After administering a 30-min bland water aerosol treatment to a dehydrated elderly patient with chronic bronchitis, you note increased wheezing and a general decrease in the intensity of breath sounds. Which of the following has probably occurred?
a. Reactive bronchospasm has occurred and worsened airway obstruction.
b. Inspissated secretions have swollen and worsened airway obstruction.
c. Nothing; this is a normal response to bland aerosol therapy.
d. The patient is developing atelectasis due to overhydration.
ANS: B
In addition to overhydration of the patient, inspissated pulmonary secretions also can swell after high-density aerosol therapy, worsening airway obstruction.
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