Your patient has a non-productive cough and presence of secretions in his tracheostomy. What should you do first before suctioning the patient?

The first step before suctioning a patient with a tracheostomy and a non-productive cough, as well as secretions, is to hyperoxygenate the patient. This is crucial because suctioning can temporarily remove oxygen from the airway, which may lead to hypoxia (low oxygen levels in the blood). By administering supplemental oxygen prior to suctioning, you help ensure that the patient maintains adequate oxygenation during the procedure.

Hyperoxygenation typically involves giving the patient a few breaths of 100% oxygen either by using a bag-valve mask or other means before tapping into the airway. This precautionary measure is particularly important in patients who may already have compromised respiratory function, as it helps to prevent potential complications associated with decreased oxygen levels during the suctioning process.

The other options, while relevant to patient care, are not the immediate priority before suctioning. For example, assessing lung sounds is important for understanding the patient's respiratory status, and positioning the patient upright aids in their overall breathing and comfort but does not specifically address the risk of hypoxia during suctioning. Administering medications might be necessary to manage the underlying condition or alleviate symptoms, but it does not directly pertain to the immediate preparation required for suctioning.