CPT Flashcards
(70 cards)
_____ involves the use of noninvasive techniques designed to help mobilize and remove secretions and improve gas exchange. Previously, airway clearance methods often were grouped under a broad category of techniques called ________
Airway clearance therapy, chest physical therapy (CPT).
Normal airway clearance requires a________
patent airway, a functional mucociliary escalator, and effective cough.
there are four distinct phases to a normal cough:
irritation, inspiration, compression, and
expulsion
Infection is a good example of cough stimulation caused by an ______ Foreign bodies can provoke a cough through _______. _______ can occur when irritating gases are inhaled (e.g., cigarette smoke). Finally, cold air may cause _____ of sensory nerves and produce a cough.
inflammatory process, mechanical stimulation, Chemical stimulation, thermal stimulation
During the third, or compression, phase, reflex nerve impulses cause _______ of the expiratory muscles. This compression phase is normally about _______and results in a rapid increase in pleural and alveolar pressures, often greater than_____ mm Hg
glottic closure and a forceful contraction, 0.2 seconds, 100
Full obstruction, or mucous plugging, can result in_______. By restricting airflow, partial obstruction can ________
atelectasis and impaired oxygenation secondary to shunting, increase the work of breathing and lead to air trapping, overdistention, and ventilation/perfusion (V/Q) imbalances
The presence of the tube in the trachea increases _____, whereas the cuff of the tube mechanically blocks the _______. In addition, movement of the tube tip and cuff can _________. Lastly, endotracheal tubes impair the compression phase of the cough reflex by preventing _______
mucus secretion, mucociliary escalator, cause erosion of the tracheal mucosa and impair mucociliary clearance further, closure of the glottis
Inadequate humidification can cause ______ of secretions, mucous plugging, and airway obstruction. High fractional inspired oxygen (FiO2) concentrations can impair _______, either directly or by causing ______.
thickening or inspissation, mucociliary clearance, acute tracheobronchitis
In CF, the_____ of the mucus is altered because of abnormal ______ transport. This alteration increases the ______ and impairs its movement up the respiratory tract.
solute concentration, sodium and chloride, viscosity of mucus
The most common conditions affecting the cough reflex are _____, including muscular dystrophy, amyotrophic lateral sclerosis, spinal muscular atrophy, myasthenia gravis, poliomyelitis, and cerebral palsy
musculoskeletal and neurologic disorders
The primary goal of airway clearance therapy is to help _________, with the ultimate aim to ________
mobilize and remove retained secretions, Improve gas exchange, promote alveolar expansion, and reduce the work of breathing
In treating acute respiratory conditions, _______ before airway clearance therapy may improve the overall effectiveness of the treatment both by opening the airways and by increasing the mucociliary activity.
inhaled bronchodilator therapy
For acute pulmonary infections, _______ after airway clearance therapy can lead to improved deposition of the antibiotic
inhaled antibiotics
Generally, sputum production must exceed _______for airway clearance therapy to improve secretion removal significantly
25 to 30 ml/day
The best-documented preventive uses of airway clearance
therapy includes _____
(1) body positioning and patient mobilization to prevent retained secretions in acutely ill patients
(2) CPT combined with physical activity to maintain lung function in patients with CF
Five general approaches to airway clearance therapy, which
can be used alone or in combination, include
(1) CPT;
(2) coughing and related expulsion techniques (including manual insufflation-exsufflation [MIE]);
(3) positive airway pressure (PAP) adjuncts (positive expiratory pressure [PEP], continuous PAP [CPAP], expiratory PAP [EPAP]);
(4) high-frequency compression/oscillation methods; and
(5) mobilization and physical activity
Postural drainage involves the use of _______to help mobilize secretions. The various body positions assumed are intended to drain secretions from each of the patient’s lung segments into the ______, where they can be removed by cough or suctioning
gravity and mechanical energy, central airways
This drainage is accomplished by simply placing the segmental bronchus to be drained in a more ____ position, permitting gravity to assist in the process. Positions generally are held for_____ minutes (longer in special situations) and modified as the patient’s condition and tolerance warrant
vertical, 3 to 15
______is most effective in conditions characterized by excessive sputum production (>25 to 30 ml/day). For maximum effect, head-down positions should exceed _______.
Postural drainage, 25 degrees below horizontal
In patients in critical care, including patients on mechanical ventilation, postural drainage should be performed every _____ as indicated. In spontaneously breathing patients, frequency should be determined by _______
4 to 6 hours, assessing patient response to therapy
To avoid gastroesophageal reflux and the possibility of aspiration, treatment times should be scheduled before or at least _______
1 and half hour to 2 hours after meals or tube feedings
Because postural drainage positioning predisposes patients to _______, pulse oximetry should be considered if hypoxemia is suspected
arterial desaturation
Generally, to obtain the proper head-down position, the clinician must
lower the head of the bed by at least _______ to achieve the desired 25-degree angle.
16 to 18 inches
A _____ allows precise positioning at head-down angles up to 45 degrees.
tilt table
