When a patient with an endotracheal tube audibly confirms their breathing is okay, what should the nurse check first?

In the scenario where a patient with an endotracheal tube audibly confirms their breathing is okay, checking the functioning of the cuff is critical. The cuff of the endotracheal tube serves an essential purpose by creating a seal within the trachea, which prevents aspiration and ensures that ventilation is effective. If the cuff is not functioning correctly—whether due to deflation or an air leak—this could lead to inadequate ventilation or risk of aspiration, even if the patient states their breathing feels fine.

While assessing pulse oximetry, respiratory rate, and sedation level are important components of overall patient assessment, ensuring the cuff's integrity is paramount to maintaining the airway and the effectiveness of mechanical ventilation. If the cuff is compromised, it may negate the patient's ability to breathe adequately even if they report comfort, thus addressing this first is vital for patient safety.