A 3-year-old girl is seen in the emergency department for aspirating a coin. Upon assessment, the child has a violent cough, dyspnea, and is choking. Chest X-ray reveals the presence of a radiopaque object. The child undergoes a bronchoscopy in order to remove the coin. After the procedure, the nurse's first action is to

assess for signs of airway obstruction


• Bronchoscopy is the insertion of a bronchoscope down the airway to visualize the lungs and remove foreign objects, obtain biopsies, and stop bleeding.

• The most common complications after undergoing a bronchoscopy are bronchospasms and hypotension related to sedation.

• Bronchospasms can cause airway obstruction and lead to respiratory failure, hypoxia, and hypercapnia. Assessing the airway should be the highest priority nursing action.

• A less critical but still important nursing action is to assess for a gag reflex. Once the gag reflex has returned, the child may resume a diet after passing a bedside swallow test.

• Incorrect: An ice collar is not needed.

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