In which scenario should a nasopharyngeal airway be avoided?

A nasopharyngeal airway should be avoided in clients with facial trauma primarily because this type of airway can exacerbate existing injuries or cause further complications. Facial trauma can lead to disruptions in the normal anatomy of the nasal passages and surrounding structures. Inserting a nasopharyngeal airway may increase the risk of penetrating the base of the skull or causing damage to the nasal mucosa and facial bones.

In contrast, while clients with a gag reflex may require special consideration when using an airway device, a nasopharyngeal airway can still be used cautiously in some cases. Clients who require suctioning may benefit from a nasopharyngeal airway to maintain airway patency during the procedure. Additionally, clients with sleep apnea may actually require a nasopharyngeal airway as part of their management, particularly in emergencies, as it can help keep the airway open. Thus, in situations of facial trauma, the risk posed to the patient's stability is significantly higher, making this the scenario where a nasopharyngeal airway should be avoided.