A nurse explains to you that a certain neuromuscular patient ...

[sjones]

A nurse explains to you that a certain neuromuscular patient cannot develop a good cough. Which of the following would you consider to manage this patient's clearance problem?
 
  1. Combining manual chest compression with suctioning
  2. Coordinating the coughing regimen with pain medication
  3. Using the autogenic drainage method
  4. Using mechanical insufflation-exsufflation
  a. 1 and 4 only
  b. 1, 2, and 3 only
  c. 2 and 3 only
  d. 1, 2, and 4 only

Question 2

Which of the following are true about the FET?
 
  1. It causes less bronchiolar collapse than traditional coughing.
  2. It occurs from mid to low lung volume without glottis closure.
  3. It has a period of diaphragmatic breathing and relaxation.
  4. It occurs from mid to high lung volume without glottis closure.
  a. 1 and 3 only
  b. 1, 2, and 3 only
  c. 3 and 4 only
  d. 2, 3, and 4 only

[leannegxo]

Answer to Question 1

ANS: A
If this problem results in retained secretions, there are only three options: (1) placement of an ar-tificial airway and removal of secretions by tracheobronchial suctioning (see Chapter 33), (2) manually assisted cough, and (3) mechanical insufflation-exsufflation.

Answer to Question 2

ANS: B
The FET, or huff cough, consists of one or two forced expirations of middle to low lung volume without closure of the glottis, followed by a period of diaphragmatic breathing and relaxation. The goal of this method is to help clear secretions with less change in pleural pressure and less likelihood of bronchiolar collapse.