Lecture 23: Pulmonary Interventions and Airway Clearance Techniques Flashcards

Question

what is the glottis

Answer 1

opening between the vocal cords in the larynx opens and closes with talking, coughing, breathing, swallowing

Answer 2

position pt to facilitate trunk ext (inhalation) and flexion (exhalation) maximize inspiratory phase via verbal cues, upright positioning, upward gaze, UE AROM, thoracic extension improved respiratory hold at end of inhalation maximize intraabdominal and intrathoracic pressure via positioning or mm contraction for exhalation brace or splint abdomen for increased cough strength can manually assist abdominal contraction of pt is in supine

Answer 3

alternative to coughing helps prevent bronchoconstriction or collapse of weak airways stabilizes bronchial walls and support structures can produce less stressful or painful coughing with more control

Answer 4

mouth open throughout, O shaped glottis doesn't close over the trachea chest and abdominal mm contraction forced exhalation that sounds like a loud forced sigh long and slow forced exhalation moves secretion in from the distal periphery short and string forced exhalation moves secretions more proximally to cough

Answer 5

series of maneuvers to emphasize independent secretion clearance from distal to proximal and thoracic extension incorporates normal breathing, deep inhalation, and huffing helps prevent bronchospasm, focused thoracic extension increases volume and promotes ventilation but allowing air behind the secretions to help force them more proximally huffing stabilizes bronchial walls performed in sitting and helps avoid GERD

Answer 6

1. breathing control - normal tidal volume breathing - in through nose, out mouth - pursed lip if needed - eyes closed helps focus/relax 2. thoracic expansion - 4-5 deep inhales with hands on lower ribs to feel expansion - percussion/vibration with exhale 3. forced expiratory technique - 1-2 deep huff cough techniques with strong abdominal contraction

Answer 7

devices/techniques that apply manual or mechanical forces to the body or intermittent changes to the airway to assist with coughing or talking a very common in neuromuscular disorders that are accompanied by considerable respiratory impairments inspiratory birds provide adequate pressure during attempts at inhalation expiratory aids provide negative pressure via vacuum to airway during attempts to cough, along with manual abdominal thrust

Answer 8

if sectresions can be cleared into mouth, oral suctioning can be performed to prevent aspiration of them back into airways if secretions cant be cleared into the mouth, suctioning may be performed to rid the deeper airways of retained material least invasive method always preferred can also be used to stimulate a cough reflex should never be performed without training, check off, etc

Answer 9

wand like device attached to suction used for mouth pt can use independently not meant to go past the back teeth

Answer 10

incorporated into an artificial airway (ETT or trace) to maintain sterile suction catheter decreased risk of infection can go from might/throat to carina

Answer 11

stand alone suction device that is passed through an airway opening (nose/mouth/trach) to the carina must maintain sterile technique lubrication must be used for nasotracheal tube

Answer 12

hand hygiene and sterile technique (if performing sterile suctioning) ensure negative pressure is engaged or turned on advance suction Cath gently but quickly into airway without applying suction yet stop advancement if any resistance is felt smoothly withdraw Cath with CONSTANT suction application no more than 10 seconds total (deep suctioning occludes airway)

Answer 13

seek out training proper hygiene quick but gentle technique always maintain suction with removal fully remove Cath once you start allow >1 min between trails

Answer 14

hesitate to ask for help/instructio apply suction during Cath advancement inter Cath past any resistance or too far stop and start advancement or suction perform if you're unsure you should

Answer 15

GERD: pt needs to remain upright osteoporosis or osteopenia bronchospasm or risk of it hemoptysis or risk of it severity of pulmonary disease acute exacerbation needs medical/pharm intervention first precautions specific to selected ACT