Answer to Question 1
A
Patients doing isometric exercises should be taught to exhale while exerting effort. Many persons hold their breath (Valsalva maneuver), which increases intrathoracic pressure, causing a decrease in venous return to the heart. Each exercise prescription is individualized according to the patient's needs and limitations. Gradual buildup of exercise repetitions improves both muscle strength and endurance. Hold the muscles tightly contracted for 5 to 15 seconds, and then relax completely for several seconds.
Answer to Question 2
A
Rhonchi are loud, low-pitched, rumbling, coarse sounds heard most often during inspiration or expiration; they may be cleared by coughing. Wheezes are high-pitched, continuous, musical sounds like a squeak heard continuously during inspiration or expiration; they are usually louder on expiration and do not clear with coughing. Pleural friction rub has a dry, grating quality heard best during inspiration and does not clear with coughing; it is heard loudest over the lower lateral anterior surface. Fine crackles are high-pitched fine, short, interrupted crackling sounds heard during the end of inspiration; they usually are not cleared with coughing.