Lung Expansion Therapy /Bronchial Hygiene Exam 1 Flashcards

atelectasis
Terms Definitions
Which of the following situations is a contraindication for incentive spirometry? I. A patient whose vital capacity is less than 10 ml/kg. II. A patient who cannot cooperate or follow instructions. III. An unconscious patient.
D) I, II, and III
Which of the following conditions is most likely to predispose a patient to atelectasis?
C) Surgery to the liver.
Ideally, when should high-risk surgical patients be oriented to incentive spirometry?
B) Preoperatively, before undergoing the surgical procedure.
A patient complains of numbness around his lips during IS. What should the therapist recommend?
B) Tell the patient to slow his/her breathing rate
Physical signs of atelectasis that involves a significant portion of the lungs include: I. decreased or bronchial/tubular breath sounds. II. tachypnea. III. normal breath sounds. IV. tachycardia when hypoxemia is present.
D) I, II and IV only I. decreased or bronchial/tubular breath sounds. II. tachypnea. IV. tachycardia when hypoxemia is present.
In teaching a patient to perform the sustained maximal inspiration maneuver during incentive spirometry, what would you say?
A) “Exhale normally, then inhale as deeply as you can, then hold your breath for 5 to 10 seconds.”
A postoperative patient using incentive spirometry complains of dizziness and numbness around the mouth after therapy sessions. What is the most likely cause of these symptoms?
B) Hyperventilation
Which of the following is FALSE about flow-oriented incentive spirometry devices?
C) They have proved less effective than volumetric systems.
Which of the outcomes would indicate improvement in a patient previously diagnosed with atelectasis who has been receiving incentive spirometry? I. Improved PaO2 II. Decreased respiratory rate III. Improved chest radiograph IV. (FVC) V. Tachycardia
A) I, II, and III I. Improved PaO2 II. Decreased respiratory rate III. Improved chest radiograph
Persistent breathing at small tidal volumes can result in which of the following?
C) Passive atelectasis
Correct instruction in the technique of incentive spirometry should include which of the following?
B) Diaphragmatic breathing at slow to moderate flows.
Lung expansion therapy works because of an increase in what pressure gradient?
A) Transpulmonary
Which of the following are potential indications for incentive spirometry? I. A restrictive disorder such as quadriplegia II. Abdominal surgery in a COPD patient III. Presence of pulmonary atelectasis
D) I, II, and III I. A restrictive disorder such as quadriplegia II. Abdominal surgery in a COPD patient III. Presence of pulmonary atelectasis
The therapist should instruct the patient to perform IS:
B) hourly.
Lung expansion methods that increase the transpulmonary pressure gradients by increasing alveolar pressure include which of the following? I. (IS) II. Positive end-expiration pressure therapy III.(IPPB) IV.(EPAP)
B) II, III, and IV II. Positive end-expiration pressure therapy III. Intermittent positive-pressure breathing (IPPB) IV. Expiratory positive airway pressure (EPAP)
In observing a postoperative woman conduct incentive spirometry, you note repetitive performance of the sustained maximal inspiration maneuver at a rate of about 10 to 12/min. Which of the following would you recommend to her?
C) Take a 30-second rest period between breaths.
Which of the following patient categories are at high risk for developing atelectasis? I. Those who are heavily sedated. II. Those with upper abdominal or thoracic pain following surgery III. Those with neuromuscular disorders.
D) I, II, and III I. Those who are heavily sedated. II. Those with upper abdominal or thoracic pain following surgery III. Those with neuromuscular disorders.
Which of the following is not a potential hazard or complication of incentive spirometry?
B) Decreased cardiac output
How do all modes of lung expansion therapy aid lung expansion?
A) By increasing the transpulmonary pressure gradient.
What should the monitoring of patients using incentive spirometry include? I. Number of breaths per session. II. Volume and flow goals achieved. III. Maintenance of breath-hold. IV. Patient effort and motivation.
C) I, II, III, and IV I. Number of breaths per session. II. Volume and flow goals achieved. III. Maintenance of breath-hold. IV. Patient effort and motivation.
Which of the following modes of lung expansion therapy is physiologically most normal?
B) Incentive spirometry
Acute respiratory alaklosis is a very common problem and occurs when the patient performs IS too rapidly.
A) True
An alert and cooperative 28-year-old woman with no prior history of lung disease underwent cesarean section 16 hours earlier. Her x-ray film currently is clear. Which of the following approaches to preventing atelectasis would you recommend?
A) Incentive spirometry
Successful application of incentive spirometry depends on:
C) the effectiveness of patient teaching.
How can the transpulmonary pressure gradient be increased? I. Increasing alveolar pressure. II. Decreasing pleural pressure. III. Decreasing transthoracic pressure.
A) I and II I. Increasing alveolar pressure. II. Decreasing pleural pressure.
Incentive spirometry devices can generally be categorized as which of the following? I. Pressure-oriented II. Flow-oriented III. Volume-oriented
D) II and III II. Flow-oriented III. Volume-oriented
Which of the following is not at high risk for developing postoperative atelectasis?
D) Those with a non-smoking history.
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