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Cardiopulmonary - Final > Part 3 > Flashcards

Part 3 Flashcards

(76 cards)

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1
Q

postural drainage is a

A

passive technique

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2
Q

what does postural drainage allow

A

bronchopulmonary tree to be drained w/ assistance of gravity

followed by cough/suction

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3
Q

T/F

lobe you aim to drain must be above the mainstem bronchus

A

true

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4
Q

contraindications for postural drainage

A

ICP

displaced rib fx

acute bleeds

anticoagulants

active PE

orthopedic precautions

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5
Q

to prepare for postural drainage

A

medications

hydration

suctioning equipment

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6
Q

with postural drainage what lobe is treated first

A

most affected lobe

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7
Q

how long is postural drainage per lob

A

5-10 min

secretions may mobilize for 1/2 - 1 hr later so must check on pt

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8
Q

indications for percussion

A

decreased CW mobility and expansion

abnormal breath sounds

auscultation findings

evaluative percussion

CXR

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9
Q

preparation for percussion

A

place in position

pre-medicated

adjust level of bed

suctioning equipment ready

remove all jewelry

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10
Q

we must percuss at a

A

steady rate of 100-480/min over a towel for 5min/lobe, 20 min/side

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11
Q

percussing should be followed by

A

vibration

coughing

suctioning

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12
Q

documenting sputum involved

A

amount

color

consistency (viscous v. watery)

smell

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13
Q

worse the smell of the sputum

A

worse the infection

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14
Q

normal color sputum

A

tan

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15
Q

bronchial sputum color

A

yellow

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16
Q

infection sputum color

A

green

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17
Q

bronchiectasis sputum color

A

brown

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18
Q

CF sputum color

A

bronze

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19
Q

TB sputum color

A

blood

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20
Q

what is the most effective way to clear secretion

A

percussion

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21
Q

con for percussion

A

fall in O2 saturation

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22
Q

contraindication for percussion

A

osteoporosis

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23
Q

what is less aggressive than percussion and can be used w/ post-op, osteoporosis and asthma pts

A

vibration

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24
Q

how do you perform vibration

A

instruct pt to take a deep breath

perform throughout exhalation

3x per lob

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25
T/F movement is contraindicated at the end of vibration
false can add a quick stretch at end
26
stages of coughing
1.inhale 2. hold breath at peak of inhalation 3. abdominals and intercostal contraction w/ trunk flexion and cough 4. expulsion
27
inhale
most important phase look up at ceiling and take deep breath
28
what happens when they pt holds breath at peak inhalation
close glottis
29
abdominals and intercostal contraction w/ trunk flexion and cough
must be deep in pitch
30
what happens when the pt is stuck in expulsiion
pt gags
31
if pts gets stuck in expulsion what does it indicate
upper level lesion instruct the pt to look up to stop the reflex
32
cough strategies include
pump cough manually assisted cough self assisted cough
33
pump cough
3 short huffs followed by 3 easy coughs 3-4x milks secretions out of pts lungs
34
when do we use a pump cough
asthma pt as a forceful cough will exacerbate bronchospasm
35
costophrenic assist
done at the end of expiration push up and in @ bottom of ribs
36
Heimlich abdominal thrust
done at end of exhalation push posterior and superior above umbilicus
37
which manually assisted coughs can be used for SCI pts
heimlich anterior chest compression
38
anterior chest compression
done in supine done during expiration PT forearms on the pt chest, upper arm below clavicles push posterior and inferior lower arm @ costophrenic border push posterior and superior
39
counter rotation
performed throughout inhalation and exhalation pt in side lying one hand positions on shoulder and other hand positioned on pelvis on inhalation, pull shoulder and push pelvis, instruct pt to take a deep breath on exhalation, instruct the pt to cough as you pull the pelvis and push the shoulders
40
whats the most effective manual assisted cough
counter rotation
41
importance with counter rotation
never take hands off
42
self assisted cough strategies
prone on elbows long sitting short sitting
43
prone on elbows
inhibits full use of diaphragm and stabilize abdominals inhalation (cervical extension) exhalation (cervical flexion)
44
long sitting
improves rib cage mobility inhale (extension) exhale (flexion) "reach down to touch your toes and cough" can stabilize at shoulders and add stretch
45
short sit
w/c pts inhale (extension) exhale (flexion) bend forward and cough
46
metabolic acidosis causes
diabetic ketoacidosis diarrhea renal failure shock NSAID overdose lactic acidosis
47
when a pt has ketoacidosis breath will have a
fruity/alcohol smell stupor/appears intoxicated
48
what should we do with a pt that seems to present with ketoacidosis
immediately draw blood and see if there is an alc level pt will die if they dont get out of metabolic acidosis
49
S/S of metabolic acidosis
hyperventilation deep respiration HC03 deficit headache stupor coma hyperkalemia cardiac arrythmias
50
respiratory acidosis causes
hypoventilation d/t drug overdose chest trauma pulmonary edema airway obstruction COPD NM dz
51
S/S of respiratory acidosis
hypoventilation hypercapnia (too much CO2) coma confusion and drowsiness depressed tendon reflexes hyperkalemia
52
metabolic alkalosis causes
loss of gastric secretions (vomit) overdose antacids potassium wasting diuretics
53
S/S of metabolic alkalosis
mental confusion HCo3 excess numb and tingling in digits tetany convulsion hypokalemia
54
respiratory alkalosis causes
hyperventilation d/t anxiety high altitude pregnancy fever PE hypoxia increased tidal volume
55
S/S of respiratory alkalosis
hypocapnia (too little CO2) tetany convulsions hypokalemia confusion numbness/tingling of digits
56
what is considered severe hypoxemia
PaO2 under 50 mmHg O2 sat under 80%
57
compensations for ABGs
tic-tac-toe method respiratory system renal system
58
how does the respiratory system compensate for metabolic acid-base imbalances
by regulating CO2 levels compensates in matter of seconds
59
how does the renal system compensate for respiratory acid-base imbalance
by excreting H+ and reabsorbs HCO3 renal compensation takes 12-24 hrs, sometimes up to 72 hrs
60
three types of compensations
uncompensated partial compensation full compensation
61
uncompensated
contraindication to PT (except positioning and chest PT)
62
partial compensation
can treat if metabolic have to be careful with respiratory do not stress the pt (deep breathing, AAROM, OOB-->chair)
63
full compensation
can treat
64
tidal volume
amount of air normally inhaled and exhaled with each breath at quiet breathing TV
65
inspiratory reserve
IRV amount of air that can be taken into the lungs at the end of normal inspiration
66
vital capacity
VC 60% needed to cough 80% of TLC amount of air that can be exhaled following max inspiration
67
VC =
TV + IRV + ERV
68
VC decreases w/
lung tissue pathology MSK disorders pregnancy and obesity enlarged heart and pleural effusion
69
alpha 1 receptor agonists are known as
decongestant epinephrine
70
what is an example of alpha 1 rec. agonist and effects
vasoconstricts nasal mucosa given systemically or locally
71
primary problems w/ decongestants
HA nausea CV stimulation
72
decongestants have
increased CV side effects
73
how long do you have to wait after the pt is given bronchodilators to treat
10 min
74
mucolytics effects
breaks up mucus molecules
75
expectorants effects
increases production and ejection of phlegm
76
mucolytics and expectorants usually given in pairs is good to use prior to
chest PT (CPT)

Cardiopulmonary - Final (4 decks)

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