What is the priority nursing action for a patient identified in respiratory failure?

The priority nursing action for a patient in respiratory failure is to ensure the airway is patent and provide supplemental oxygen. In respiratory failure, the patient is unable to maintain adequate gas exchange, leading to hypoxemia or hypercapnia. Maintaining a clear airway is crucial because any obstruction can significantly worsen the patient's condition, potentially leading to respiratory arrest. Providing supplemental oxygen helps to increase the oxygen levels in the blood, addressing immediate hypoxemia and supporting the body's vital functions.

Considering the other options, starting a saline IV may not address the urgent needs of a patient with respiratory failure, as fluid resuscitation is not the immediate priority. Administering oral medications is usually contraindicated in this scenario since the patient may be unable to swallow safely due to compromised breathing. Preparing for patient discharge is inappropriate in this situation, as patients in respiratory failure typically require ongoing assessment and treatment under close medical supervision. Thus, ensuring the airway is open and providing oxygen are foundational actions that directly target the life-threatening aspects of respiratory failure.