A female patient's chest radiograph shows bilateral lower lobe atelectasis. She is alert and ori-ented
Arterial blood gas analysis reveals mild hypoxemia and respiratory alkalemia; her vital signs are within normal limits. Which of the following is most appropriate at this time?
a. Chest physiotherapy every 4 hours
b. Continuous positive airway pressure +5 cm H2O
c. Intrapulmonary percussive ventilation every 2 hours
d. Intermittent positive-pressure breathing 35 cm H2O Q4
ANS: B
This patient requires lung expansion therapy to reverse the atelectasis. Chest physiotherapy and intrapulmonary percussive ventilation are both bronchial hygiene therapy. Intermittent posi-tive-pressure breathing is lung expansion therapy, but it is not appropriate for this patient because she is alert and oriented. Continuous positive airway pressure will help to reverse her mild hy-poxemia and atelectasis.
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