A nurse is caring for a patient with a tracheostomy admitted for pneumonia who requires suctioning of secretions. The patient hits the call button and as the nurse enters the room, the nurse notes the patient is apprehensive, tachypneic, and gesturing for the nurse to come in. Using critical thinking to make a clinical judgment, which action does the nurse take first?
O Calls the code team
O Suctions the patient
O Encourages the patient to cough
O Auscultates the patient’s breath sounds