Treatment Techniques Prec/Contras

Question 1

positioning use

Answer 1

improve regional lung ventilation
reduce work of breathing
move lung secretions

Question 2

Positioning precautions

Answer 2

Labile CVS
Labile or raised ICP
Severe pulmonary disease with poor gas exchange resulting in de-saturation, unstable fractures including spinal injuries and pelvic fractures

Question 3

Deep breathing exercises used for (indications)

Answer 3

improve ventilation, re expand collapsed lung sections
Prevent atelectasis and to mobilise secretions.
3sec hold is used to assist collateral ventilation

Question 4

DBEs contraindications

Answer 4

tension pneumothorax - once under water drain in situ and working successfully than breathing exercises are essential

Question 5

DBE precautions

Answer 5

hyperinflated

Question 6

Incentive Spirometry

Answer 6

encourages deep breathing giving visual feedback
indicated if pt has undergone open abdominal or thoracic surgery, rib fractures or haemo/pneumothorax

IS can be used to prevent or assist in re-expanding the lung following atelectasis

Question 7

incentive spirometry contraindications

Answer 7

tension pneumothorax

impaired conscious levels

Question 8

incentive spirometry precautions

Answer 8

poor understanding

hyperinflated patients

Question 9

Controlled breathing

Answer 9

use tidal volumes

Question 10

Controlled breathing precautions

Answer 10

severe dyspnoea if patient not already competent with technique

Question 11

ACBT

Answer 11

used to help mobilise secretions by alternating between relaxed and deep breathing

controlled breathing 
deep breaths x 3-4
controlled breathing 
Huff x 1-2
controlled breathing
huff or cough to clear secretions 
repeated until huff is dry and non-productive

Question 12

ACBT contraindications

Answer 12

altered consciousness
uncooperative patient
severe dyspnoea
tension pneumothorax

Question 13

ACBT precautions

Answer 13

patient must be compliant with technique

children not allowed to perform independently until 8-10

Question 14

Spirometry contraindication

Answer 14

Unstable cardiovascular status 
Haemoptysis
Recent pneumothorax 
Thoracic, abdominal or eye surgery 
Thoracic, abdominal or cerebral aneurysm 
N/V
severe resp disease
cognitive impairment

Question 15

Preparation for spirometry

Answer 15

Avoid smoking 1hr prior
consuming alcohol at least 4hr prior
performing vigorous exercise within 30mins of testing
eating a large meal 2hr prior
wearing restrictive clothes
With hold short acting bronchodilator 6hrs prior, long acting 12 hrs
record S&S, Meds taken and time and dosage