A nurse is performing tracheostomy care for a client and suctioning to remove copious secretions. Which of the following actions should the nurse take?

A. Hyperventilate the client on 100% oxygen prior to suctioning: Pre-oxygenating the client helps prevent hypoxemia during suctioning, especially when removing copious secretions. Delivering 100% oxygen for 30–60 seconds before the procedure increases oxygen reserves and improves patient safety. B. Lubricate the suction catheter tip with sterile saline: Lubricating the catheter with saline is not recommended because it does not improve suctioning efficacy and may introduce infection. Sterile water or saline is only used to loosen thick secretions if prescribed. C. Perform chest physiotherapy prior to suctioning: Chest physiotherapy can assist with mobilizing secretions, but it is not always required immediately before suctioning. The priority is ensuring airway patency and preventing hypoxemia during suctioning. D. Suction two to three times with a 60-second pause between passes: Suction passes should be limited to 10–15 seconds with intermittent oxygenation between passes. Prolonged suctioning or extended pauses can increase the risk of hypoxemia and patient distress.