Chapter 39

Question 0

What is the definition of passive atelectasis?

Answer 0

Persistent small tidal volumes

Question 1

What are the indications of atelectasis?

Answer 1

Temperature and respiratory rate increase, bronchial breath sounds, late inspiratory crackles over the affected area, decreased VC FRC and VT, increased opacity, shifts of trachea heart and lungs, and elevated diaphragm

Question 2

Who is at risk of developing atelectasis?

Answer 2

Anyone who can’t take a deep breath, neuromuscular patients, sedated patients and patients who have had thoracic or abdominal surgery

Question 3

What are the goals of incentive spirometry?

Answer 3

To prevent postoperative atelectasis, to treat pre existing atelectasis, improve cough mechanism, provide early detection of atelectasis or pneumonia by observing decreasing IC levels and to maintain airway during the preoperative period by strengthening the lung muscles before surgery and improving mobilization of secretions

Question 4

What are the conditions that predispose patients to atelectasis?

Answer 4

History of lung disease, decrease VC, cigarette smoking, obesity, and increase in mucus production

Question 5

What are the hazards of incentive spirometry?

Answer 5

Hyperventilation and respiratory alkalosis, discomfort secondary to inadequate pain control, fatigue, pneumothorax, pulmonary barotrauma, hypoxemia associated with interruption of oxygen therapy and exacerbation of bronchospasm

Question 6

What are the contraindications of incentive spirometry?

Answer 6

Unconscious patient who is unable to cooperate, patient cannot follow instructions, patient who cannot generate adequate inspiration, VC less than 10ml/kg and IC less than 1/3 predicted normal

Question 7

What are signs of patient improvement?

Answer 7

An improvement of baseline values, decreased respiratory rate, normal pulse rate, normal or improved chest X-ray, resolution of normal breath and improved PaO2 or decrease in P(A-a)O2

Question 8

When should the patient be taught incentive spirometry?

Answer 8

Before surgery

Question 9

How many times per hour should the patient perform SMI therapy?

Answer 9

5-10 times per hour

Question 10

What do you monitor for a patient’s performance of incentive spirometry?

Answer 10

Return visits, patient’s progress, increase goals each day, patient assessment should be improving from baseline values, frequency of visits, number of breaths per session, volume of achieved goal, breath hold in seconds, independent performance, effort and motivation