Which action would the nurse take first for a patient with a tracheostomy who appears anxious and is having difficulty in coughing up thick respiratory secretion?

A. Hypertension is not typically associated with pneumonia, especially in older adults. Pneumonia can lead to hypotension or sepsis, but not usually hypertension.
B. Unequal pupils are not a typical finding associated with pneumonia. This could suggest a neurological issue or a possible eye problem, not a respiratory infection.
C. Confusion is a common sign of pneumonia in older adults, especially in the elderly, who may present with altered mental status due to hypoxia, infection, or dehydration. Delirium or confusion is a common manifestation of pneumonia in this population.
D. Tympany on chest percussion suggests air in the abdominal cavity, not in the lungs, and is not typically associated with pneumonia. Pneumonia is more likely to present with dullness upon percussion due to consolidation in the lungs.

A. Fatigue: While fatigue can occur in lung cancer patients, it is not the most common symptom. Fatigue is more of a generalized symptom that can be seen in many diseases, not specific to lung cancer.
B. Hoarseness: Hoarseness can be a symptom of lung cancer, particularly if a tumor is affecting the laryngeal nerves. However, it is less common than a persistent cough and is not usually the initial symptom.
C. Anorexia: Anorexia (loss of appetite) can occur in patients with advanced cancer, including lung cancer, but it is not the most common presenting symptom. Weight loss due to anorexia is more common in later stages.
D. Persistent cough: This is the correct answer. A persistent cough is the most common symptom of lung cancer, especially in the early stages. The cough may be dry or productive and is often overlooked or mistaken for a chronic respiratory condition. It is frequently one of the first signs that leads to further investigation and diagnosis.