A nurse is preparing to perform endotracheal suctioning for a client. Which of the following actions should the nurse plan to take?

A. Applying suction for 30 to 45 seconds is incorrect. Prolonged suctioning can cause hypoxia, tissue trauma, and vagal stimulation leading to bradycardia. The recommended suction time is generally no longer than 10 to 15 seconds per pass to minimize oxygen deprivation. B. Selecting a suction catheter that is 3/4 the diameter of the endotracheal tube is incorrect. The catheter should be appropriately sized to avoid occluding airflow and causing excessive negative pressure. The recommended size is usually no more than one-half the internal diameter of the endotracheal tube to prevent hypoxemia and trauma. C. Initiating suctioning when advancing the catheter into the endotracheal tube is incorrect. Suction should never be applied while inserting the catheter because this can damage airway mucosa and remove oxygen, increasing the risk of hypoxia. Suction is only applied while withdrawing the catheter using intermittent technique. D. Hyperoxygenating the client prior to suctioning is correct. Preoxygenation (typically with 100% oxygen) helps prevent hypoxemia during the procedure, as suctioning temporarily removes oxygen from the airway and can decrease oxygen saturation. This is a key safety step before initiating endotracheal suctioning.