To promote effective airway clearance in a client with acute respiratory distress syndrome (ARDS), which measure is recommended?

• A. Administer sedatives as frequently as possible.
• B. Turn the client every 4 hours.
• C. Increase ventilator settings every 2 hours.
• D. Suction as needed.

Answer: (D)

Airway clearance in ARDS hinges on removing secretions that block airways while avoiding actions that could worsen lung injury. Suctioning as needed directly targets the buildup of secretions, helping to keep the air passages open and improving ventilation and oxygen exchange. It’s done when there’s visible or suspected secretions or when the patient shows signs of obstruction, rather than on a fixed schedule, which makes it responsive and safer.

Frequent sedatives would dampen cough reflex and the ability to clear secretions, potentially worsening airway clearance and ventilation. Turning the patient every 4 hours helps with drainage and lung expansion, but it’s not the specific measure that actively clears secretions as they appear. Increasing ventilator settings every 2 hours isn’t appropriate as a general rule; adjustments should be individualized based on gas exchange and lung mechanics, and unnecessary increases can risk lung injury. Suctioning as needed provides the most direct, effective means to clear the airway in this scenario.