رجل عمره ٦٢ سنة في اليوم الأول بعد استئصال فص رئوي بالجراحة المفتوحة. يتنفس بشكل سطحي، والتشبع ٩١٪، ويُسمع بلغم في صدره، ويقيّم ألمه ٨/١٠، ويرفض السعال بسبب الألم. ما التدخل الأنسب أولاً؟

A 62-year-old man on day 1 after open lobectomy breathes shallowly with SpO2 91% and audible secretions. He rates his pain 8/10 and refuses to cough because of it. What is the most appropriate first intervention?

1. Restrict his movement in bed to reduce wound pain
2. Give analgesia, then help him cough while splinting with a pillow
3. Wait until the pain has fully gone before any breathing exercises
4. Give a cough suppressant so he gets relief from the pain

Answer: B) Give analgesia, then help him cough while splinting with a pillow. Pain stops deep breathing and coughing, raising atelectasis and pneumonia risk. Good analgesia, splinted coughing, incentive spirometry and early mobilisation are needed.