Which of the following indicate a potential need for administration of a water or isotonic saline aerosol?

a. Stridor or brassy, crouplike cough
b. Evidence of increased volume of secretions
c. Hoarseness after extubation
d. Patient discomfort after bronchoscopy
a. 1 and 3 only
b. 1, 3, and 4 only
c. 2 and 4 only
d. 2, 3, and 4 only


ANS: B
The AARC has published Clinical Practice Guideline: Bland Aerosol Administration. Excerpts are in CPG 38-2.

The presence of one or more of the following may be an use indication for administration of a water or isotonic or hypotonic saline aerosol:
• Stridor
• Brassy, crouplike cough
• Hoarseness after extubation
• Diagnosis of laryngotracheobronchitis or croup
• History of upper airway irritation and increased work of breathing (e.g., smoke inhalation)
• Patient discomfort associated with airway instrumentation or insult
• Bypassed upper airway
• Need for sputum induction (e.g., Pneumocystis pneumonia or tuberculosis) is an indication for administration of hypertonic saline aerosol.

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