If a child has swallowed a foreign object and is conscious with the ability to cough, what should the nurse do first?

If a child has swallowed a foreign object and is conscious with the ability to cough, what should the nurse do first?

• A. Immediately perform abdominal thrusts
• B. Allow coughing to attempt to dislodge
• C. Start CPR
• D. Give water to swallow

Answer: (B)

When a child is conscious and able to cough, coughing is the body's best defense to clear a small airway blockage. The first step is to allow and encourage the coughing to dislodge the object while you observe closely. This approach lets the airway remain open and gives the body a chance to clear the obstruction without interrupting airflow. Giving water isn’t helpful here and could worsen the situation by risking aspiration or pushing the object deeper. Abdominal thrusts are reserved for when coughing is ineffective or the obstruction becomes complete—these are actions taken only if the child can’t cough effectively or can’t breathe. CPR is only used if the child becomes unresponsive or stops breathing. If the coughing fails to relieve the obstruction, or the child shows signs of distress (inability to breathe, cannot cough, wheezing, cyanosis), you would escalate to abdominal thrusts for a conscious child older than age one; for an infant under one year, the equivalent steps are back blows and chest thrusts.

When a child is conscious and able to cough, coughing is the body's best defense to clear a small airway blockage. The first step is to allow and encourage the coughing to dislodge the object while you observe closely. This approach lets the airway remain open and gives the body a chance to clear the obstruction without interrupting airflow.

Giving water isn’t helpful here and could worsen the situation by risking aspiration or pushing the object deeper. Abdominal thrusts are reserved for when coughing is ineffective or the obstruction becomes complete—these are actions taken only if the child can’t cough effectively or can’t breathe. CPR is only used if the child becomes unresponsive or stops breathing.

If the coughing fails to relieve the obstruction, or the child shows signs of distress (inability to breathe, cannot cough, wheezing, cyanosis), you would escalate to abdominal thrusts for a conscious child older than age one; for an infant under one year, the equivalent steps are back blows and chest thrusts.