Exam (elaborations)
_Therapeutic exam 2_ DS
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_Therapeutic exam 2_ DS
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"Therapeuticexam
2"
DS
An
effective
cough
is
broken
down
to
4
phases.
What
are
they?
-
ANSWER-irritation,
inspiration,
compression,
expulsion
The
____
phase
where
the
cough
reflex
is
stimulated
by
inflammation,
a
foreign
body,
chemicals
or
heat
-
ANSWER-Irritation
Normal
clearance
involves____
-
ANSWER-1-Patent
airway
2-Functional
mucociliary
escalator
3-Effective
cough
the
inspiration
phase
occurs
when
the
person
inhales
between
___
liters
of
air
-
ANSWER-1
to
2
the____
phase
occurs
when
the
glottis
is
closed
and
there
is
muscle
contraction
this
can
cause
pressures
of
up
to
___
mm
Hg
behind
the
closed
glottis
-
ANSWER-compression,
100
the
____phase
occurs
when
the
glottis
opens
abruptly
and
there
is
a
violent
expulsion,
the
speed
of
a
cough
can
be
as
much
as
miles
____per
hour.
-
ANSWER-expulsion;
500
______Clearance
Altered
airway
patency
Impaired
mucociliary
function
Composition
and
production
of
mucus
Impaired
cough
reflex
Therapeutic
interventions
-
ANSWER-abnormal
Lis
at
least
two
things
that
can
alter
airway
patency?
-
ANSWER-Foreign
bodies
tumor
chronic
bronchitis
asthma Name
a
few
things
that
can
impair
mucocilary
function?
-
ANSWER-Presence
of
an
artificial
airway
Tracheobronchial
suctioning
(damage
to
mucosa)
Inadequate
humidification
High
FIO2's
Drugs:
general
anesthesia,
opiates,
narcotics
and
some
pulmonary
disease
Some
pulmonary
diseases
cause
an
increase
in
production
and
composition
of
mucus.
These
are
four
main
diseases
that
cause
this
type
of
change.
-
ANSWER-Cystic
Fibrosis
Bronchiectasis
Ciliary
dyskinetic
syndromes
Chronic
bronchitis
____phase
is
affected
or
impaired
by:
anesthesia
CNS
depression
narcotic-analgesics
-
ANSWER-Irritation
Impairment
of
the
____phase
can
occur
with
Pain,
Neuromuscular
dysfunction
(such
as
polio,
muscular
dystrophy,
ALS,
etc.),
Pulmonary
restriction
(ARDS,
fibrosis,
kyphoscoliosis,
etc),
Abdominal
restriction
(obesity,
post-surgical
bandages
etc).
-
ANSWER-Inspiration
Impairment
of
the
____phase
can
be
caused
by
laryngeal
nerve
damage
artificial
airway
abdominal
muscle
weakness
or
abdominal
surgery
-
ANSWER-Compression
____phase
impairment
can
be
caused
by
airway
compression,
obstruction,
abdominal
muscle
weakness
and
inadequate
lung
recoil
(such
as
with
emphysema).
-
ANSWER-Expulsion
Name
the
five
factors
that
alter
mucociliary
clearance.
-
ANSWER-1-Altered
airway
patency
2-Impaired
mucociliary
function
3-Composition
and
production
of
mucus
4-Impaired
cough
reflex 5-Therapeutic
interventions
The
acute
conditions
for
bronchial
hygiene
therapy
include
-
ANSWER-Acute
lobar
atelectasis
Acute
respiratory
failure
with
retained
secretions
V/Q
abnormalities
caused
by
unilateral
lung
disease
Copious
secretions
Immobile
patients
Abundant;
plentiful
-
ANSWER-Copious
If
the
patient
has
copious
and
or
retained
secretions
this
is
an
indication
for
_____therapy
-
ANSWER-BHT
Y/N:
If
the
patient
has
acute
lobar
atelectasis,
significant
infiltrates,
or
consolidation
with
hypoxemia
the
patient
should
receive
BHT.
-
ANSWER-yes
infiltrate
-
ANSWER-to
pass
through
or
gain
entrance
to
gradually
or
stealthily
Severe
pneumonia
with
copious
secretions
and
Respiratory
failure
with
inability
to
clear
retained
secretions
should
receive_____therapy
-
ANSWER-BHT
Should
BHT
be
used
during
an
acute
exacerbation
of
COPD
?
-
ANSWER-No
because
exacerbation
the
patient
can
not
tolerate
most
BHT
procedures
Y/N
Just
because
a
patient
has
pneumonia
does
that
mean
they
automatically
have
secretions
-
ANSWER-No,
not
all
pneumonias
produce
secretion
Y/N
Does
a
patient
with
uncomplicated
asthma
requires
BHT?
-
ANSWER-No
Chronic
conditions
for
BHT
are?
-
ANSWER-Cystic
fibrosis
Bronchiectasis
Chronic
bronchitis
How
often
does
a
patient
with
chronic
condition
such
as,
Cystic
fibrosis,
Bronchiectasis,
Chronic
bronchitis
should
use
BHT?
-
ANSWER-Several
times
each
day
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