Which coughing technique will the nurse use to help a patient ...

[kaid0807]

Which coughing technique will the nurse use to help a patient clear central airways?
 
  a. Huff
  b. Quad
  c. Cascade
  d. Incentive spirometry

Question 2

The nurse is caring for a patient with a tracheostomy tube. Which nursing intervention is most effective in promoting effective airway clearance?
 
  a. Suctioning respiratory secretions several times every hour
  b. Administering humidified oxygen through a tracheostomy collar
  c. Instilling normal saline into the tracheostomy to thin secretions before suctioning
  d. Deflating the tracheostomy cuff before allowing the patient to cough up secretions

[lucas dlamini]

Answer to Question 1

ANS: A
The huff cough stimulates a natural cough reflex and is generally effective only for clearing central airways. While exhaling, the patient opens the glottis by saying the word huff. The quad cough technique is for patients without abdominal muscle control such as those with spinal cord injuries. While the patient breathes out with a maximal expiratory effort, the patient or nurse pushes inward and upward on the abdominal muscles toward the diaphragm, causing the cough. With the cascade cough the patient takes a slow, deep breath and holds it for 2 seconds while contracting expiratory muscles. Then he or she opens the mouth and performs a series of coughs throughout exhalation, thereby coughing at progressively lowered lung volumes. This technique promotes airway clearance and a patent airway in patients with large volumes of sputum. Incentive spirometry encourages voluntary deep breathing by providing visual feedback to patients about inspiratory volume. It promotes deep breathing and prevents or treats atelectasis in the postoperative patient.

Answer to Question 2

ANS: B
Humidification from air humidifiers or humidified oxygen tracheostomy collars can help prevent drying of secretions that cause occlusion. Suctioning should be done only as needed; too frequent suctioning can damage the mucosal lining, resulting in thicker secretions. Normal saline should not be instilled into a tracheostomy; research showed no benefit with this technique. The purpose of the tracheostomy cuff is to keep secretions from entering the lungs; the nurse should not deflate the tracheostomy cuff unless instructed to do so by the health care provider.

[kaid0807]

TYSM

[gcook]

Excellent