A 15-year-old with cystic fibrosis is admitted for a respiratory infection and presents with cyanosis, a barrel-shaped chest, and growth at the 10th percentile. What is the priority nursing intervention?

A 15-year-old with cystic fibrosis is admitted for a respiratory infection and presents with cyanosis, a barrel-shaped chest, and growth at the 10th percentile. What is the priority nursing intervention?

• A. Increasing physical activities
• B. Performing postural drainage
• C. Maintaining dietary restrictions
• D. Administering prescribed pancreatic enzymes

Answer: (B)

In cystic fibrosis, the immediate priority during a respiratory infection is to improve airway clearance to enhance oxygenation. The thick, sticky mucus tends to clog airways, worsen ventilation, and trap bacteria, so mobilizing and removing secretions is essential right away. Postural drainage uses specific positions, along with percussion and vibration, to loosen mucus from the smaller airways and move it toward the larger airways where it can be coughed up or suctioned. By clearing these secretions, you improve airflow, reduce atelectasis, and help correct the hypoxemia suggested by cyanosis. Other options don’t address the acute need to clear mucus and improve gas exchange. Increasing physical activity during an active infection can worsen breathing difficulty. Maintaining dietary restrictions isn’t appropriate in CF, since these patients need adequate calories and enzymes to support growth and digestion. Pancreatic enzymes are important for nutrition but do not directly improve airway clearance during an acute respiratory event.

In cystic fibrosis, the immediate priority during a respiratory infection is to improve airway clearance to enhance oxygenation. The thick, sticky mucus tends to clog airways, worsen ventilation, and trap bacteria, so mobilizing and removing secretions is essential right away. Postural drainage uses specific positions, along with percussion and vibration, to loosen mucus from the smaller airways and move it toward the larger airways where it can be coughed up or suctioned. By clearing these secretions, you improve airflow, reduce atelectasis, and help correct the hypoxemia suggested by cyanosis.

Other options don’t address the acute need to clear mucus and improve gas exchange. Increasing physical activity during an active infection can worsen breathing difficulty. Maintaining dietary restrictions isn’t appropriate in CF, since these patients need adequate calories and enzymes to support growth and digestion. Pancreatic enzymes are important for nutrition but do not directly improve airway clearance during an acute respiratory event.