To monitor a patient for the possibility of reactive bronchospasm ...

[Deast7027]

To monitor a patient for the possibility of reactive bronchospasm during aerosol drug therapy, what should you do?
 
  1. Measure pre- and postpeak flow and/or percentage forced expiratory volume in 1 second (FEV1).
  2. Auscultate for adventitious breath sounds.
  3. Carefully observe the patient's response.
  4. Communicate with the patient during therapy.
  a. 1 and 3 only
  b. 1, 3, and 4 only
  c. 2, 3, and 4 only
  d. 1, 2, 3, and 4

Question 2

A patient with chronic bronchitis is receiving heated water aerosol treatments through a jet nebu-lizer four times daily to aid in mobilizing retained secretions.
 
  After each treatment, you note a dramatic increase in the magnitude of coarse crackles heard on auscultation. Which of the following recommendations would you make to the physician?
  a. Discontinue the heated water aerosol treatments.
  b. Switch to a higher-density aerosol (e.g., ultrasonic).
  c. Add coughing and postural drainage to the therapy.
  d. Consider prior treatment with a broncho-dilator.

[Moriaki]

Answer to Question 1

ANS: D
Monitoring for reactive bronchospasm should include peak flow measurements or percentage forced expiratory volume in 1 second (FEV1) before and after therapy; auscultation for adven-titious breath sounds, and observation of the patient's breathing pattern and overall appearance; and, most essentially, communication with the patient during therapy to determine the perceived work of breathing (WOB).

Answer to Question 2

ANS: C
For patients unable to clear their own secretions, suctioning or other airway clearance techniques may be indicated as an adjunct to aerosol therapy.

[Deast7027]

TYSM

[frankwu0507]

Excellent