The nurse is caring for a patient with a tracheostomy tube.Which nursing intervention is most effective in promoting effective airway clearance?

A) Suctioning respiratory secretions several times every hour.
B) Administering humidified oxygen through a tracheostomy collar.
C) Instilling normal saline into the tracheostomy to thin secretions before suctioning.
D) Deflating the tracheostomy cuff before allowing the patient to cough up secretions.

Humidification of air will help keep the mucous membranes moist and will make secretions easier to expel.Suctioning should be done only as needed;too frequent suctioning can damage the mucosal lining,which would result in thicker secretions.Normal saline should never be instilled into a tracheostomy because this could lead to infection.The purpose of the tracheostomy cuff is to keep secretions from entering the lungs;the nurse should not deflate the tracheostomy cuff unless instructed to do so by the physician.