Mucous Clearance

Question 1

Disease contradictions of mechanical cough assist

Answer 1

Bullous emphysema
Pneumothorax or pneumomediastinun
Recent barotrauma
Prone to AW closure

Question 2

What is chest PT a combination

Answer 2

Forced exhalation
Postural drainage
Percussion/ shaking

Question 3

What patients is postural drainage used on

Answer 3

Stable and acute

Question 4

How do you determine what segments need chest PT

Answer 4

Physician order
BS
Palpation
Percussion
X-Ray

Question 5

How long should you percussion with CF or Bronchiectasis

Answer 5

5 minutes

Question 6

How long should you preform percussion on the average patient

Answer 6

1-2 minutes

Question 7

What should you avoid clapping on when preforming chest PT

Answer 7

Spine
liver
chest
scapula
clavicle
sternum
Kidneys (lower back)
Stomach

Question 8

Procedure for chest PT

Answer 8

Patient performs diaphragmatic breathing

Percussion

Inhale slowly and deeply and exhale through pursed lips as you vibrate

Question 9

When should you relieve pressure during chest PT

Answer 9

Thorax as patient inhales

Question 10

How many vibrations do you do during chest PT

Answer 10

3 to 4

Question 11

Last step to chest PT

Answer 11

Cough

Question 12

How long does chest PT last

Answer 12

15 to 30 minutes

Question 13

What sound should be heard during percussion

Answer 13

Hollow

Question 14

When is chest PT best done

Answer 14

Before or 1.5-2 hrs after eating
(Early morning or bedtime)

Question 15

OPEP devices

Answer 15

VPEP
Aerobika
Flutter
Acapella
Quake
Coronet

Question 16

Pulmonary disorders for OPEP

Answer 16

CF
COPD
Brpnchoiectasis

Question 17

What does OPEP combine

Answer 17

Positive pressure
Airway vibration
During exhalation

Question 18

Interface for OPEP

Answer 18

Mouthpiece
tracheostomy tube
Resuscitation mask

Question 19

Directions for OPEP

Answer 19

Inhale above VT hold for 2-3 seconds

6-10/ cycle

Huff followed by controlled breathing (1-3x)

6-10 cycles

Question 20

Indication for IPV

Answer 20

Whenever the body’s ability to mobilize secretions is impaired

Question 21

Disease that indicate IPV

Answer 21

Bronchiectasis
CF
Neuromuscular disease
COPD

Question 22

Other medical patients that cause for IPV

Answer 22

Tracheostomized patients
Burns
Inhalation injury

Question 23

How is IPV powered

Answer 23

Pneumatically (50 psi)

Question 24

How many cycles per minute does IPV deliver

Answer 24

100-300 cycles/minute

Question 25

Pressure changes to AW by IPV

Answer 25

5-35 cm H2O

Question 26

What does IPV small burst do

Answer 26

Loosen and free mucus from AW walls

Question 27

What does mist from IPV do

Answer 27

Makes mucus less sticky

Question 28

What does the high flow rate from IPV do for the patient

Answer 28

Encourages deep breathing, which helps air get around mucus plug

Question 29

What does IPV do during inspiration

Answer 29

Creates shear to loosen secretions

Question 30

What does IPV do during exhalation

Answer 30

Creates asymmetrical flow pattern that moves secretions toward head

Question 31

Application for metaneb

Answer 31

Deliver bronchodilator Expand alveoli and move secretions Inpatient or out patient

Question 32

How is metaneb applied

Answer 32

Non-invasively

Question 33

Interface for metaneb

Answer 33

Mask Mouthpiece

Question 34

Directions for the metaneb

Answer 34

Fill Nebulizer Set to CPEP (lowest) 50 psi O2 source Inhale exhale (3-4 sec) CPEP 2 1/2 minutes CHFO 2 1/2 minutes 10 minute treatment

Question 35

Potential hazards for IPV

Answer 35

Gastric insufflation Hyperventilation Hemodynamic compromise Air leak Air trapping

Question 36

What type of pressure does the HFCWC deliver

Answer 36

Both positive and negative

Question 37

What does HFCWC do

Answer 37

Mobilizes secretions in the airway

Question 38

Other name for the HFCWC

Answer 38

The vest

Question 39

How long does HFCWC last

Answer 39

15-30 minutes

Question 40

What should you do between different frequencies of the HFCWC

Answer 40

Huff cough

Question 41

What does low frequencies of the vest do

Answer 41

Loosens secretions

Question 42

What does the mid-level frequencies of the HFCWC do

Answer 42

Mobilizes secretions to the head

Question 43

What is the inflation pressure of the HFCWC

Answer 43

5-20 cm H2O

Question 44

What volume of air does the HFCWC generate

Answer 44

17-57mL

Question 45

What flow does the HFCWC achieve

Answer 45

96L/min

Question 46

Available HFCWC

Answer 46

The vest Incourage Smart vest

Question 47

Deposition of meter dose inhaler

Answer 47

10-25 %

Question 48

Position for upper lobe, apical segment

Answer 48

Seated up

Question 49

Position for upper lobes, posterior segment

Answer 49

Seated up hunched over pilliow

Question 50

Position for upper lobes, anterior segment

Answer 50

Flat on back

Question 51

Position for lower lobes, anterior basal segment

Answer 51

Trendelenburg right side

Question 52

Position for lingula

Answer 52

Trendelenburg right side

Question 53

Position for middle lobe

Answer 53

Trendelenburg left side

Question 54

Position for lower lobes, posterior basal segment

Answer 54

On stomach Trendelenburg

Question 55

Position for lower lobes, lateral basal segment

Answer 55

Left side Trendelenburg

Question 56

Position for lower lobe, superior segment

Answer 56

Flat on stomach.