use the next size down (e.g., 6 or 7 Fr), ensure adequate patient hydration and airway humidification, and consider requesting an order for mucolytic agents if appropriate. A smaller catheter is always safer than one that is too large.
How to Approach the Question
- First, identify the critical piece of information provided in the question stem, which is the internal diameter of the endotracheal tube (4 mm).
- Recall the standard formula or rule of thumb for calculating the appropriate suction catheter size: Catheter Size (Fr) = 2 × ETT Size (mm).
- Apply the formula using the given value: 2 multiplied by 4 mm equals 8 Fr.
- Scan the options to find the one that matches your calculated result.
- Mentally confirm the choice by remembering that the catheter should not block more than half of the ETT's opening to prevent complications.
Concept Tested & Keywords
- Concept Tested: Selection of appropriate suction catheter size for a pediatric patient with an endotracheal tube.
- Stem keywords: baby, ICU, ventilator support, 4 mm ET tube, suction catheter size
- Lead-in keywords: Which
- Clinical cues: The ETT size of 4 mm is the critical piece of data needed to solve the problem.
Question ID
QP8m2PfaWJDKEOu1s0WK-a
Practise the full NORCET 2 - 2021 (shift-1)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Pediatric Critical Care Questions
- Formula of measuring the ET tube size in children?
- In the emergency department, during CPR of neonate, on duty nurse unable to access venous site then what is the priority action for next?
- Identify the device in the image:
- In a school, children are gathering on the playground surrounding a child who is unconscious and.....By the history reveals that child had raisins. W…
- After a tonsillectomy, a child begins to vomit bright red blood. The nurse would take which initial action?
- A 3-year-old child is hospitalized with burns covering her trunk and lower extremities. Which of the following would the nurse use to assess adequacy…
- The most common cause of cardiac arrest in infants and young children is?
- In a conscious choking child, an upward thrust is applied to the upper abdomen with a fisted hand at a point just below the rib cage, what is this ac…
- What is the Rate of chest compression and ventilation in children?
- If a child is not breathing, the first nursing action should be?
More NORCET 2 - 2021 (shift-1) Questions
- Which type of bandage used in ankle injury?
- A nurse knows that under the National Family Health Program, the duration of Copper T 380A is?
- Which diet should be avoided in acute renal failure disease?
- What was the first indigenous vaccine in India?
- Which bone is known as the breast bone?
- Which of the following food contains high fiber?
- What is the most common type of episiotomy performed during labor?
- A child comes to the emergency room with acute bronchospasm after a bee sting. What is the most preferred route of adrenaline administration?
- What is the chemical name of Baking soda?
- Which solution is used in the COVID area for disinfection?