An assessment of a patient with newly diagnosed chronic bronchitis reveals an alert, cooperative, and oriented patient. Low-pitched wheezes are heard bilaterally on auscultation
The patient has a productive cough, producing copious amounts of sputum; no fever; a pulse of 85 beats/min; respirations of 18 breaths/min; and blood pressure of 145/90. The most appropriate lung expansion therapy for this patient is which of the following?
a. Incentive spirometry
b. Intermittent positive-pressure breathing
c. Positive expiratory pressure
d. Flutter valve
ANS: C
Because he is alert, cooperative, and oriented, intermittent positive-pressure breathing is not ap-propriate for him. Incentive spirometry might be an alternative; however, it will not help this pa-tient to mobilize the copious amounts of sputum being produced. Positive expiratory pressure not only acts as an enhancement to the movement of mucus, but it also reverses atelectasis and opti-mizes delivery of bronchodilators to patients with chronic bronchitis. The flutter valve will serve only as bronchial hygiene therapy.
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