What is the next step in assessing a client diagnosed with acute respiratory failure who shows cyanosis?

• A. Place on mechanical ventilation
• B. Administer bronchodilator
• C. Initiate chest CT scan
• D. Increase oxygen, elevate HOB

Answer: (D)

When someone is in acute respiratory failure and cyanosed, the immediate priority is to improve oxygenation. Cyanosis signals that arterial oxygen content is low, so the first step is to boost oxygen delivery and optimize breathing mechanics. Providing supplemental oxygen and elevating the head of the bed helps raise the available oxygen in the blood and reduces the work of breathing, buying time to identify and treat the underlying cause.

Jumping straight to mechanical ventilation isn’t the default move unless the patient doesn’t respond to supplemental oxygen, shows signs of fatigue, altered mental status, or deteriorating gas exchange. Bronchodilators may help if there’s a reversible airway component, but they don’t address the hypoxemia as directly as increasing oxygen does. A chest CT scan isn’t an immediate priority in acute assessment; imaging can be pursued after stabilization to evaluate underlying pathology. The key is to maximize oxygenation now and escalate only if needed.