Which of the following groups of patients is not at risk for developing postoperative atelectasis?

a. Those with chronic obstructive pulmonary disease
b. Those with a significant history of ciga-rette smoking
c. Those with impaired mucociliary clearance
d. Those with pneumonia

ANS: D
An ineffective cough impairs normal clearance mechanisms and increases the likelihood of re-tained secretions and gas absorption atelectasis in the patient with excessive mucus production. For this reason, patients with a history of lung disease that causes increased mucus production (e.g., chronic bronchitis) are most prone to develop complications in the postoperative period. Similarly, a significant history of cigarette smoking should alert the respiratory therapist to the high risk for respiratory complications with surgery.