The nurse identifies that the client is unable to cough to produce a sputum specimen, and must be ...

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Nasotracheal suctioning is the preferred route for obtaining a sputum specimen when the client is unable to cough to produce a sputum specimen on his or her own.
The nasopharyngeal route for suctioning is used when the client is able to cough, but is unable to clear secretions by expectorating or swallowing. It is not the preferred route for obtaining a spu-tum specimen.
The oropharyngeal route is used when the client is able to cough, but is unable to clear secretions by expectorating or swallowing. It is not the preferred route for obtaining a sputum specimen.
The orotracheal route is used when the client is unable to manage secretions by coughing. The nasotracheal route is preferred over the orotracheal route because stimulation of the gag reflex is minimal.