Ch. 8: Bronchopulmonary Hygiene Techniques Flashcards
What are some techniques included in CPT?
- Postural drainage
- Chest percussion
- Chest vibration
- Cough techniques
- Breathing exercises
List the goals of CPT. (4)
- To prevent the accumulation of pulmonary secretions
- To improve the mobilization of retained secretions
- To improve the distribution of ventilation
- To decrease airway resistance
What are the indications for CPT?
What disease processes?
Lung conditions that cause increased difficulty in mobilizing pulmonary secretions
* Bronchiectasis
* Cystic fibrosis
* Acute respiratory failure with retained pulmonary secretions
* Acute atelectasis
* Ventilation and perfusion abnormalities resulting from retained pulmonary secretions
* Inefficient breathing patterns in patients withCOPD
* Prevention of postoperative respiratory
complications
CPT is indicated for patients who produce more than ____ of secretions per day and have difficulty clearing them from the airway.
30 mL
What is the position to drain the posterior basal segment of the lower lobe of the lung?
Trendelenberg
What is the position to drain the lateral basal segment of the lower lobe of the lung?
Trendelenberg
What is the position to drain the anterior basal segment of the lower lobe of the lung?
Trendelenberg
ANYTHING BASAL WILL BE TRENDELENBURG
What is the position to drain the superior segment of the lower lobe of the lung?
Prone
What is the position to drain the lateral and medial segments of the right middle lobe of the lung?
Trendelenberg
What is the position to drain the anterior segment of the upper lobe of the lung?
Supine
What is the position to drain the apical segment of the upper lobe of the lung?
High fowlers - sitting up
What is the position to drain the posterior segment of the upper lobe of the lung?
High fowlers - sitting up
List some contraindications for CPT (14) 😐
- Patients with ICP greater than 20 mm Hg
- Recent spinal surgery or injury
- Head and neck injury (until stabilized)
- Active hemoptysis
- Empyema
- Bronchopleural fistula
- Rib fractures
- Pulmonary edema associated with CHF
- Large pleural effusions
- Tube feeding or recent meal
- Subcutaneous emphysema
- Pulmonary tuberculosis
- Lung contusion
- Osteoporosis
List some complications of CPT (7)
- Hypoxemia
- Rib fractures
- Increased ICP
- Increased Raw
- Hemorrhage
- Decreased CO
- Aspiration
Things to know about autogenic drainage
This technique has shown some promise in patients with cystic fibrosis. It appears to mobilize secretions in a way comparable to postural drainage and percussion but without the degree of O2 desaturation, and it is tolerated better in these patients.
This technique is difficult to teach the patient, which can pose a problem because it is taught for the patient’s independent use.
Indications for the use of MetaNeb:
a. COPD
b. Cystic fibrosis
c. Asthma
d. Bronchiectasis
e. Neuromuscular disorders
f. Postoperative airway management
g. Atelectasis
h. Chest wall trauma (when percussion would be
painful)
Just read
The MetaNeb pneumatic system combines secretion mobilization techniques and lung expansion therapy. Aerosolized medications and oxygen may also be utilized through the system.
2. Two modes are utilized during the 10-minute therapy:
a. CPEP (continuous positive expiratory pressure) mode provides for nebulizing medications and hyperinflation therapy for 2.5 minutes.
b. CHFO (continuous high-frequency oscillation) mode provides for nebulizing medications and continuous pulses of positive pressure to mobilize secretions for 2.5 minutes.
c. Both modes are repeated for 2.5 minutes each to complete the 10-minute therapy.
…
Generally, PEP levels of _________ are used.
10 to 20 cm H2O
PEP is a bronchial hygiene therapy used in the management of __________.
airway secretions and postoperative atelectasis.
Contraindications to PEP
a. Acute sinusitis
b. Middle ear infection
c. Epistaxis (nose bleed)
d. Recent facial, oral, or skull injury or surgery
e. Active hemoptysis
What is another term used for the forced expiratory technique (FET)?
Huff cough
What type of patients is the quad coughing technique commonly used on?
Patients with spinal cord injuries or neuromuscular disease to aid in providing for an efficient cough.
Postchapter Study Questions
What patients seem to benefit the most from intrapulmonary percussive ventilation?
CF
Postchapter Study Questions
What patients may benefit from MIE?
Patients with neuromuscular disorders
