What is the optimal nursing action to support airway clearance for a patient after pneumonia and COPD with recent extubation?

• A. Reinforce deep breathing exercises.
• B. Increase bed elevation to Trendelenburg.
• C. Encourage complete rest without activity.
• D. Withhold all oral intake for 24 hours.

Answer: (A)

Encouraging deep breathing exercises helps reopen airways and promote clearance of secretions after extubation. When someone has pneumonia and COPD, airways can be partially obstructed by mucus and areas of atelectasis can develop from shallow breaths. Taking slow, deep breaths increases tidal volume, expands the alveoli, and improves ventilation to all lung regions. This sets up a more productive cough, helping to mobilize and expectorate mucus.

Positioning supports this goal—leaning toward a position that allows the chest and diaphragm to expand, such as semi-Fowler or high-Fowler, is more effective for airway clearance than a position like Trendelenburg, which can impede breathing and raise aspiration risk. Rest alone doesn’t promote airway clearance, and while rest has its place, long-term inactivity can worsen mucus buildup. Withholding oral intake isn’t related to clearing the airways and isn’t necessary once swallowing is safe after extubation.

So, reinforcing deep breathing exercises directly targets improving ventilation, opening collapsed lung areas, and enabling effective coughing to clear secretions.