A client develops acute respiratory distress, and a tracheostomy is performed. Which intervention is most important for the nurse to implement when caring for this client?

• A. Encouraging a fluid intake of 3 L daily
• B. Suctioning via the tracheostomy every hour
• C. Applying an occlusive dressing over the surgical site
• D. Using cotton balls to cleanse the stoma with peroxide

Answer: (A)

Hydration to keep secretions thin is essential after a tracheostomy. When secretions are watery, they’re easier to expectorate or suction away, which helps prevent blockage of the tube and supports easier breathing during acute distress. Encouraging adequate fluid intake helps maintain mucous viscosity and supports overall airway clearance.

Suctioning should be used as needed to remove secretions, not on a fixed hourly schedule, because unnecessary suctioning can irritate the airway and cause hypoxia. Occlusive dressings over the stoma can obstruct drainage and healing and are not appropriate. Cleaning the stoma with peroxide is not recommended due to potential mucosal irritation.