A nurse is caring for a client who is receiving mechanical ventilation. Which of the following actions should the nurse implement to decrease the client's risk for ventilator-associated pneumonia (VAP)? (Select all that apply.)

Rationale: A. Wear a protective gown when suctioning the client's airway: While wearing appropriate personal protective equipment protects the nurse from contamination, it does not directly reduce the client’s risk for ventilator-associated pneumonia. B. Monitor for oral secretions every 2 hr: Regular assessment for and removal of oral secretions reduces the risk of aspiration, which is a key contributor to the development of ventilator-associated pneumonia. C. Provide oral care every 2 hr: Frequent oral hygiene decreases the colonization of bacteria in the oropharynx, thereby reducing the risk of these organisms being aspirated into the lungs and causing infection. D. Maintain the client in a supine position: Keeping the client supine increases the risk of aspiration. To prevent VAP, the head of the bed should typically be elevated 30 to 45 degrees unless contraindicated. E. Assess the client daily for readiness of extubation: Daily evaluation for weaning from the ventilator reduces the duration of mechanical ventilation, which directly lowers the risk of developing ventilator-associated pneumonia.