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Exam 39: Lung Expansion Therapy

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Question 1

Multiple Choice

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Incentive spirometry devices can generally be categorized as which of the following? I.pressure-oriented II.flow-oriented III.volume-oriented

A) III
B) I and II
C) I, II, and III
D) II and III

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Question 2

Multiple Choice

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A surgeon orders lung expansion therapy for an obtunded 68-year-old, 170-lb man who has developed atelectasis after thoracic surgery. On baseline assessment, the patient cannot perform an IC or VC maneuver, but has no evidence of retained secretions. Which of the following would you recommend?

A) intermittent positive-pressure breathing (IPPB) at 6 to 8 breaths/min at 10 to 15 ml/kg
B) continuous positive airway pressure therapy at 12 cm H₂O for 24 hours
C) positive end-expiratory pressure therapy with bronchodilator and bronchial hygiene
D) incentive spirometry 10 times an hour at an initial volume of 600 to 800 ml

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Question 3

Multiple Choice

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All of the following machine performance characteristics should be monitored during intermittent positive-pressure breathing therapy except:

Correct instruction in the technique of incentive spirometry should include which of the following?

When checking a patient's intermittent positive-pressure breathing (IPPB) breathing circuit before use, you notice that the device will not cycle off, even when you occlude the mouthpiece. What would be the most appropriate action in this case?

Which of the following are potential complications of continuous positive airway pressure (CPAP) therapy? I.barotrauma II.hyperventilation III.gastric distention IV.hypercapnia

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 for this patient?

All of the following parameters should be evaluated after intermittent positive-pressure breathing therapy except:

Which of the following is NOT a potential contraindication for intermittent positive-pressure breathing?

Ideally, when should high-risk surgical patients be oriented to incentive spirometry?

Persistent breathing at small tidal volumes can result in which of the following?

The short-term application of inspiratory positive pressure to a spontaneously breathing patient best defines which of the following?

Which of the following initial flow settings would you select when setting up a continuous positive airway pressure flow-mask system for a patient with atelectasis?

Which of the following is FALSE about flow-oriented incentive spirometry devices?

During administration of a continuous positive airway pressure flow mask to a patient with atelectasis, you find it difficult to maintain the prescribed airway pressure. Which of the following is the most common explanation?

Which of the following are essential components of a continuous positive airway pressure (CPAP) flow system? I.blended source of pressurized gas II.nonrebreathing circuit with reservoir bag III.low-pressure or disconnect alarm IV.expiratory threshold resistor

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?

Which of the following clinical findings indicate the development of atelectasis? I.opacified areas on the chest x-ray film II.inspiratory and expiratory wheezing III.tachypnea IV.diminished or bronchial breath sounds

Prior to starting intermittent positive-pressure breathing (IPPB) on a new patient, what should the practitioner explain? I.why the physician ordered the treatment II.what the IPPB treatment will do III.how the IPPB treatment will feel IV.what the expected results are

What is the major contributing factor in the development of postoperative atelectasis?