Breathing exercises Flashcards
diaphragmatic breathing indications
- post surgical patient with pain in the chest wall or abdomen or restricted mobility
- patient learning active cycle of breathing or autogenic drainage airway clearance techniques
- dyspnea at rest or with minimal activity
- inability to perform ADLs due to dyspnea or inefficient breathing pattern
DB precautions/contraindications
- mod to severe COPD and marked hyperinflation of the lungs without diaphragmatic movement
- patients with paradoxical breathing patterns, or who demonstrate increased inspiratory muscle effort, and increased dyspnea during DB
DB expected outcomes
- decrease respiratory rate
- decrease use of accessory muscles of inspiration
- increase tidal volume
- decrease respiratory flow rate
- subjective improvement of dyspnea
- improve tolerance to activity
Inspiratory muscle training indications
- impaired inspiratory muscle strength and/or a ventilatory limitation to exercise performance
IMT precautions/indications
- tachypnea
- reduced tidal volume
- increased PaCO2
- bradypnea and decreased minute ventilation
IMT expected outcomes
- increase inspiratory muscle strength and endurance
- decrease dyspnea at rest and during exercise
- increase functional exercise capacity
paced breathing and exhale with effort
Paced breathing- a strategy to decrease the work of breathing and prevent dyspnea during activity
Exhale with effort- employed during activity to prevent a patient from holding their breath
Paced breathing and exhale with effort indications
- patients with dyspnea at rest or with minimal activity
- inability to perform activity due to pulmonary limitation
- inefficient breathing pattern during activity k
paced breathing and exhale with effort precautions/contraindications
- avoid valsalva maneuver during activity
pace breathing and exhale with effort procedure
walking
- inhale through nose with walking two steps and then pause; exhale through pursed lips while walking four steps
climbing stairs
- inhale through nose while standing
- exhale through pursed lips while stepping up one or two steps
- remain on the step until breath control is restored
lifting
- inhale through the nose while standing or sitting; exhale through pursed lips while bending to reach the object
- pause
- inhale through the nose while grabbing the object; exhale through pursed lips while standing up
pace breathing and exhale with effort expected outcomes
- complete activity without dyspnea
- decrease patient’s fear of becoming short of breath during activity
pursed lip breathing
- reduce respiratory rate, reduce dyspnea, and maintain a small positive pressure in the bronchioles
PLB indications
tachypnea
dyspnea
PLB precautions/contraindications
- forcing exhalation
PLB expected outocmes
- decrease respiratory rate
- relieve dyspnea
- reduce arterial partial pressure of carbon dioxide
- improve tidal volume
- improve oxygen saturation
- prevent airway collapse in patients with emphysema
- increase activity tolerance
segmental breathing
- localized breathing or thoracic expansion exercise
- improve regional ventilation and prevent and treat pulmonary complications after surgery
SB indications
- decreased intrathoracic lung volume
- decreased chest wall lung compliance
- increased flow resistance from decreased lung volume
- ventilation; perfusion mismatch
SB precautions/contraindications
- none
SB expected outcomes
- increase chest wall mobility
- expand collapsed alveoli via airflow through collateral ventilation channels
- assist with secretion removal
Sustained max inspiration with incentive spirometer
- a max inspiratory effort is held for three or more seconds before exhalation
- also called incentive spirometry
SMI indications
- decreased intrathoracic lung volume
- deceased 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
SMI precautions/contraindications
- patient is not cooperative or is unable to understand or demonstrate proper use of the incentive spirometer
- patient is unable to deep breathe effectively
- patients with moderate to severe COPD with increased respiratory rate and hyperinflation
SMI expected outcomes
- absence of or improvement in signs of atelectasis
- decreased respiratory rate
- resolution of fever
- normal pulse rate
- normal chest x ray
- improved PaO2
- increased forced vital capacity and peak expiratory flows
