Which of the following clients are more than likely experiencing impairment of the mucociliary blank with cilia dysfunction? Select all that apply
A) A smoker who smokes 2 packs of cigarettes/day and currently hospitalized with pneumonia
B) A middle-aged diabetic client with bilateral neuropathy
C) A military guard person stationed in Germany
D) A mountain skier who spends all day outside teaching ski lessons
E) A nursing home client diagnosed with H1N1 influenza with fever of 102°F
Ans: A, D, E
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The mucociliary blanket protects the respiratory system by entrapping foreign particles in mucus; then cilia move the mucus with trapped particles upward toward the oropharynx to be coughed out or swallowed. The function of the cilia in clearing the lower airways and alveoli is optimal at normal oxygen levels and is impaired in situations of low and high oxygen levels. It is also impaired by drying conditions, such as breathing heated but unhumidified indoor air during the winter months. Cigarette smoking slows down or paralyzes the motility of the cilia. This slowing allows the residue from tobacco smoke, dust, and other particles to accumulate in the lungs, decreasing the efficiency of this pulmonary defense system. During fever, the water vapor in the lungs increases, causing more water to be lost through the respiratory tract. In addition, fever usually is accompanied by an increase in respiratory rate so that more air passes through the airways, withdrawing moisture from its mucosal surface. As a result, respiratory secretions thicken, preventing free movement of the cilia and impairing the protective function of the mucociliary defense system.
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