Final answer:
The initial nursing action when a tracheostomy tube becomes dislodged after a strong cough is to check if the patient can breathe and call for help immediately, while preparing to provide basic life support measures.
Step-by-step explanation:
If a trach becomes dislodged after a client coughs strongly, the initial nursing action is to assess the patient's airway to ensure they can breathe and immediately call for help. Nurses should be prepared to provide basic life support, which includes repositioning the tracheostomy tube or inserting a spare tube if trained and able to do so. If there is complete airway obstruction, encouragement to cough and careful performance of back slaps may be necessary, but if the patient is unable to breathe or cough effectively, urgently summoning emergency medical care is critical.
It is vital to stay calm and swift to act according to the situation's urgency. All steps should be taken in consideration of the patient's specific health condition and institutional policies. Trained personnel may also perform the Heimlich maneuver if there is a high suspicion of a foreign object causing the obstruction and the facility's protocols allow for it.