Breathing Interventions

Question 1

diaphragmatic breathing

Answer 1

increase ventilation
improve gas exchange
decrease work
facilitate relaxation
improve chest wall mobility

Question 2

segmental breathing

Answer 2

post trauma or risk of atelectasis.
contraindicated with intractable hypoventilation

improve ventilation to hypoventilated segments
restore functional residual capacity
improve chest wall mobility

Question 3

Segmental breathing procedure

Answer 3

1. position to facilitate inhalation of segment
2. apply gentle pressure over area of hypoventilation during expiration
3. increase firm pressure just before inhale
4. pt breathes against resistance
5. release resistance, full inhale

Question 4

Sustained max inspiration

Answer 4

increase inhaled volume
improve alveolar inflation
restore functional residual capacity

post op / trauma pain
acute lobe collapse

Question 5

sustained max inspiration procedure

Answer 5

1. inhale slowly through nose or pursed lips to max inspiration
2. hold for 3 seconds
3. passively exhale

Question 6

inspiratory muscle training

Answer 6

pts with:
- decreased compliance
- decreased intrathoracic volume
- resistance to airflow
- alteration in length tension relationship of respiratory muscles
- decreased strength of respiratory muscles

Question 6

inspiratory muscle training

Answer 6

pts with:
- decreased compliance
- decreased intrathoracic volume
- resistance to airflow
- alteration in length tension relationship of respiratory muscles
- decreased strength of respiratory muscles

Question 7

inspiratory muscle training procedure

Answer 7

1. determine max inspiratory pressure
2. 30-70% of MIP for 10-15 min per session
3. inhale through device while maintaining their usual RR and TV for at least 10-15 min
4. progress duration to 30 min before progressing intensity

Question 8

Paced Breathing

Answer 8

pace breathing with activity for pts who have dyspnea

Question 9

Huffing

Answer 9

effective in pts with collapsable airways (COPD). prevents premature airway closure

Question 10

Huffing procedure

Answer 10

1. inhale deeply
2. exhale with “ha, ha”

Question 11

Assisted cough

Answer 11

used when pt’s abdominal muscles can’t generate cough

Question 12

tracheal stimulation

Answer 12

pts unable to cough on command (infants, tbi, cva).

finger/thumb placed just above suprasternal notch with quick inward/downward pressure on trachea for cough reflex

Question 13

active cycle breathing

Answer 13

1. controlled, diaphragmatic breath
2. deep inhalation with hold at top if possible. can be performed with or without percussion/shaking
3. controlled diaphragmatic breathing:
   - if no secreations, forced huffs or coughs
   - if secretions cleared, return to diaphragmatic breathing
   - repeat this cycle as many times as necessary

Question 14

autogenic breathing

Answer 14

used to clear peripheral secretions without tracheobronchial irritation

1. quiet breathing at low lung volumes to affect peripheral secretions in middle airways
2. breath at mid lung volumes to affect secretions in middle airways
3. breathing from mid-high volumes to clear secretions from central airways (replaces coughing)

repeat until all secretions removed