RT-13 · Initiation & Modification

Bronchial Hygiene, Lung Expansion & Hyperinflation Therapy

Secretion clearance and lung expansion therapies — who needs which, how to judge effectiveness, and when to stop.

~18 min read3 concept sections·4 questions with rationale

What you'll be able to do

  • Select a secretion clearance technique by pathology and patient ability
  • Differentiate lung expansion from secretion clearance therapy
  • Set up and evaluate incentive spirometry and IPPB
  • Recognize contraindications and adverse responses
Concept breakdown
01

Two different problems

Atelectasis needs volume. Retained secretions need clearance. Choosing the wrong family is the classic exam error.

  • Lung expansion therapy: incentive spirometry, IPPB, CPAP/EPAP, and deep breathing — for atelectasis and postoperative prevention.
  • Secretion clearance: directed cough, postural drainage and percussion, PEP and oscillating PEP, high-frequency chest wall oscillation, and airway clearance devices — for retained secretions.
  • Incentive spirometry is first line for the cooperative postoperative patient; it needs a vital capacity above roughly 10 mL/kg and an inspiratory capacity above about one third of predicted.
  • IPPB is reserved for the patient who cannot take a deep breath on their own or needs short-term hyperinflation with medication delivery.
At the bedside

An unconscious patient cannot use an incentive spirometer. The device must match what the patient can actually do.

Practice quiz

Check yourself before you read the rationale.

Question 1 of 1

A postoperative patient with left lower lobe atelectasis is alert, cooperative, and has a vital capacity of 15 mL/kg. The most appropriate therapy is:

Practice questions

Answer first, then read why the distractors fail.

Question 1

A postoperative patient with left lower lobe atelectasis is alert, cooperative, and has a vital capacity of 15 mL/kg. The most appropriate therapy is:

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2 more concept sections, 3 more questions, and the exam-day playbook for this module.

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