During a tracheostomy care procedure, the client begins coughing vigorously. What is the nurse's immediate action?

TRACHEOSTOMY TUBE SAFETY DURING COUGHING: TUBE DISPLACEMENT RISK: Coughing generates significant intrathoracic pressure — a tracheostomy tube, especially one within the first 7-10 days of placement (before the stoma tract is established), can be expelled from the stoma; if this happens, the airway may close rapidly; NURSING ACTION: Pause the procedure; SECURE the tube — place a hand on the tube or hold the flanges to prevent accidental decannulation; allow the cough to complete naturally; suction if secretions are in the airway after coughing; DECANNULATION EMERGENCY SUPPLIES: An extra tracheostomy tube of the same size and one size smaller should be at the bedside at all times; tracheal dilators should be available; AFTER COUGHING: Assess breath sounds; assess tube placement (air movement through the tube); assess skin colour and SpO2; resume procedure only when stable; PN SCOPE: Perform routine tracheostomy care per protocol; report any concerns about tube placement or client distress to RN immediately.