FISDAP Obstetrics and Pediatrics Practice Test

In the scenario of a three-year-old with a tracheostomy experiencing increased work of breathing and thick secretions, the most appropriate action is to irrigate and suction. This procedure is critical because thick secretions can obstruct the airway, making it difficult for the child to breathe effectively. By suctioning, you help clear the airway of those secretions, which can alleviate the work of breathing and improve oxygenation.

Irrigation may also be performed to thin out thick secretions, enhancing the efficacy of suctioning. By addressing the issue of secretions directly, you can provide immediate relief to the child's breathing difficulties.

Administering oxygen is important, but it may not address the root cause of the increased work of breathing if the cause is due to airway obstruction from secretions. Similarly, calling for advanced support could be necessary if the situation doesn't improve after suctioning, but immediate intervention is crucial. Applying a chest seal is unnecessary in this scenario as it is typically used for managing open chest wounds, which is not relevant here. Thus, the focus should be on airway management through suctioning and irrigation to prevent further respiratory distress.