nurse is caring for a client who has a tracheostomy and requires suctioning. Identify the sequence of steps the nurse should follow after applying sterile gloves. (Move the steps, placing them in the selected order of performance. Use all the steps.)

A. Lubricate the catheter with sterile saline: Lubrication reduces friction and trauma to the tracheal mucosa during insertion, facilitating smoother catheter advancement and minimizing irritation. B. Insert the catheter until resistance is felt: The catheter is advanced gently until the first point of resistance, which indicates proximity to the carina or a main bronchus. This prevents excessive insertion that could injure airway structures. C. Withdraw the catheter 1 to 2 cm (0.4 to 0.8 in): Withdrawing slightly before applying suction helps avoid direct trauma to the carina while still targeting secretions in the larger airways for effective clearance. D. Rotate the catheter while suctioning: Rotating the catheter while applying suction maximizes removal of secretions from the trachea and bronchi while distributing suction forces evenly, reducing the risk of mucosal injury.