A patient recovering from abdominal surgery is having difficulty ...

[maegan_martin]

A patient recovering from abdominal surgery is having difficulty developing an effective cough. Which of the following actions would you recommend to aid this patient in generating a more effective cough?
 
  1. Coordinating coughing with pain medication
  2. Using the forced expiration technique (FET)
  3. Supplying manual epigastric compression
  4. Splinting the operative site
  a. 1, 2, and 4 only
  b. 1, 2, and 3 only
  c. 3 and 4 only
  d. 2, 3, and 4 only

Question 2

Indications for directed coughing include which of the following?
 
  1. Enhance other airway clearance therapies.
  2. Help patients with tuberculosis clear secretions.
  3. Help prevent postoperative pulmonary complications.
  4. Obtain sputum specimens for diagnostic analysis.
  a. 1 and 3 only
  b. 1, 2, and 3 only
  c. 3 and 4 only
  d. 1, 3, and 4 only

[Fayaz00962]

Answer to Question 1

ANS: A
The postoperative regimen can be enhanced by coordinating the coughing sessions with pre-scribed pain medication and assisting the patient in splinting the operative site. This may initially be accomplished by the clinician, using his/her hands to support the area of incision. Eventually, the patient can learn to use a pillow to splint the incision site. The FET may also be of value in these patients.

Answer to Question 2

ANS: D
The AARC has published Clinical Practice Guideline: Directed Cough. See CPG 43-2.