Ch. 8 Bronchopulmonary Hygiene Techniques Flashcards
Postural drainage and percussion are not indicated in which of the following conditions?
A. bronchiectasis
B. CF
C. pulmonary edema
D. atelectasis
pulmonary edema
While administering postural drainage to a patient on a 2 L/min nasal cannula, the RT observed frequent cardiac arrhythmias on the cardiac monitor. Which of the following should the therapist do at this time?
A. continue the treatment but avoid the Trendelenburg position
B. stop the treatment, return the patient to the previous resting position, increase the leader flow to 5 L/min and notify the physician
C. Allow the patient to rest for 3 minutes and begin therapy again
D. increase the liter flow to 3 L/ MINand continue the treatment
stop the treatment, return the patient to the previous resting position, increase the leader flow to 5 L/min and notify the physician
The RT received an order for postural drainage on a patient to mobilize secretions from the anterior segment of the right upper lobe of the lung. How should the patient be positioned for the lung to drain most effectively?
A. patient lying supine with pillows under their knees
B. patient lying on right side and Trendelenburg position
C. Patient lying on stomach and Trendelenburg position
D. patient lying on left side, rotated back 25°, with the bed flat
patient lying supine with pillows under their knees
A 34 year old patient using a 40% aerosol mask has right lower lobe pneumonia. He becomes short of breath, and his SPO2 decreases from 96% to 89% when lying on his right side. Which of the following should the RT recommend?
A. increase the O2 to 80%
B. place the patient on his left side
C. Place the patient on CPAP
D. suction the patient
place the patient on his left side
A patient receiving PEP therapy through a mouthpiece at 15 CM H2O has minimum secretion production. Auscultation revels retained secretions. The RT should recommend which of the following?
A. Decrease PEP to 10 cm H2O
B. Discontinue the tx and begin percussion and postural drainage
C. Increase PEP to 20 cm H2O
D. administer the treatment with a mask in place of the mouthpiece
Increase PEP to 20 cm H2O
The RT has received an order for postural drainage and percussion for a 34 year old patient whose chest x-ray shows atelectasis of the posterior basal segment of the right lower lobe. The patient should be placed in which of the following positions to help train the segment?
A. lying on left side with bed flat
B. prone, with head of the bed down
C. Lying on left side with head of dead down
D. supine, with head of bed down
prone, with head of the bed down
When coordinating the sequence of the following therapies related to bronchopulmonary clearance which should the RT do first?
A. Percussion
B. Deep breathing exercises
C. Bronchodilator therapy
D. Postural drainage
Bronchdilator therapy
Upon initiation of PEP therapy via face mask, the RT noticed that the device is unable to maintain a constant pressure during exhalation. To correct this problem the therapist should evaluate for which of the following?
A. Inadequate inspiratory flow
B. leaks around the mask
C. Inadequate system pressure
D. evidence of obstructive lung disease
Leaks around the mask
The RT is administering PEP therapy to a patient with atelectasis. Which of the following would indicate that the atelectasis is improving?
A. decreased late inspiratory crackles
B. decreased inspiratory wheezes
C. Reduced inspiratory stridor
D. coarse crackles that clear with coughing
decreased late inspiratory crackles
Before initiating postural drainage and percussion on a patient with a head injury, the RT observed the patient’s ICP reading to be 22 mm Hg. Which of the following should a therapist to at this time?
A. do not give the treatment, and consult physian
B. proceed with the patient in supine position
C. Proceed with the treatment but avoid the Trendelenburg position for more than three minutes
D. proceed with the treatment all positions but Trendelenburg
Do not give the treatment, and consult physian
Define Chest physical therapy (CPT)
It is a variety of techniques aimed to mobilize secretions and promotion of greater use of respiratory muscles which should result in an increase in the distribution of ventilation.
What are some CPT techniques? (5)
- pstural drainage
- chest percussion
- chest vibration
- cough techniques
- breathing exercises
What are some goals of CPT?
- mobilize secretions
- acute respiratory failure with retained secretions
- acute atelectasis
- ventilation and perfusion abnormalities resulting from retained secretions
- inefficient breathing patterns in patients with COPD
- prevention of postop respiratory complications
What are some contraindications for CPT?
- Pts with ICP > 20 mm Hg
- Recent spinal surgery/ injury
- Head and neck injury (until stablized)
- Active hemoptysis
- Empyema
- Bronchopleural fistula
- Rib fractures
- Pulmonary edema associated w/ CHF
- Large pleural effusion
- Tube feeding ore recent meals
- Subcutaneous emphysema
- Pulmonary TB
- Lung contusion
- Osteoporosis
CPT is indicated for patients who produce more than 30 mL of secretion per day and have difficulty clearing them from the airway
KNOW
