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.

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.