A surgeon writes an order for lung expansion therapy for a 28-year-old 110-lb woman who has undergone lower abdominal surgery
In evaluating this patient at the bedside, you obtain a VC of 800 ml and an IC of 44% predicted. Although a chest radiograph indicates basal atelectasis, she has no problem with retained secre-tions. What lung expansion treatment would you recommend?
a. Intermittent positive-pressure breathing at 6 to 8 breaths/min at 10 to 15 ml/kg
b. Continuous positive airway pressure ther-apy at 10 cm H2O for 24 hr
c. Positive end expiratory pressure therapy with bronchodilator and bronchial hygiene
d. Incentive spirometry 10 times an hour at an initial volume of 500 to 600 ml
ANS: D
For the patient having no difficulty with secretions, if the VC exceeds 15 ml/kg of lean body weight, or the IC is greater than 33% of predicted, incentive spirometry is given.
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