Why is strenuous patient coughing during postural drainage in a head-down position contraindi-cated?

a. It can impair the mucociliary clearance mechanism.
b. It can increase expiratory airway resistance (Raw).
c. It can cause air trapping and pulmonary distension.
d. It can markedly increase intracranial pres-sure (ICP).

ANS: D
When using the head-down position, the patient should avoid strenuous coughing, because this will markedly raise ICP.

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