Care responsibility | Expected frequency | What the RN should expect | Arrival assessment | At arrival and with every change | Establish respiratory and neurological baseline: color, alertness, work of breathing, airway sounds, cough effectiveness, secretions, stoma condition, oxygen saturation, lung sounds, gag/airway protection, G-tube site, skin, seizure concerns, and equipment readiness. The RN should expect very frequent suctioning, frequent oxygen-saturation assessment, oxygen administration under current orders, management of an open tracheostomy stoma, respiratory treatments, G-tube feeding, seizure readiness, skin and mobility support, detailed documentation, and immediate response to potentially rapid respiratory deterioration.