Breathing Exercises Flashcards
(34 cards)
What are the indications for diaphragmatic breathing?
- post-surgical patient with pain in the chest wall or abdomen or restricted mobility
- patient learning active cycle of breathing or autogenic drainage airway clearance techniques
- dyspnea at rest or with minimal activity
- inability to perform ADLs due to dyspnea or inefficient breathing pattern
What are the precaution/contraindications for diaphragmatic breathing?
- moderate to severe COPD and marked hyperinflation of the lungs without diaphragmatic movement
- patient with paradoxical breathing patterns, or who demonstrate increased respiratory muscle effort, and increased dyspnea during DB
What is the procedure for diaphragmatic breathing?
- semi-fowler’s position is best starting position for most
- sniffing can be used to facilitate contraction of the diaphragm
- have patient place one hand on the upper chest and the other hand below the rib cage
- instruct patient to breathe into the hand below the ribs and try to make sure the hand on the chest does not move and then exhale through pursed lips while keeping the hand on the chest still
What are the expected outcomes for diaphragmatic breathing?
- decreased respiratory rate
- decreased use of accessory muscles of inspiration
- increase tidal volume
- decrease respiratory flow rate
- subjective improvement of dyspnea
- improve activity tolerance
What is the goal of inspiratory muscle training?
strengthen the diaphragm and intercostal muscles
What are the two types of inspiratory muscle training?
flow resistive training (breathing with a mouthpiece that decreases diameter to increase resistance to breathing
threshold breathing which requires a buildup of negative pressure before flow occurs through a valve that opens at critical pressure which provides consistent and specific pressure for IMT
What are the indications for inspiratory muscle training?
impaired respiratory muscle strength and/or a ventilatory limitation to exercise performance
What are the precautions/contraindications for inspiratory muscle training?
-clinical signs of inspiratory muscle fatigue such as tachypnea, reduced tidal volume, increased PaCO2 and bradypnea
What is the procedure for using the threshold respiratory muscle trainer when performing inspiratory muscle training?
- measure patient’s maximum inspiratory pressure with a manometer in order to calculate the training load
- have patient put the mouthpiece in their mouth and inspired with enough force to to open the valve
- begin training at 30-40% of the patient MIP (max insipiratory pressure)
- breath at resting respiratory rate for 5-15 minutes 3 times a day
- resistance can be increased slowly until it is at 40-60% of MIP
What is the procedure for using the PFLEX inspiratory muscle trainer when performing inspiratory muscle training?
- measure patient’s maximum inspiratory pressure with a manometer in order to calculate the training load
- have patient place PFLEx in mouth and breathe at tidal volume
- begin training at 30-40% of MIP for 10-15 minutes daily, increasing towards 20-30 minutes for 3-5 days a week
- once a patient can stand 30 mins at one pressure you can increase pressure to next setting
What are the expected outcomes for inspiratory muscle training?
- increased respiratory muscle strength and endurance
- decreased dyspnea at rest and during exercise
- increased functional exercise capacity
What is the goal for paced breathing and exhale with effort?
paced breathing is a strategy to decrease the work of breathing and prevent dyspnea during activity by allowing anyone who experiences SoB to become less fearful of activity and exercise
exhale with effort is used to prevent a patient from holding their breath by having patient inhale during the less active part of a movement and exhale during the strenuous phase of a movement
What are the indications for paced breathing and exhale with effort?
- patients with dyspnea at rest or with minimal activity
- inability to perform activities due to pulmonary limitation
- inefficient breathing pattern during activity
What are the precautions for paced breathing and exhale with effort?
avoid valsalva maneuver during activity
When should a patient inhale and exhale when performing exhale with effort?
inhale before or during the easier component of an activity
Exhale during the more vigorous component of the activity
When should a patient inhale/exhale when walking if they are performing exhale with effort?
inhale through the nose while walking two steps and then pause; exhale through pursed lips while walking four steps
When should a patient inhale/exhale when climbing stairs if they are performing exhale with effort?
- inhale through the nose while standing
- exhale through pursed lips while stepping up or down one or two stairs
- remain on the step until breathing control is restored
When should a patient inhale/exhale when lifting objects if they are performing exhale with effort?
- inhale through the nose while standing or sitting; exhale through pursed lips while bending to reach the object
- pause
- inhale through the nose while grabbing the object; exhale through pursed lips while standing up
What are the expected outcomes with paced breathing and exhale with effort intervention?
- complete activity without dyspnea
- decrease patient;s fear of becoming short of breath during activity
What is the goal of pursed lip breathing?
reduce respiratory rate, dyspnea, and maintain a small positive pressure in the bronchioles to help prevent airway collapse in patients with emphysema
What are the indications for pursed lip breathing?
- tachypnea
- dyspnea
What is semi-fowler’s position?
patient is reclined to 30-45 degrees in a bed
What are the expected outcomes for pursed lips breathing?
- decrease respiratory rate
- relieve dyspnea
- reduce PaCO2
- improve tidal volume
- improve oxygen saturation
- prevent airway collapse in patients with emphysema
- increase activity tolerance
What is segmental breathing (thoracic expansion exercise or localized breathing)?
an intervention intended to improve regional ventilation and prevent and treat pulmonary complications after surgery and based on the presumption that inspired air can be directed to a particular area through proper hand placement or cues to either facilitate or inhibit chest wall movement
