During treatment with aerosolized dornase alpha, what is the best action if a patient exhibits marked congestion and significant coughing?

Assisting the patient in clearing secretions through cough coaching is the most appropriate action when a patient experiences marked congestion and significant coughing during treatment with aerosolized dornase alpha. Dornase alpha is a mucolytic agent used primarily in cystic fibrosis patients to help break down and thin mucus, ultimately aiding in its clearance from the airways.

When a patient exhibits signs of congestion and is coughing, it indicates that they may have difficulty managing the increased mucus production effectively. Cough coaching, which involves guiding the patient on effective coughing techniques, can help facilitate the mobilization of secretions from the airways. This approach not only helps the patient to clear their lungs but also promotes better airway hygiene and prevents potential complications associated with retained secretions, such as infections or further airway obstruction.

While providing oxygen, reporting to a physician, or reducing the dosage may seem relevant steps, they do not directly address the immediate needs of managing the airway congestion caused by the treatment. Administering oxygen could be required if there is evidence of respiratory distress or hypoxemia, but it does not specifically resolve the issue of clearance of secretions. Reporting to the physician is essential for ongoing care but may not be necessary in an acute situation where immediate relief is needed.