A patient with pulmonary congestion needs to cough to clear secretions. The nurse instructs the patient to inhale and perform a series of coughs during exhalation. What type of cough did the nurse teach the patient?
a. Quad
b. Huff
c. Cascade
d. Splinting
C
With the cascade cough a patient takes a slow, deep breath and holds it for 2 seconds while contracting expiratory muscles. He or she then opens the mouth and performs a series of coughs throughout exhalation, thereby coughing at progressively lowered lung volumes. This technique promotes airway clearance and a patent airway in patients with large volumes of sputum. A quad cough is used for patients who have a spinal cord injury and no use of their abdominal muscles. While the patient breathes out with a maximal expiratory effort, the patient or you push inward and upward on the abdominal muscles toward the diaphragm, causing the cough. A huff cough stimulates a natural cough reflex. While exhaling, a patient opens the glottis by saying the word huff. Splinting occurs when the patient supports the abdomen when coughing; it is not a type of cough.
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