To ensure proper positioning of an endotracheal tube, what nursing action is most appropriate?

Listening for bilateral breath sounds is crucial to ensure proper positioning of an endotracheal tube. When the tube is correctly placed in the trachea, breath sounds should be audible and equal on both sides of the chest. This indicates that both lungs are being adequately ventilated. Absence or diminished breath sounds on one side could suggest that the tube has been inadvertently advanced into one of the bronchi or that there may be other complications, such as a pneumothorax.

While monitoring oxygen saturation, checking ventilator settings, and visually inspecting the tube placement are important aspects of patient care, they do not directly confirm adequate placement of the tube in the trachea. Oxygen saturation can be influenced by multiple factors, not just tube positioning, and while ventilator settings need to be checked for correct settings, they do not directly indicate if the tube is positioned appropriately. Visual inspection may also suggest placement but does not provide auditory confirmation, which is essential for ensuring effective gas exchange in the lungs. Therefore, listening for bilateral breath sounds is the most definitive nursing action to verify proper endotracheal tube placement.