Question Answer
What are the four phases of a cough? 1. Irritation2. Inspiration3. Compression4. ExpulsionEgan’s page 922 NECC
What therapy involves the use of gravity and mechanical energy to help mobilize secretions? Postural DrainageEgan’s page 928 NECC
Secretions that are hardened or thickened through the absorption or evaporation of the liquid portion, as can occur with respiratory secretions when the upper airway is bypassed are called? InspissatedEgan’s page 1318 NECC
What 3 things does normal airway clearance require? 1. patent airway2. functional mucociliary escalator3. effective coughEgan’s page 922 NECC
Where does mucus originate from? Goblet cells and submucosal glandsEgan’s page 922 NECC
Sputum production must exceed_________ mL/day for bronchial hygiene therapy to significantly improve secretion removal. 25-30 mL/dayEgan’s page 925 NECC
The primary goal of bronchial hygiene therapy is to help mobilize and remove retained secretions, with the ultimate aim to? Improve gas exchange and reduce work of breathing.Egan’s page 924 NECC
What 3 acute conditions would bronchial hygiene therapy NOT be useful for? 1. acute exacerbation of COPD2. pneumonia without significant sputum production.3. uncomplicated asthmaEgan’s page 925 NECC
What disease can alter normal mucociliary clearance and cause secretion retention? Cystic FibrosisEgan’s page 924 NECC
Conditions in which the respiratory tract cilia do not function properly are classified as? Ciliary Dyskinetic SyndromesEgan’s page 1304 NECC
What are the ONLY 2 absolute contraindications to use “turning” for bronchial hygiene therapy? 1. Unstable spinal cord injuries2. Traction of arm abductorsEgan’s page 928 NECC
What are the 2 main types of disorders that can impair coughing and lead to mucus plugging, airway obstruction, and atelectasis? 1. Musculoskeletal2. NeurologicalEgan’s page 943 NECC
When using postural drainage, how long should a patient be kept positioned? 3-15 minutesEgan’s page 943 NECC
Supporting the area of incision or pain during a cough is referred to as? SplintingEgan’s page 935 NECC
Name 5 of the causes of impaired mucociliary clearance in intubated patients. 1. Endotracheal or tracheostomy site2. Tracheobronchial suction3. Inadequate humidification4. High FIO25. DrugsEgan’s page 923 Box 40-1 NECC
List 4 mechanisms that can impair the cough reflex. 1. Anesthesia2. CNS depression3. Narcotics4. PainEgan’s page 923 Table 40-1 NECC
What are 5 general approaches to bronchial hygiene therapy? 1. postural drainage2. coughing and expulsion techniques3. PAP4. high-frequency compression oscillation methods5. mobilization and exerciseEgan’s page 925 NECC
Name 4 hazards and/or complications of postural drainage therapy? 1. hypoxemia2. acute hypotension3. pulmonary hemorrhage4. vomiting and aspirationEgan’s page 927 AARC Clinical Practice Guidelines NECC
What is the “triple S” rule used during postural drainage therapy? STOP the therapy (return patient to original position)STAY with the patient until the patient is STABLE.Egan’s page 931 Rule of Thumb
What are 3 contraindications from the AARC Clinical Practice Guidelines for a directed cough? -Inability to control possible transmission of infection from patients suspected or known to have pathogens transmittable by droplet nuclei. (M.Tuberculosis)-Elevated ICP or know intracranial aneurysm-Acute unstable head, neck, or spine injury.