Fundamentals of Nursing Q 373
A practitioner orders chest physiotherapy with percussion and vibration for a newly admitted patient. Which information obtained by the nurse during the health history should alert the nurse to question the practitioner’s order?
A. Emphysema
B. Osteoporosis
C. Cystic fibrosis
D. Chronic bronchitis
Correct Answer: B. Osteoporosis
Implementing the practitioner’s order may compromise patient safety because percussion and vibration in the presence of osteoporosis may cause fractures. Osteoporosis is an abnormal loss of bone mass and strength. Chest physiotherapy is a group of physical techniques that improve lung function and help you breathe better. Chest PT, or CPT expands the lungs, strengthens breathing muscles, and loosens and improves drainage of thick lung secretions.
Option A: These are appropriate interventions for a patient with emphysema. Emphysema is a chronic pulmonary disease characterized by an abnormal increase in the size of air spaces distal to the terminal bronchioles with destructive changes in their walls. Chest percussion and vibration to help loosen lung secretions. Some patients wear a special CPT vest hooked up to a machine. The machine makes the vest vibrate at a high frequency to break up the secretions.
Option C: These are appropriate interventions for a patient with cystic fibrosis causes widespread dysfunction of the exocrine glands. It is characterized by thick, tenacious secretions in the respiratory system that block the bronchioles, creating breathing difficulties. Chest PT helps treat such diseases as cystic fibrosis and COPD (chronic obstructive pulmonary disease). It also keeps the lungs clear to prevent pneumonia after surgery and during periods of immobility.
Option D: These are appropriate interventions for a patient with chronic bronchitis. Bronchitis is an inflammation of the mucous membranes of the bronchial airways. The doctor may recommend chest PT to help loosen and cough up thick or excessive lung secretions from such conditions as lung infections, which include pneumonia, acute bronchitis, and lung abscess.