Which of the following actions should a nurse perform when suctioning clients with tracheostomy tubes, according to best practices? Select All that Apply.

Tracheostomy suctioning is performed to maintain airway patency by removing secretions from the tracheobronchial tree. It is an invasive procedure that can temporarily reduce oxygenation, irritate airway mucosa, and trigger vagal stimulation leading to complications such as hypoxia, bradycardia, and mucosal injury. Safe suctioning requires proper technique, sterile equipment, and careful monitoring of the client’s respiratory status before, during, and after the procedure. Rationale: A. Waiting 1 minute before suctioning again allows the client time to reoxygenate and recover from potential hypoxia caused by suctioning. Repeated suctioning without adequate rest can lead to oxygen desaturation, bronchospasm, and cardiac stress. This pause helps stabilize oxygen levels and reduces procedural complications. B. Inserting the catheter slowly is important to minimize trauma to the tracheal mucosa. Rapid insertion can cause irritation, bleeding, and stimulation of the vagus nerve, which may result in bradycardia or coughing. Gentle insertion ensures safer navigation of the airway and reduces patient discomfort. C. Disposing of the suction catheter after each use is a key infection control practice when using sterile suction technique for tracheostomy care. Reusing a catheter increases the risk of introducing pathogens into the lower respiratory tract. Proper disposal prevents cross-contamination and reduces the risk of ventilator-associated or tracheostomy-related infections. D. Suctioning at set intervals based on a schedule is not recommended because suctioning should be performed based on clinical need rather than routine timing. Unnecessary suctioning can damage airway mucosa and cause hypoxia. Indications include audible secretions, visible mucus, or signs of respiratory distress. E. Performing hyperoxygenation before suctioning is essential to prevent hypoxemia during the procedure. Increasing oxygen delivery prior to suctioning helps offset the temporary loss of oxygen during catheter insertion and secretion removal. This practice reduces the risk of oxygen desaturation and cardiac complications.