Percussion and vibration is ordered on a patient with retained ...

[codyclark]

Percussion and vibration is ordered on a patient with retained pulmonary secretions. Which action by the student nurse should the nursing instructor question?
 
  a. Performs percussion for 3 to 5 minutes in each position as tolerated
  b. Uses the wrist and elbow to create movement when performing percussion
  c. While the patient inhales, gently pushes down and vibrates the chest wall with the flat part of the hand
  d. Repeats the vibration 3 times and then instructs the patient to take a deep breath and cough while exhaling

Question 2

A patient who is very frail and thin with osteoporosis has just undergone abdominal surgery. The nurse anticipates that which technique will be used to control respiratory secretions in this patient?
 
  a. Forceful coughing
  b. Percussion
  c. Vibration
  d. Shaking

[CAPTAINAMERICA]

Answer to Question 1

C
Vibration is performed while the patient is exhaling, not inhaling. Percussion is performed for 3 to 5 minutes in each position. When clapping, most arm movement comes from the elbow and wrist joints. Vibration is repeated 3 times and then the patient cascade coughs by taking a deep breath and doing a series of small coughs until the end of the breath.

Answer to Question 2

A
Thin, frail patients with osteoporosis are most susceptible to injury and are taught other secretion control measures (e.g., forceful coughing, humidification). Percussion, vibration, and shaking are contraindicated with rib fracture; fracture of other rib cage structures such as clavicle or sternum; pain; severe dyspnea; and severe osteoporosis.

[codyclark]

Excellent

[kthug]

Thanks for the timely response, appreciate it