11. A nurse is caring for a client who has a tracheostomy and requires suctioning. Identify the sequence of steps the nurse should follow after applying sterile gloves. (Move the steps into the box, placing them in the selected order of performance. Use all the steps.)

C. Lubricate the catheter with sterile saline. After donning sterile gloves, the nurse should lubricate the catheter to reduce friction and prevent trauma to the tracheal mucosa during insertion.

B. Insert the catheter until resistance is felt. The catheter should be gently inserted into the tracheostomy until resistance is met, indicating that it has reached the carina. Inserting beyond this point may cause injury.

A. Withdraw the catheter 1 to 2 cm (0.4 to 0.8 in). Pulling back slightly after resistance ensures the catheter is not pressing directly on sensitive structures and is positioned correctly for effective suctioning.

D. Rotate the catheter while suctioning. Suction should be applied while withdrawing the catheter in a rotating motion to evenly clear secretions and minimize damage to the tracheal lining.

A. "You should take a second dose if there is no relief within fifteen minutes after the initial dose." The second dose of sumatriptan should not be taken sooner than 2 hours after the first dose if there is no relief or if the migraine returns. Taking it too soon increases the risk of adverse effects.
B. "You may experience low blood pressure while taking this medication." Sumatriptan more commonly causes hypertension, not hypotension. It can cause vasoconstriction, which may elevate blood pressure and poses risks, especially in clients with cardiovascular disease.
C. "You should have complete relief in six hours after taking this medication." Relief from sumatriptan is often experienced within 1–2 hours after administration. While not all clients achieve complete relief, the medication acts quickly, and six hours is not the expected timeframe.
D. “You may experience muscle cramps as a potential adverse effect of the medication." Muscle cramps or tightness in the chest, neck, or limbs can occur due to vasoconstriction caused by sumatriptan. This is a known side effect and should be reported if severe or persistent.