To promote airway clearance in pneumonia, which intervention is most appropriate?

• A. Increase fluid intake to 3 L/day if tolerated
• B. Humidify the oxygen as able
• C. Administer cough suppressant q4hr
• D. Teach patient to splint the affected area

Answer: (A)

Promoting airway clearance in pneumonia relies on thinning secretions so they can be mobilized and coughed up more easily. Adequate hydration directly reduces mucus viscosity, helping cilia move mucus toward the mouth and allowing for more productive coughing. Encouraging a fluid intake of about 3 liters per day, if tolerated, supports this process and can help prevent mucus plugging.

Humidifying inspired air or oxygen can ease airway dryness and may be a helpful adjunct, but it doesn’t address mucus thickness as effectively as systemic hydration. Cough suppressants dampen the cough reflex, which is the body's primary mechanism for clearing secretions, so they hinder airway clearance. Splinting the chest during coughing can reduce pain but doesn’t improve the actual clearance of mucus and can limit effective coughing if overused.

So, increasing fluids to optimize hydration is the best choice to promote airway clearance.