An emergency tracheotomy is performed on a toddler in acute respiratory distress from laryngotracheobronchitis (viral croup). what early signs of respiratory distress indicate that it is necessary for the nurse to suction the tracheotomy? select all that apply.

Early signs of respiratory distress that will indicate suctioning in a patient with tracheotomy are restlessness, pallor, increase in respiratory rate, and increase in heart rate. When these signs are present, suctioning should be done. While intercostal and subcostal retractions as well as cyanosis are signs of respiratory distress, these are late signs and suctioning should have been done before these late signs manifest.

This movement is also referred to as  glacial plucking

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