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NPTE Study: Cardiopulmonary > PT Interventions 3 > Flashcards

PT Interventions 3 Flashcards

1
Q

Who should not perform diaphragmatic breathing?

A
  • Moderate to severe COPD
  • marked hyperinflation of lungs without diaphragmatic movement
  • Pts with paradoxical breathing patterns or who demonstrate increased inspiratory muscle effort

pts with increased dyspnea during DB

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2
Q

What are the expected outcomes of diaphragmatic breathing?

A
  • Decreased respiratory rate
  • Decreased use of accessory muscles of inspiration
  • Decreased respiratory flow rate
  • Increased tidal volume
  • Improved dyspnea and tolerance for activity
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3
Q

IMT =

A

Inspiratory muscle training

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4
Q

IMT attempts to strengthen:

A
  • Diaphragm

- Intercostals

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5
Q

2 different types of IMT devices

A
  • Flow resistive breathing

- Threshold breathing

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6
Q

Flow resistive breathing

A
  • pt inspires through mouthpiece and adapter with adjustable diameter
  • decreased diameter increases resistance to breathing
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7
Q

Threshold breathing

A

Requires buildup negative pressure before flow occurs through a valve that opens at a critical pressure

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8
Q

Inspiratory muscle training: expected outcomes

A
  • increased inspiratory mm strength and endurance
  • increased functional exercise capacity
  • decreased dyspnea at rest and during exercise
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9
Q

Paced breathing used for

A
  • decrease work of breathing

- prevent dyspnea during activity

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10
Q

Paced breathing: walking

A

Inhale 2 steps, pause

Exhale 4 steps

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11
Q

Paced breathing: stairs

A
  • Inhale through nose while standing
  • Exhale through pursed lips while stepping up/down 1-2 stairs
  • Remain on step until breathing control restored
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12
Q

Paced breathing: lifting

A
  • Inhale through nose while standing or sitting
  • exhale through pursed lips while bending to reach the object, pause
  • Inhale through nose while grabbing object
  • Exhale through pursed lips while standing up
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13
Q

Pursed lip breathing (PLB) used for

A
  • Reduction in respiratory rate
  • Reduction in dyspnea
  • Maintain small positive pressure in bronchioles
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14
Q

Why is it good to maintain small positive pressure in bronchioles?

A

May help prevent airway collapse in pts with emphysema

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15
Q

Pursed lip breathing: expected outcomes

A
  • Decreased RR
  • Relieve dyspnea
  • Reduce PaCO2
  • Improve tidal volume
  • Improve SpO2
  • Prevent airway collapse in emphysema pts
  • Increase activity tolerance
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16
Q

What is segmental breathing used for?

A

To improve regional ventilation and prevent/treat pulmonary complications after surgery

17
Q

Segmental breathing positioning

A
  • Sitting position for basal atelectasis
  • Sidelying with affected lung uppermost
  • Postural drainage positions with affected lung uppermost to assist with secretion removal
18
Q

How does the therapist help with segmental breathing?

A
  1. Apply firm pressure at end of exhalation to chest wall overlying area to be expanded
  2. Pt inhales deeply and slowly expands ribcage under therapist’s hands
  3. Therapist reduces hand pressure during pt’s inhalation
19
Q

Indications for incentive spirometers (Sustained maximal inhalation -SMI)

A
  • Decreased lung volume
  • Decrease chest wall lung compliance
  • Increased flow resistance from decreased lung volume
  • Ventilation: perfusion mismatch
  • Atelectasis or risk of atelectasis due to thoracic and upper abdominal surgery
  • Restrictive lung defect associated with quadriplegia and/or dysfunctional diaphragm
20
Q

Who should not use incentive spirometry?

A

Pts with mod to severe COPD with increased respiratory rate and hyperinflation

21
Q

Incentive spirometry: expected outcomes

A
  • absence of or improvement in signs of atelectasis
  • decreased respiratory rate
  • resolution of fever
  • normal pulse rate
  • normal chest x-ray
  • improved PaO2
  • Increased FVC and PEF
22
Q

Why does the forward leaning position often provide relief from dyspnea for pts with lung disease?

A
  • Optimizes length-tension relationship of the diaphragm

- Allows pec minor and pec major to assist in elevating the rib cage during inspiration

23
Q

What is the reverse Trendelenburg position and what is it used for?

A
  • Supine with head above trunk and LEs

- Decreases weight of abdominal contents on diaphragm and reduces resistance to movement during breathing

24
Q

What is the Semi-Fowler’s position and what is it used for?

A
  • pt supine with head of bed elevated to 45˚, pillows under knees for support
  • used for pts with CHF or other cardiac conditions

NPTE Study: Cardiopulmonary (23 decks)

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