The practical nurse (PN) prepares to suction a client's tracheostomy as seen below. What should the PN do next?

A. Insert the catheter into the tracheostomy: The PN must gently and quickly insert the suction catheter without applying suction (to prevent damage to the mucosa and oxygen depletion) until resistance is met or the client coughs. This places the catheter in the correct position for suctioning secretions. B. Use the thumb to apply intermittent suction: Applying suction is the step that occurs after the catheter has been fully inserted to the desired depth and is being withdrawn. Applying suction during insertion can cause trauma and hypoxia. C. Explain the need for the client to swallow: The client with a tracheostomy doesn't swallow through the tracheostomy tube. While the PN should explain the procedure and encourage deep breaths before starting, this is not a correct or necessary instruction for the immediate next step of insertion. D. Stop the procedure to obtain new supplies: The image doesn't show any breach in sterile technique or a lack of supplies that would necessitate stopping the procedure. The PN appears ready to proceed.