A Surgeon Writes an Order for Lung Expansion Therapy for a 28-Year-Old

A surgeon writes an order for lung expansion therapy for a 28-year-old 110-lb woman who has undergone lower abdominal surgery. In evaluating this patient at the bedside, you obtain a VC of 800 ml and an IC of 44% predicted. Although a chest radiograph indicates basal atelectasis, she has no problem with retained secretions. What lung expansion treatment would you recommend?

A) Intermittent positive-pressure breathing at 6 to 8 breaths/min at 10 to 15 ml/kg
B) Continuous positive airway pressure therapy at 10 cm H₂O for 24 hr
C) Positive end expiratory pressure therapy with bronchodilator and bronchial hygiene
D) Incentive spirometry 10 times an hour at an initial volume of 500 to 600 ml