A patient with a neuromuscular disease has been assessed by the therapist, and the information obtained is listed below: • ? Inability to speak in full sentences • ? Orthopnea • ? FVC 8 ml/kg • ? MIP – 18 cm H2O • ? Paradoxical inward motion of diaphragm during inspiration Based on these findings, what should the therapist recommend at this time for this patient?
A. Continue monitoring this patient.
B. Recommend the bronchial hygiene protocol.
C. Propose the implementation of the O2 therapy protocol.
D. Suggest intubation and mechanical ventilation.
ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: Patients with neuromuscular disease must be assessed for the ability to maintain a patent airway. Orthopnea, inability to speak in complete sentences, or paradoxical inward abdominal motion during inspiration indicate respiratory muscle weakness and fatigue. A drop in FVC below 15 ml/kg and an MIP of less than –25 cm H2O are considered to be an indication for prophylactic intubation and mechanical ventilation.?
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