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2) Cardiopulm > 3) Therapeutic Body Positioning > Flashcards

3) Therapeutic Body Positioning Flashcards

1
Q

Why is therapeutic body positioning done?

A

To incr arterial oxygenation

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2
Q

Why does TBP work?

A

It has a direct effect on the O2 transport system

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3
Q

What is the single most important objective of CPPT?

A

TBP

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4
Q

What are the goals of TBP?

A
  • Decr dyspnea
  • Decr work of breathing
  • Optimize lung vol
  • Improve VQ matching
  • Improve gas exchange
  • Assist w/AW clearance
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5
Q

What needs to be considered for TBP?

A
  • Pain
  • GI system
  • CV response
  • Neuromuscular system
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6
Q

What needs to be done after a TB position is determined to be good?

A

Monitor the pt & re-position if necessary

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7
Q

What determines time course for TBP?

A
  • Pathology
  • Type
  • Severity
  • Other factors
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8
Q

True or False: TBP duration should be response-dependent, not time-dependent

A

True

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9
Q

Why is sitting upright w/arms fixed on thighs effective at decreasing work of breathing?

A

It incr intra-abdominal pressure so the curvature of the spine incr, which optimizes the diaphragm’s MA & its capacity to generate pressure

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10
Q

What is the most physiologically important position?

A

Upright w/dependent legs

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11
Q

What did MJ say about supine positioning?

A

It is the “god awfulest position you can put a pt in”

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12
Q

Considerations for TBP?

A
  • Time constrains
  • Prone positioning will require multiple PT’s
  • Use modified positions when extremes aren’t feasible
  • Encourage movement & DB/C
  • Monitor vitals
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13
Q

What is bed rest deconditioning

A

Separate process that occurs along w/the course of the disease

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14
Q

How long does it take for fluid shifts to start after a pt is on bedrest?

A

24hrs

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15
Q

Negative effects of bed rest

A 
*
*
*
*
*
*
*
*
*
*
*
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16
Q

What does bed rest equal besides death?

A

Sensory deprivation

17
Q

Sx’s of adverse rxn to exercise

A
  • Unusual/severe fatigue
  • Angina
  • Dizziness
  • Irregular pulse
  • Marked SOB
  • HR>THR or >20BAR
  • SBP or DBP drop >10mmHg
  • No rise in SBP
  • DBP rise >10mmHg
  • Cyanosis
  • Pallor
  • Pain in teeth, jaw, arms, or ears
  • Severe claudication
  • Nausea/vomiting
  • HA
  • Ataxia
  • Mental confusion
18
Q

If a pt is hemodynamically unstable, should you tx them?

19
Q

If a pt has dyspnea, what position should you put them in & why?

A

Upright w/arms fixed on thighs

*This incr intra-abdominal pressure, which incr the curvature of the diaphragm, which optimizes its MA & ability to generate pressure

20
Q

What should upright positioning be coupled w/?

A

Exercise to optimize O2 transport

21
Q

True or False: Upright positioning slightly incr main airway diameter.

22
Q

What position decr myocardial work & urinary stasis?

23
Q

If a pt has unilateral lung disease, how should they be positioned & why?

A

Sidelying w/healthy lung down–>incr PaO2

24
Q

If pt has bilateral lung pathology, how should they be positioned?

A

Sidelying w/R lung down–>Its larger so there will be less compression on it from the heart

25
Q

If pt has a lung removed, how should they be positioned?

A

Side w/no lung down–>Don’t want fluid to go into their remaining lung

26
Q

What does trendelenburg position favor?

A

Gas exchange in the upper lung fields & alveolar distension at the bases

27
Q

Benefits of Trendelenburg position

A
  • Augments O2 transport in pt’s w/chronic air flow limitations & patho in the base
  • Decr dyspnea
  • Decr risk of reflux
28
Q

True or False: The diaphragm still has a decent mechanical advantage in trendelenburg.

29
Q

True or False: Side-lying accentuates AP expansion of the chest wall

30
Q

What are the physiologic benefits of prone positioning?

A
  • Incr arterial oxygenation
  • Incr arterial O2 tension
  • Incr tidal volume
  • Incr lung compliance
  • Decr work of breathing
31
Q

True or False: In prone, the abdomen can be restricted or free

32
Q

What does prone positioning w/free abdomen enhance?

A
  • Lung compliance
  • Tidal volume
  • FRC
  • Diaphragm excursion
33
Q

True or False: Semiprone positioning can provide many of the same benefits as prone w/less risks for ventilated pt’s.

34
Q

What part of the lung do ventilated pt’s have preferential ventilation?

A

Upper lung

35
Q

Why is prone positioning good?

A

The posterior aspect of the lungs has a much greater surface area than the anterior region does so it allows for incr gas exchange

36
Q

What do frequent positional changes stimulate?

A
  • Lymphatic drainage
  • Surfactant production
  • Distribution of pulmonary immune factors

2) Cardiopulm (16 decks)

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