Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical lab > Mucus Clearance > Flashcards

Mucus Clearance Flashcards

1
Q

What is responsible for mucus clearance in healthy people?

A

The mucociliary escalator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acute diseases can affect the efficacy of the mucociliary escalator. How are secretions cleared then?

A

Coughing is the primary mechanism for removing mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The huff cough is performed by taking several deep diaphragmatic breaths then squeezing the abdominal and thoracic muscles against a closed glottis and then forcefully coughing

A

False. The huff cough is performed by patients taking several deep breaths and then contracting their abdominal and thoracic muscles with the glottis and mouth open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Patients affected by neurological muscle disorders or paralysis can benefit from what?

A

Manual assisted cough
Place hands over diaphragm and have patient breath deeply, then coordinated their exhalation with pressure applied by the caregiver on the diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

This breathing technique utilizes periods of relaxed diaphragmatic breathing followed by several deep breaths followed by huff coughing

A

Active cycle of breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The mechanical cough assist provides negative pressure solely during exhalation in order to assist a patient cough

A

False. The MIE device provides positive pressure during inhalation and negative pressure during exhalation in order to help stimulate a cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mechanical cough assist devices are suitable for patients with

A

Trauma
Muscular dystrophy
Myasthenia gravis
Poliomyelitis
Spinal cord injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The cough assist provides positive and negative pressures of up to 30/-30 cm of water

A

False. The MEI provides positive and negative pressures of up to 60/-60 cm of water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How much inspiratory flow can an MIE device generate?

A

An MIE device can generate between 3.3 and 10 L/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The MIE cannot operate independently and must be manually actuated by an RT

A

False. The MIE can operate independently and manually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The MIE is not suitable for patients with and ET tube or Tracheostomy tube

A

False
The MIE can be administered with an oronasal mask, a mouthpiece, and ET tube or a tracheostomy tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Would the MIE be suitable for patients suffering from active gross hemoptysis?

A

No.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the contraindications for MIE use?

A

Untreated pneumothorax
Hemodynamic instability
Intercranial pressures greater than 20 mmHg
Recent maxillofacial and skull surgery/trauma
Known or suspected tympanic membrane rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe bullous emphysema

A

Bullous emphysema is a condition characterized by damaged alveoli that distend to form large air spaces, especially in the uppermost portions of the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are hazards of using a cough assist device?

A

Bullous emphysema, known susceptibility to pneumothorax
Recent barotrauma
Individuals prone to airway closure (COPD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Percussion, forced exhalation and postural drainage are all examples of what?

A

A Conventional chest physiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the clinical application for postural drainage?

A

Excessive sputum production that a patient is having difficulty clearin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

v

A

Palpation-uneven thoracic movement
Percussion-area would sound dull
Xray-could potentially show a consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The patient has secretions in their upper lobes in the anterior segments. What position should they be put in to optimize drainage? Where should the percussions be performed?

A

Supine
Pectoral region below the clavicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A patient has secretions in the posterior segments of their upper lobes. How should you position them for optimal drainage? Where should the percussions be performed?

A

Sitting up, pillow in lap and bending forward as far as possible with arms out in front of them
Upper portion of the back between the shoulder blades

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A patient has secretion in the apical segments of their upper lobes. How should they be positioned for chest PT? Where should the percussions be performed?

A

Sitting upright if possible, supported from the back with pillows, arms forward and hands on knees
Percussions should be performed on either side of the spine slightly above the shoulder blades

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A patient has secretions in their lingula. How should they be positioned to optimize drainage? Where should percussions be performed?

A

They should be positioned in trendelenburg laying on their right side with the left side of their rib cage exposed
Percussions should be performed on the lower left anterior side of the rib cage below the pectoral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A patient has secretions in their right middle lobe. How should they be positioned to optimize drainage? Where should percussions be performed?

A

Trendelenburg, laying on their left side with right arm positioned out of the way
Percussions should be performed on the lateral middle section of the right side of the ribcage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A patient has secretions in the anterior segments of their lower lobes. What position should they be in to optimize drainage? Where should the percussions be performed?

A

Trendelenburg, on their right side
Percussions should be performed on the lower lateral portion of the left side of the rib cage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

A patient has secretions in the posterior basal segment of the lower lobes. What position should they be in to optimize drainage? Where should the percussions be performed?

A

Trendelenburg, prone. Tilt thorax according to which side has secretions.
Percussions should be performed on the lower posterior portion of the ribcage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

A patient has secretions in the lateral basal segments of the lower lobes. What position should they be in to optimize drainage? Where should the percussions be performed?

A

Trendelenburg. On the side opposite to the affected region
Percussions should be performed on the lower lateral region of the rib cage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

A patient has secretions in the superior segments of the lower lobes. What position should they be in to optimize drainage? Where should the percussions be performed?

A

Prone, with a pillow under the hips
Percussions should be performed between and slightly below the shoulder blades

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

T/F: For cystic fibrosis and bronchiectasis, the caregiver should perform 1-2 minutes of percussions per affected region.

A

False. For CF and bronchiectasis the caregiver should provide 5 minutes of percussion for each affected region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How should you guide a patient to breathe during vibrations?

A

Inhale slowly and deeply. Coordinate patients breathing with vibrations and pressure. Have patient slowly exhale through pursed lips

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Following chest PT, what should you instruct the patient to do?

A

Rest and take diaphragmatic breaths while trying to cough using abdominal muscles to expectorate secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

T/F: When performing percussion, your hand should be balled up into a fist to ensure efficient energy transference into the patient

A

False. The percussion should be formed with a cupped hand, as if you were holding water, with the palm facing down
The cupped hand curves to the chest wall and traps a cushion of air to soften the blow]
Sounds kind of like a horse galloping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which areas should you NOT perform percussion over?

A

Spine
Sternum
Stomach’
Lower ribs or back to prevent injury to the speel on the left, the liver on the right and the kidneys in the lower back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When should chest PT/PD not be performed?

A

After meals
When a patient is nauseous
When a patient cannot tolerate percussion or the positioning
Trendelenburg can be extremely uncomfortable for some patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

OPEP devices are designed to

A

Use oscillatory positive pressure to loosen secretions while performing LET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Why are OPEP devices useful for patients with difficulty clearing secretions?

A

The airflow oscillations create turbulence with a shearing effect on the secretions adhering to airway walls
Shear forces can also decrease the viscoelastic properties of mucus making it easier to mobilize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

T/F: A OPEP can not be used with a tracheostomy tube

A

False. An OPEP device can be used with a mouthpiece, tracheostomy tube and a oronasal mask (resuscitation mask)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

T/F: Patients performing OPEP should take slow, very deep breaths and perform and end inspiratory breath hold for 2-3 seconds prior to exhaling through the device

A

False. The patient should slowly take a breath slightly greater than tidal volume and perform an end inspiratory breath hold for 2-3 seconds before exhaling through the device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

T/F: One cycle with the OPEP consists of 5 breaths through the device

A

False. One cycle consists of 6-10 breaths through the device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What should follow each cycle of exhalations through the OPEP device?

A

Huff cough and breathing control
1-3 hugg coughs depending on the fatigue level of the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How many cycles should an OPEP treatment consist of?

A

6-10 cycles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the hazards associated with OPEP?

A

May increase the WOB
Risk of claustrophobia
Minimal risk of gastric distention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the advantages of OPEP?

A

Easy to use
Patients can use them independently
Not time consuming
Cheap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

List common OPEP devices

A

Flutter
Coranet
VPEP
Aerobika
Quake
Acapella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

This OPEP device uses a counterweight and a magnet to incorporate a wide range of flow rates

A

Acapella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

This OPEP device uses a steel ball to interrupt air flow as the patient exhales

A

Flutter

45
Q

This OPEP device uses a flexible piece of tubing inside a shaft which whips back and forth randomly as the patient exhales through the device

A

Coronet

46
Q

The metaneb provides what kind of ventilation to the patient?

A

Intrapulmonary percussive ventilation

47
Q

T/F: The metaneb operates pneumatically at 20-30 psi to deliver small bursts of high flow gas at 100-300 cycles per minute

A

False. The metaned pneumatically operates at 50 psi to deliver small bursts of high flow gas at 100-300 cycles/min

48
Q

T/F: The metaned operates pneumatically at 50 psi to deliver small bursts of high flow gas at 300-500 cycles per minute

A

False>The metaned pneumatically operates at 50 psi to deliver small bursts of high flow gas at 100-300 cycles/min

49
Q

Airflow bursts from the metaneb can result in airway pressure changes of ….?

A

5-35 cm of water

50
Q

Describe the ways that the Metaneb aids in secretion clearance

A

The fast bursts provided by the metaneb loosens and frees mucus from the airway walls
The metaneb delivers a mist to make mucus less sticky
The high flow rate encourages deep breather which helps air to get around and behind trapped mucus

51
Q

Describe the effects of the metaneb on secretions during inspiration

A

The metaneb creates shear forces that loosen secretions from the airway walls

52
Q

Describe the effects of the metaneb on secretions during expiration

A

Creates asymmetrical flow pattern that augments the movement of secretions in a cephalad direction

53
Q

The MetaNeb is effective because it allows patients to simultaneously recieve:

A

LET
Mucus Clearance
Aerosol therapy

54
Q

T/F: Patients with COPD should not be put on the Metaneb

A

False. The Metaneb can be used to deliver aerosolized bronchodilators to COPD patients

55
Q

When giving a metaneb treatment, the caregiver should switch between (blank) and (Blank) every 2.5 minutes

A

CPEP and CHFO

56
Q

T/F: A Metaneb can be used with a mouthpiece, oronasal mask, or a tracheostomy tube

A

True

57
Q

When using a metaneb, how should the patient breath?

A

The patient should inhale normally and exhale slowly through the mouthpiece or mask

57
Q

What can be done if the resistance is too high and the patient is becoming fatigued?

A

The resistance can be adjusted on near the mouthpiece by changing the resistance setting. 3 dots is the highest resistance and 1 dot is the lowest resistance

58
Q

How many cycles of CPEP should a patient receive in a singular metaneb treatment?

A

2 cycles of CPEP and 2 cycles of CHFO

59
Q

List relative contraindication for IPV

A

Increased intracranial pressure
TE fistula
Hemodynamic instability
Active hemoptysis
nausea

60
Q

You are about to give a patient a metaneb treatment and they mention that they are feeling nauseous, what should you do?

A

Assess their vitals and give them some time to start to feel better. Report that they were nauseous and you are concerned about potential aspiration

61
Q

T/F: An untreated pneumothorax is a relative contraindication for IPV therapy

A

False. An untreated pneumothorax is an absolute contraindication for IPV therapy

62
Q

T/F: The vest generates positive transrepiratory pressure by compressing the chest externally to cause short, rapid expiratory flow pulses

A

False. The vest generates negative transrepiratory pressure by compressing the chest externally to cause short, rapid expiratory flow pulses

63
Q

How does the vest generate short bursts of expiratory flow?

A

By rapidly inflating and compressing the thorax creating a short expiratory burst and then rapidly deflating allowing elastic recoil to return the lungs to their FRC

64
Q

The vest has 2 frequencies ranges. What is the goal with low frequencies?

A

Loosen secretions from the walls of the conducting airways

65
Q

The vest has 2 frequencies ranges. What is the goal with mid-level frequencies?

A

Mobilize secretions in cephalad direction toward central airways

66
Q

What is the range of inflation pressures for the HFCWC?

A

5-20 cm of water

67
Q

T/F: Use of the vest can lead to hypoventilation and hypercarbia

A

True

68
Q

Hazards associated with HFCWC and HFCWO include

A

Increased WOB
Cardiovascular compromise
Pulmonary barotrauma
Skin irritation

69
Q

This device utilized a chest cuirass to generate biphasic changes in transrepiratory pressure

A

HFCWO

70
Q

The HFCWO can be used to simulate a cough and propel secretions towards the oropharynx. What else can the HFCWO device be used for

A

Allow for control of inspiration and expiration ie non invasive ventilatory support

71
Q

Contraindications for HFCWC and HFCWO include

A

Untreated pneumothorax
Hemoptysis
Hemodynamic instability
Intracranial pressure greater than 20 mmHg
Chest or spinal trauma
Surgical incision or trauma to thorax

72
Q

The best position for a patient taking a jet nebulizer treatment is

A

Sitting up

73
Q

The highest pressure a positive expiratory therapy device (PEP) can deliver is

A

20 cm of water

74
Q

T/F: Mechanical cough-assist devices should be used on patients with acute illnesses

A

False

75
Q

The procedure for an Active Cycle of Breathing

A

Huff coughs at low volume followed by Huff coughs at a high volume

76
Q

OPEP devices combine positive pressure with airway vibrations or oscillations during

A

Exhalation

76
Q

T/F: During high-frequency chest wall compression (HFCWC) (the Vest) treatment positive or negative pressure pulses or both, get air behind secretions and move them toward the larger airways, where they can be coughed up and expectorated

A

True

77
Q

The typical high-frequency chest wall compression (HFCWC) (the Vest) treatment lasts

A

15-30 minutes

78
Q

T/F CPAP can be applied invasively

A

True

79
Q

Mr. E. is recovering from an pneumonectomy. The physician orders lung expansion therapy (LET). Which LET therapies could the respiratory therapist choose?

A

Incentive spirometry
Diaphragmatic breathing
Segmental breathing

80
Q

A patient is wheezing, with coarse crackles and diminished breath sounds. The most efficient way to treat this patient would be with

A

Metaneb

81
Q

T/F Bradypnia is a sign of atalectasis

A

False. Tachycardia is a sign of atelectasis

81
Q

A post operative chest surgery patient has a weak cough and decreased breath sounds the therapist could try

A

Teaching patient to huff cough
IS
PEP

81
Q

During a huff cough the therapist directs the patient to

A

Take 3 to 5 slow deep breaths by inhaling through the nose exhaling through pursed lips, and using diaphragmatic breathing. Then take a breath and squeeze it out by contracting the abdominal and chest wall muscles with the mouth open during exhalation.

82
Q

T/F: During diaphragmatic breathing your abdomen expands during exhalation

A

False

82
Q

During a directed cough the therapist directs the patient to

A

Take a deep breath, hold the breath, and use the abdominal muscles to force air against a closed glottis, then cough with a single exhalation

83
Q

An elderly weak female patient with chronic obstructive pulmonary disease has a peak inspiratory flow of 20 L/min. The physician wishes to order a bronchodilator with a steroid BID (twice a day). The respiratory therapist recommends a(n):

A

Small Jet neb

84
Q

A disadvantage of aerosol drug delivery includes

A

Higher systemic side effects

85
Q

T/F: Incentive spirometry may be a volume or flow device

A

True

86
Q

When initiating an incentive spirometry treatment, a respiratory therapist should instruct a patient to

A

Inhale slowly and deeply

87
Q

Intrapulmonary percussive ventilation (IVP) clearance devices

A

Create positive changes in transrespiratory pressures to produce high frequency oscillations in the airways.

88
Q

Mr. E. is recovering from an pneumonectomy. The physician orders lung expansion therapy (LET). Which LET therapies could the respiratory therapist choose

A

Incentive spirometry
Diaphragmatic breathing
Segmental breathing

89
Q

What situations can cause atelectasis?

A

recent chest surgery
Are on bed rest
Have a poor cough
Have a history of lung disease
Have a neuromuscular disorder

90
Q

A patient is wheezing, with coarse crackles and diminished breath sounds. The most efficient way to treat this patient would be with:

A

Metaneb therapy

91
Q

Signs and symptoms of atelectasis include

A

Increased density and signs of volume loss on x-ray

Fine late-inspiratory crackles

Diminished breath sounds

Tachycardia

92
Q

A patient has diminished breath sounds and coarse rales on auscultation. The therapist should choose a(n)

A

OPEP device

93
Q

During a huff cough the therapist directs the patient to:

A

Take 3 to 5 slow deep breaths by inhaling through the nose exhaling through pursed lips, and using diaphragmatic breathing. Then take a breath and squeeze it out by contracting the abdominal and chest wall muscles with the mouth open during exhalation.

94
Q

High frequency chest wall oscillation devices (HFCWO) also known as mechanical insufflation-exsufflation devices:

A

Use a rigid external enclosure or chest cuirass connected to a compressor.

95
Q

A high flow chest wall oscillation (HFCWO) device may be used for noninvasive ventilation.

A

True

96
Q

Mr. C. has an order for right lower lobe lateral basal segment chest physical therapy postural drainage (CPT/PD). How should the respiratory therapist position Mr. C. to receive treatment? Mr. C. should be:

A

In Trendelenburg on his left side.

96
Q

Choose all that apply. A neuro-muscular patient with decreased breath sounds and secretions who is unable to cough effectively should be treated with

A

Cough assist
HFCWO

97
Q

Oscillatory positive expiratory pressure (OPEP) devices:

A

Combine positive pressure during exhalation with airway vibrations.

98
Q

During diaphragmatic breathing your abdomen expands during exhalation

A

False

99
Q

During a directed cough the therapist directs the patient to

A

Take a deep breath, hold the breath, and use the abdominal muscles to force air against a closed glottis, then cough with a single exhalation

100
Q

The interfaces for mechanical cough assist devices include

A

Mouth piece
Connection to a tracheotomy tube
Oronasal mask

101
Q

A respiratory therapist can determine which segments of the lungs need lung expansion or mucous clearance therapy through

A

A physician’s order
Auscultation
Palpation
Percussion
Chest X-ray

102
Q

Ms. D. has an order for chest physical therapy postural drainage (CPT/PD) to the lower lobes superior segments. How should the respiratory therapist position Ms. D. to receive treatment? Ms. D. should be:

A

Lying prone with the bed flat and a pillow at the hips.

103
Q

A cystic fibrosis patient has a strong cough and thick secretions, the therapist should recommend:

A

HFCWC therapy
or chest PT

Clinical lab (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions