A nurse educator is overseeing a new-grad RN who is preparing to suction a client who has a tracheostomy. Identify the sequence of actions the new-grad RN should take.

Proper suctioning technique for a tracheostomy client follows a logical sequence that prioritizes safety, sterility, and client assessment. The process begins by assessing the client for the need of suctioning, because suctioning should only be performed when clinically indicated. Next, supplies are gathered so everything is at hand before beginning the procedure. The wall suction is then turned on and adjusted to the appropriate pressure setting. Sterile gloves are donned to maintain sterile technique throughout the procedure. The suction catheter is tested by applying suction to verify equipment function before insertion. The suction catheter is then inserted into the tracheostomy without applying suction on insertion to avoid trauma and hypoxia. Suction is applied intermittently while withdrawing the catheter using a rotating motion to maximize secretion removal and minimize mucosal trauma. Finally, the nurse assesses for secretion clearance to determine whether suctioning was effective or needs to be repeated. The keyed sequence places assessing the need first, then gathering supplies, adjusting suction, donning gloves, testing the catheter, inserting the catheter, withdrawing while suctioning, and assessing for clearance — this is the standard, evidence-based sequence and is clinically sound.