3) Therapeutic Body Positioning Flashcards
(36 cards)
Why is therapeutic body positioning done?
To incr arterial oxygenation
Why does TBP work?
It has a direct effect on the O2 transport system
What is the single most important objective of CPPT?
TBP
What are the goals of TBP?
- Decr dyspnea
- Decr work of breathing
- Optimize lung vol
- Improve VQ matching
- Improve gas exchange
- Assist w/AW clearance
What needs to be considered for TBP?
- Pain
- GI system
- CV response
- Neuromuscular system
What needs to be done after a TB position is determined to be good?
Monitor the pt & re-position if necessary
What determines time course for TBP?
- Pathology
- Type
- Severity
- Other factors
True or False: TBP duration should be response-dependent, not time-dependent
True
Why is sitting upright w/arms fixed on thighs effective at decreasing work of breathing?
It incr intra-abdominal pressure so the curvature of the spine incr, which optimizes the diaphragm’s MA & its capacity to generate pressure
What is the most physiologically important position?
Upright w/dependent legs
What did MJ say about supine positioning?
It is the “god awfulest position you can put a pt in”
Considerations for TBP?
- Time constrains
- Prone positioning will require multiple PT’s
- Use modified positions when extremes aren’t feasible
- Encourage movement & DB/C
- Monitor vitals
What is bed rest deconditioning
Separate process that occurs along w/the course of the disease
How long does it take for fluid shifts to start after a pt is on bedrest?
24hrs
Negative effects of bed rest
* * * * * * * * * * *
What does bed rest equal besides death?
Sensory deprivation
Sx’s of adverse rxn to exercise
- Unusual/severe fatigue
- Angina
- Dizziness
- Irregular pulse
- Marked SOB
- HR>THR or >20BAR
- SBP or DBP drop >10mmHg
- No rise in SBP
- DBP rise >10mmHg
- Cyanosis
- Pallor
- Pain in teeth, jaw, arms, or ears
- Severe claudication
- Nausea/vomiting
- HA
- Ataxia
- Mental confusion
If a pt is hemodynamically unstable, should you tx them?
No
If a pt has dyspnea, what position should you put them in & why?
Upright w/arms fixed on thighs
*This incr intra-abdominal pressure, which incr the curvature of the diaphragm, which optimizes its MA & ability to generate pressure
What should upright positioning be coupled w/?
Exercise to optimize O2 transport
True or False: Upright positioning slightly incr main airway diameter.
True
What position decr myocardial work & urinary stasis?
Upright
If a pt has unilateral lung disease, how should they be positioned & why?
Sidelying w/healthy lung down–>incr PaO2
If pt has bilateral lung pathology, how should they be positioned?
Sidelying w/R lung down–>Its larger so there will be less compression on it from the heart
