Deck 13: Postoperative Atelectasis

Question 1

Which of the following factors increases the risk of postoperative atelectasis by reducing the patient's inspiratory capacity?

A)Patient is over 55 years of age
B)Marked obesity
C)Men below 68 inches in height
D)History of diabetes

Answer 1

B

Question 2

Which of the following findings in the medical history of the patient about to undergo major surgery suggests that he/she may benefit from bronchial hygiene prior to surgery?

A)Significant smoking history
B)History of COPD
C)History of bronchiectasis
D)All the above

Answer 2

D

Question 3

Which of the following factors contributes to the incidence of postoperative atelectasis during general anesthesia?

A)Use of humidified anesthetic gases
B)Excessive blood loss
C)Use of paralytic agents
D)Too little fluid replacement

Answer 3

C

Question 4

What is the primary symptom associated with the onset of significant atelectasis in the postoperative period?

A)Chest pain
B)Dyspnea
C)Anxiety
D)Cough

Question 5

What must also be applied to the patient with postoperative atelectasis due to mucus plugging who is being treated with positive pressure techniques?

A)Oxygen therapy
B)Bronchoscopy
C)Bronchial hygiene techniques
D)Frequent ambulation

Question 6

Which of the following findings on the chest radiograph suggests that the atelectasis is due to mucus plugging?

A)Air bronchograms
B)Shift of the mediastinum
C)Elevation of the diaphragm
D)Blurring of the right heart border

Question 7

What surgical site represents the greatest risk for postoperative atelectasis?

A)Upper thoracic
B)Lower abdominal
C)Upper abdominal
D)Pelvic

Question 8

What is the primary objective when intrapulmonary percussive ventilation (IPV)is applied to the postoperative patient with atelectasis?

A)Hyperinflate the lung
B)Enhance secretion removal
C)Improve surfactant production
D)Improve CO2 removal

Question 9

What prior diagnosis increases the risk of postoperative atelectasis due to mucus plugging?

A)Chronic bronchitis
B)Pulmonary fibrosis
C)Sarcoidosis
D)Congestive heart failure

Question 10

In the fully awake and cooperative patient,what lung inflation technique may be best for treating and preventing postoperative atelectasis?

A)IPPB
B)Deep breathing and coughing
C)PEP therapy
D)CPAP by mask

Question 11

What therapy is often very effective in treating lobar atelectasis in the postoperative patient?

A)A short,vigorous course of chest physical therapy
B)IPPB
C)CPAP with humidity therapy
D)Simulated coughing

Question 12

What therapy should be added to the COPD patient with postoperative atelectasis?

A)High FIO₂
B)Bronchodilators and humidity therapy
C)Ultrasonic mist with mucolytics
D)Intravenous steroids

Question 13

Which of the following conditions can lead to a reduction in surfactant production and atelectasis?

A)Inhaled anesthetics
B)Breathing high FIO₂ concentrations
C)Prolonged breathing at large tidal volumes
D)A and B only

Question 14

What abnormalities would be seen in bedside spirometry tests for the patient with severe atelectasis?

A)Reduced vital capacity
B)Reduced inspiratory capacity
C)Reduced FEV1/FVC
D)A and B only

Question 15

What physical examination finding suggests a more severe case of postoperative atelectasis?

A)Hypotension
B)Inspiratory wheezing
C)Bronchial breath sounds
D)Use of accessory muscles to breathe

Question 16

Which of the following increases in proportion to the amount of the lung involved in the atelectasis?

A)Heart rate
B)Respiratory rate
C)P(A-a)O₂
D)Body temperature

Question 17

Which two physical examination findings are commonly seen in patients with postoperative atelectasis?

A)Fever and cough
B)Tachypnea and cough
C)Tachypnea and late-inspiratory crackles
D)Bronchial breath sounds and bradypnea

Question 18

Which of the following is NOT a typical pathophysiologic change associated with atelectasis?

A)V/Q mismatching and hypoxemia
B)Reduced lung compliance and an increased work of breathing
C)Overinflation of unaffected lung regions during mechanical ventilation
D)Poor diffusion of oxygen across the AC membrane due to edema