A nurse is caring for a 4-year-old child who underwent surgery. The child is unable to verbalize pain reliably. Which pain assessment tool is most appropriate?

A. Increasing the child’s intake of high-fat foods is incorrect as the primary concern in this scenario is acute respiratory compromise, not malnutrition. While high-calorie, high-fat diets are important for CF management to address nutritional deficits, this intervention does not immediately improve airway clearance or reduce respiratory symptoms.

B. Encouraging increased fluid intake is partially correct because hydration helps thin mucus, making it easier to clear. However, hydration alone is insufficient for managing acute airway obstruction, especially when the child has decreased breath sounds and increased respiratory secretions.

C. Administering inhaled corticosteroids is incorrect as these reduce airway inflammation over time but are not the first-line intervention for acute mucus obstruction or compromised ventilation. They are adjunctive therapy rather than the priority in acute management.

D. Initiating chest physiotherapy (CPT) is correct because CF causes thick, sticky mucus that obstructs the airways, leading to infection and decreased oxygenation. CPT, including percussion, vibration, and postural drainage, helps mobilize mucus, improve ventilation, prevent atelectasis, and reduce the risk of further respiratory complications. This is considered the priority nursing intervention for acute respiratory exacerbations in CF.

A. Treatments are done in hospitals is incorrect because peritoneal dialysis is typically performed at home, not exclusively in hospitals. Home-based treatment is one of its key distinctions from hemodialysis.

B. Protein loss is less extensive is incorrect because peritoneal dialysis is associated with greater protein loss compared with hemodialysis due to protein leakage across the peritoneal membrane.

C. Parents and older children can perform treatments is correct because peritoneal dialysis can be done at home after proper training. This allows greater independence, flexibility, and a more normal lifestyle for children and families.

D. Dietary limitations are not necessary is incorrect because dietary and fluid restrictions are still required with peritoneal dialysis, although they may be less strict than with hemodialysis.