What initial action should a nurse take if a client with a tracheostomy shows signs of respiratory distress?

In a situation where a client with a tracheostomy is exhibiting signs of respiratory distress, checking the patency of the tracheostomy tube is crucial as an initial action. This is because obstruction of the tracheostomy tube is a common cause of respiratory distress in these patients.

When the tube becomes obstructed—whether by secretions, displacement, or a blockage—it can severely hinder airflow, leading to increased respiratory effort and the potential for hypoxia. By assessing the tube's patency first, the nurse can quickly determine if the issue is mechanical and whether immediate interventions, such as suctioning or repositioning the tube, are necessary to restore adequate breathing.

The other actions, while important in the emergency response process, may not directly address the underlying problem causing the respiratory distress in this context. Administering oxygen or calling for help may be necessary steps, but ensuring that the airway is clear is fundamental and should be prioritized to stabilize the patient's condition. Starting chest compressions would not be appropriate unless there is a cardiac arrest situation, which is not indicated solely by respiratory distress.