What should a nurse do first when discovering a patient in respiratory distress with the endotracheal tube on the floor?

When a nurse discovers a patient in respiratory distress and finds the endotracheal tube on the floor, the immediate priority is to ensure adequate ventilation and oxygenation. Manually ventilating the patient with 100% oxygen serves to quickly provide the patient with the necessary support for their breathing until further interventions can be implemented. This step addresses the critical situation directly by helping to restore oxygen supply and maintain sufficient ventilation, which can be life-saving if the patient is unable to breathe adequately on their own.

This action is crucial because if the endotracheal tube is dislodged, the patient is at risk for hypoxia and respiratory failure. By manually ventilating with 100% oxygen, the nurse effectively mitigates the immediate danger while preparing to carry out further actions, such as calling for help or preparing to reinsert the tube.

Following this immediate intervention, it is essential for the nurse to activate the rapid response team or notify the healthcare provider, but ensuring the patient is receiving oxygen is the first and most critical step in managing this emergency.