Pulm PT Flashcards
what is the optimal position for cardiopulm function
upright and moving
what is Dean’s Hierarchy rankings (9)
- mobilization and exercise
- body positioning
- breathing control maneuvers
- coughing maneuvers
- relaxation/energy conservation
- ROM exercise
- postural drainage
- manual techniques
- suctioning
PTs should assess/reassess patients ________ the administration of pulmonary interventions
before, during, and after
what are the four most common education interventions for pulm patietns
- impact of environmental factors on disease
- pharm
- O2 delivery systems
- signs of disease exacerbation
what are the 7 components of chest PT
- postural drainage
- percussion
- vibration
- coughing
- breathing techniques
- suctioning
- mobilization
when do you stop providing airway clearance techniques
when the secretions reach the upper airway or the patient stops producing secretions
how do we know that chest PT is effective
reduction in rate of pulm infections
what are three important precautions regarding postural drainage
- may inc metabolic demand or worsen V/Q resulting in dec oxygenation
- trendelenburg in CHF/HTN/PE/obese/etc may increase cardiac pressure
- sidelying may hurt patients with orthopedic pathologies
what are the four contraindications to postural drainage
- hemorrhage/hemoptysis
- untreated acute conditions
- CV instability
- recent neurosurgery (increased ICP)
what is the most important way to determine which lob of the lung needs chest PT/postural drainage?
auscultation
how long should each postural position be maintained?
5-20 min per position and 30-40 min per session
what do you do after a postural drainage session?
encourage deep breathing and coughing
what are the five precautions/contraindications for percussion
- platelets <50,000 or hemoptysis
- orthopedic sites
- PE or unstable CV status
- chest wall pain
- open wounds
T/F: percussion should be performed with a thin layer covering the site to be percussed
true, place a thin cloth or hospital gown over the patient prior to tx
how long should percussion last
3-5 min per area
what should follow a percussion session
vibration, coughing, and/or suctioning
what are the five precautions and contraindications for vibration
same as percussion
- platelets <50,000 and hemoptysis
- orthopedic sites
- PE or unstable CV status
- chest wall pain
- open wounds
how do you direct a vibration session
what comes after vibration
ask the patient to deep breathe for 3-5 cycles
apply vibrations during exhalation
coughing and/or suctioning should follow treatment
how many generations of airways does coughing clear?
up to 7
when making a cough as active as possible for a patient, how do you position them for success?
inhale with trunk extension and trunk flex during expiration
how do you teach an effective cough? (3)
- have the pt place hand on abdomen
- take two deep huffs and make the “k” sound
- take a deep relaxing inhale followed by a sharp double cough
coughing is not appropriate for emphysema patients, how would you instruct them to cough?
have them take small or medium breaths followed by huffs or a small series of coughs
post op patients fatigue quickly if they max cough each time, how do you fix this problem?
have them use a series of coughs starting with a small breath/cough, then a medium breath/cough, and finally a large breath and cough
what are three things you should avoid during coughing instruction
- avoid letting the pt gasp for air
- avoid uncontrolled coughing
- avoid forceful coughs with recent CVA/aneurysm (huff instead)
