Exam 2: Airway Clearance Dysfunction Flashcards
(48 cards)
What is the life expectancy with CF?
40.6 y/o
mainly affects Caucasians of european decent
What is another name for CF?
genetic bronchiectasis
What are the general characteristics of CF?
due to genetic mutation of CFTR gene the sodium and chloride channels are switched
this pulls water into the airway walls- this makes mucus thick and sticky and destroys cilia
What happens to excess mucus in the airways?
pts will usually get an infection in this mucus stuck in airways resulting in inflammation of the airways due to immune response thus creating more mucus
What is another major complications from CF?
damage to pancreas leads to pancreatic insufficiency which is the pancreas not being able to produce enzymes to break down fat
without supplemental enzymes this usually leads to malnutrition
What are the 6 areas to focus on with patients with CF?
- airway clearance- get rid of mucus
- aerobic training- can be as effective as AC
- postural re-education- due to anterior hypertrophy
- anaerobic training
- strength training
- balance and urinary incontinence- due to increased abdominal pressure from coughing
Why is aerobic training effective in AC?
turbulent air moving during exercise helps mucus move proximally
it also switches the pumps back to normal
What other type of pathologies receive ACT?
bronchiectasis, chronic bronchitis, recurrent pneumonia, asthma, pneumonitis
What is airway clearance?
consists of removal of secretions or debris away from patients airways
no one way proven better than another
What are three types of ACT that are usually combined?
percussion, vibration and postural drainage
What are three airway devices used for ACT?
High Frequency Chest Wall Oscillation, Positive Expiratory Pressure, Oscillatory PEP: Flutter and Acapella devices
What are three additional types of ACT?
active cycle of breathing, autogenic drainage, forced expiratory technique: Huffing
What is the science behind percussion?
sends pressure waves into body help clearing mucus on chest wall
usually last 2-5 minutes, over a thin layer of clothes
What is vibrations?
shaking of the chest wall while a patient breaths out - called high frequency
low frequency called shaking
What is the literature on postural drainage by itself?
in pts with CF has been shown to move mucus very slowly
however with vibrations and percussions, has been the gold standard
What are possible side effects of percussions etc.?
increased intracranial pressure, short term decreased PaO2, decreased CO, short term decreased FEV1, hemoptysis, bronchoconstrcition, GERD, Dyspnea
What are some cardiac considerations with percussion etc.?
chest wall pain, unstable angina, hemodynamic instability, low platelet count, unstable arrhythmias
What are MS considerations with percussion etc?
osteopo, spinal fusions (acute), rib fractures, immediate post op thoracic surgery
What are pulmonary considerations with percussions etc?
hemoptysis, bronchospasm, severe dyspnea, pneumothorax
What other considerations with percussions etc?
cancer, skin grafts, burns, open wounds, thoracic infection
What are positives with percussions etc.?
effective with all patients with all types of secretions, gold standard of ACT, can be done with home care in MA, increased adherence,
can be done with cognitively impaired or unconscious patients
What are negatives with percussions etc.?
multiple side effects, pts can be indpt with treatment, may worsen bronchiectasis with GERD, time intensive
What is the active cycle of breathing?
combination of several different techniques in phases designed to mobilize and clear secretions
What are the three different techniques combined in active cycle of breathing?
- breathing control
- thoracic expansion
- forced expiratory technique
