The respiratory therapist has just stopped postural drainage for a 24-year-old patient with cystic fibrosis because of shortness of breath and slight cyanosis in the "head-down" position
The respiratory therapist should recommend which of the following adjustments to therapy?
a. Continue postural drainage and monitor patient with capnography.
b. Use only upright or flat postural drainage positions and draw an arterial blood gas (ABG).
c. Administer oxygen via nasal cannula and monitor with pulse oximetry.
d. Use a transcutaneous partial pressure of oxygen (PtcO2) monitor to assess the ex-tent of hypoxemia.
ANS: C
The presence of slight cyanosis and shortness of breath in the "head-down" position is indicative of hypoxemia. The respiratory therapist should administer supplemental oxygen via nasal cannula (possibly 1-2 L/min) and monitor the patient with a continuous pulse oximetry. Capnography is not useful in detecting hypoxemia. Using flat postural drainage positions where the head is not lower than the shoulders has not been proven to be effective.
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