Asthma and COPD Q 28

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The nurse in charge is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide?

  

     A. It helps prevent early airway collapse.

     B. It increases inspiratory muscle strength.

     C. It decreases use of accessory breathing muscles.

     D. It prolongs the inspiratory phase of respiration.

    

    

Correct Answer: A. It helps prevent early airway collapse.

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Pursed-lip breathing helps prevent early airway collapse. Learning this technique helps the client control respiration during periods of excitement, anxiety, exercise, and respiratory distress. The positive pressure created opposes the forces exerted on the airways from the flow of exhalation. As a result, pursed-lip breathing helps support breathing by the opening of the airways during exhalation and increasing excretion of volatile acids in the form of carbon dioxide preventing or relieving hypercapnia.

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Option B: To increase inspiratory muscle strength and endurance, the client may need to learn inspiratory resistive breathing. Inspiratory resistive breathing is a clinically relevant model encountered in many disease states such as upper airway obstruction, chronic obstructive pulmonary disease (COPD) exacerbations and asthma attacks. Resistive breathing increases the plasma level of proinflammatory cytokines.

Option C: To decrease accessory muscle use and thus reduce the work of breathing, the client may need to learn diaphragmatic (abdominal) breathing. Diaphragmatic breathing is a type of breathing exercise that helps strengthen the diaphragm, an important muscle that helps breathe as it represents 80% of breathing. This breathing exercise is also sometimes called( belly breathing or abdominal breathing).

Option D: In pursed-lip breathing, the client mimics a normal inspiratory-expiratory (I:E) ratio of 1:2. (A client with emphysema may have an I:E ratio as high as 1:4.). The expiratory phase of respiration is going to prolong when compared to inspiration to expiration ratio in normal breathing.

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