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Special Clientele > Breathing Ex's > Flashcards

Breathing Ex's Flashcards

1
Q

Breathing Ex’s

A
  • Should be performed a few at a time so that maximum effort is put into each breath and shoulder tension is discourgaed
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2
Q

Once _____, most alveoli can stay open for about an _______ so pt’s should be asked to perform at least ___ reps every waking ______.

A
  • Inflated
  • Hour
  • 10
  • Hour
  • Not so easy to do, so link to routine activites
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3
Q

Diaphragmatic / Deep Breathing

A
  • Designed to improve efficiency of ventilation
  • Decrease work of breathing
  • Increase excursion
  • Improve gas exchange and oxygenation
  • Mobilize lung secretions during postural drainage
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4
Q

Diaphragmatic / Deep Breathing Treatment

A
  • Place pt in appropriate position - Semi Fowler’s (reclined sitting) or side lying inclined towards prone
  • Assure comfort and relaxation, avoid distractions or conversation
  • Ask pt to breathe in deeply, comfortably and slowly through nose and sigh out through mouth. Place one hand on your upper chest and one just below your rib cage.
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5
Q

While breathing _____ & ______ your hand on your chest should not ______.

A
  • Deeply
  • Slowly
  • Move
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6
Q

Nasal breathing _____ and _____ air.

A
  • Warms

- Humidifies

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7
Q

Breathing _____ usually results in breathing more _____ due to ______ airway turbulence and better _______ to dependent regions

A
  • Slowly
  • Deeply
  • Reduced
  • Distribution
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8
Q

Pt’s experiencing ________ should not be asked to breathe _______, they should be reassured they are in _______ of the _____ of their treatment

A
  • Breathlessness
  • Slowly
  • Control
  • Pace
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9
Q

Have pt practice in a variety of ______ as able, including ______ with pillow under the _____ and ____ ______

A
  • Positions
  • Supine
  • Head
  • Bent Knees
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10
Q

End-Inspiratory-Hold

A
  • Air can be coaxed into poorly ventilated regions by breath holding for 3 seconds at FULL INSPIRATION.
  • Can be done at every deep breath or every few deep breaths
  • Careful instruction and close observation are needed to prevent shoulder girdle tension
  • It in inappropriate for breathlessness
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11
Q

Sniff

A
  • Often possible to squeeze in a little more air and further augment collateral ventilation
  • Ask pt’s to take a sniff at the end inspiration
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12
Q

Single Percussion during breath-holding

A
  • Single manual percussion with one hand at full INSPIRATION sends oscillating wave through the lung
  • May further encourage alveoli to open
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13
Q

Ventilatory Muscle Training and (3) types

A
  • Is thought that mm’s of inspiration respond to overload and specificity of training as skeletal mm’s do (often suggests for pt’s with weakness)
  • Diaphragmatic Training
  • Inspiratory Resistance
  • Incentive Respiratory Spirometry
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14
Q

Diaphragmatic Training

A
  • Ventilatory mm Training
  • Pt’s MUST be proficient at diaphragmatic breathing
  • Supine or slightly head up position
  • Place small 3-5 lb weight epigastric region and have pt breath deeply against the resistance of the weight while keeping upper chest quiet
  • Gradually increase time pt breaths against weight
  • Manual resistance or head-down positioning may also be used
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15
Q

Inspiratory Resistance Training

A
  • Using specifically designed device with narrow tubes of varying diameters to provide resistance to airflow during inspiration
  • Pt inhales through tube for specified period of time, gradually increasing to 20-30 minutes to increase inspiratory mm endurance
  • As strength and endurance improve, diameter of tube is decreased
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16
Q

Incentive Respiratory Spirometry

A
  • Low level resistance training that emphasizes sustained maximal inspiration utilizing a spirometer for visual or auditory feedback
  • It increases volume of air inspired, prevents alveolar collapse postoperatively, and strengthens weak inspiratory mm’s in pt’s with neuromuscular disorders
17
Q

Incentive Respiratory Spirometry Treatment

A
  • Have pt take 3-4 slow, easy breaths and exhale maximally with the last one
  • Place spirometer in mouth, maximally inhale through it, and hold the inspiration for several seconds
  • Repeat 5-10 times several times a day up to 5-10 times hourly
18
Q

Segmental Breathing

A
  • Attempt to teach pt to expand localized areas of lung while keeping other areas quiet
19
Q

Segmental Breathing Technique

A
  • Sitting or hook lying position
  • Place hands along appropriate area of chest as pt breathes in and out for a few breaths, “squeezing” the chest during expiration and allowing chest to move during inspiration
  • Then at end of an expiration, squeeze chest and give some resistance to inspiration while asking pt to push up against hands
  • Pt can be taught to provide resistance using his/herhands or a belt
20
Q

Hand placement for Segmental Breathing

A
  • Lateral costal or lateral basal (hands over the lateral / lower ribs)
  • Posteriaor Basal
  • Anterior Basal
  • Right middle lobe or lingula (R/L side of chest)
  • Apical (usually unilateral) below clavicles using fingertips
21
Q

Glossopharyngeal Breathing

A
  • Frog Breathing
  • Means of increasing inspiratory capacity in presence of severe weakness of inspiratory mm’s
  • Has been shown to significantly increase pulmonary function by producing a tidal volume sufficient to give a degree of freedom from continuous mechanical support
22
Q

Glossopharyngeal Breathing Technique

A
  • Pt uses lips, soft palate, mouth, tongue, pharynx and larynx to swallow air into lungs
  • Enlarge buccal or mouth cavity to create negative pressure and cause air to rush in
  • Close off entrance (lips)
  • Force air back down throat, with a stroking maneuver of tongue, pharynx and laryngx
23
Q

Pursed Lip Breathing

A
  • Often adopted by breathless people, acts as a form of expiratory CPAP (Continuous Positive Airway Pressure) to prevent airway closure but increases the work of breathing, reduces the respiratory rate and relieves dyspnea and may decrease air trapping by reducing bronchiolar collapse during expiration
24
Q

Pursed Lip Breathing Technique

A
  • Forced expiration during pursed lip breathing must be avoided
  • Comfortable, relaxed position
  • Explain that expiration must be passive and the abdominal mm’s should not be contracted
  • Place hand over abdominals to detect any contraction
  • Instruct to breathe in slowly and deeply
  • Loosely purse lips and exhale

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