The nurse is teaching a patient with chronic obstructive pulmonary disease (COPD) about huff coughing to clear secretions.
During the patient’s return demonstration, the patient exhales using pursed lips. What should the nurse do next?
A.
Advise the patient that the procedure is being performed correctly.
B.
Tell the patient to take several shallow breaths before the next exhalation.
C.
Instruct the patient to inhale deeply and then quickly and forcefully exhale 2 to 3 times.
D.
Position the patient in the semi-Fowler’s position and apply oxygen.
The Correct Answer and Explanation is:
The correct answer is C. Instruct the patient to inhale deeply and then quickly and forcefully exhale 2 to 3 times.
Explanation
Huff coughing is a technique designed to help clear mucus from the airways, particularly beneficial for patients with chronic obstructive pulmonary disease (COPD). The goal of huff coughing is to produce a controlled, forceful expulsion of air to help mobilize and expel secretions from the lungs. Here’s a detailed breakdown of why option C is the most appropriate next step:
- Understanding Huff Coughing: Huff coughing involves a sequence of deep breaths followed by a forced exhalation that resembles a “huff” sound. This method is less harsh on the lungs compared to traditional coughing and is effective in mobilizing mucus from the smaller airways into the larger airways where it can be more easily expelled.
- The Technique: The patient should begin by taking a deep breath in, which helps to expand the lungs and fill the airways with air. Following this, the patient should exhale quickly and forcefully 2 to 3 times while keeping the mouth open, aiming to produce a “huff” sound. This approach helps in loosening and clearing the mucus from the airways.
- Pursed Lip Breathing: While pursed lip breathing is a useful technique for managing breathlessness and improving oxygenation by keeping the airways open longer, it is not the primary method for performing huff coughing. It is often used in combination with other techniques but does not replace the need for a deep inhalation and forceful exhalation in huff coughing.
- Incorrect Options:
- Option A: Advising the patient that the procedure is being performed correctly without further guidance may not be sufficient, as the patient needs to follow specific steps to effectively perform huff coughing.
- Option B: Taking several shallow breaths is not appropriate for huff coughing, which requires deep inhalations followed by forceful exhalations to be effective.
- Option D: Positioning the patient in the semi-Fowler’s position and applying oxygen might be necessary in other contexts, but it does not directly address the correct technique for huff coughing.
In summary, instructing the patient to inhale deeply and then exhale quickly and forcefully 2 to 3 times aligns with the correct technique for huff coughing, ensuring that the mucus is effectively mobilized and cleared from the airways.