Respiratory failure is one of the most frequent causes of admission or longer stay in acute care settings. It is usually accompanied by a variety of medical problems, such as stroke and other neurological conditions, cardiovascular disease, and respiratory disorders. Patients with acute respiratory failure require urgent medical attention by the health care team to prevent further deterioration that can eventually lead to mortality. With medical advancement, mortality can be prevented if interventions are quickly and properly provided. Endotracheal tube (ETT) intubation and tracheostomy tube (TT) are the most commonly used advanced artificial airways in managing respiratory failure. Intubated or tracheostomy patients are placed on a mechanical ventilator. These patients are critically ill and require close monitoring by the health care providers and are usually transferred to the intensive care unit (ICU) for further management. The nurses who are providing direct care to patients on mechanical ventilation (MV) carefully assess for signs of respiratory complications such as ventilator-associated pneumonia (VAP). Oral suctioning and tracheal suctioning are crucial nursing interventions to prevent VAP. Hemodynamic changes can also occur during suctioning of these patients. Nurses provide judicious patient care, and they monitor for any changes in the patient’s status so they can quickly and accurately respond to any situations that may arise.