clinical positioning for optimizing dyspnea, ventilation, perfusion

Question 1

clinical indications for changing position

Answer 1

reduce dyspnea
decrease work/stress of breathing
optimize lung volume
aid ventilation / perfusion (gas exchange)

Question 2

clinical factors to consider in changing position

Answer 2

MD parameters
pain
lines
precautions / conttras
intubated

Question 3

positions to reduce dyspnea general guidelines

Answer 3

lean forward
supine, upright
fixate arms / legs
pillows

Question 4

positions

Answer 4

sitting
sitting w pillow
lean against wall
lean over counter 
lying (head lifted)
side lying (pillow legs)

Question 5

Why lean forward in COPD

Answer 5

diaphragm curvature increases
diaphragm generates more pressure
mm stabilized to help w ventilation (reverse origin insertion)

Question 6

what causes diaphragm increase in curvature

Answer 6

increase in intra abdominal pressure

Question 7

how to increase ventilation capacity

Answer 7

diaphragm curvature increases
diaphragm generates more pressure
mm stabilized to help w ventilation (reverse origin insertion)

Question 8

causes of impaired oxygenation

Answer 8

decrease in inspiration

ventilation / perfusion mismatch

Question 9

ventilation

Answer 9

air in and out of lungs

Question 10

perfusion (Q)

Answer 10

blood to pulmonary caps

Question 11

diffusion

Answer 11

substance high to low concentration

Question 12

lung compliance

Answer 12

ability for lungs to stretch

Question 13

how is negative pressure in lung established

Answer 13

1. natural tendency for lungs to recoil
2. surface tennis of alveolar fluid
3. elasticity of chest wall

Question 14

where is regional ventilation greater

dependent or independent part of lung

Answer 14

dependent

Question 15

in standing supine and side lying

where is greatest regional ventilation

Answer 15

standing: inferior diaphragm
supine: posterior areas
side lying: the lung down

Question 16

why greatest ventilation in these potions

Answer 16

gradient of pleural pressure

gravity

Question 17

dependent lung

Answer 17

lung in lowest gravitational field

Question 18

non-dependent lung

Answer 18

lung in highest gravitational field

Question 19

at the apex, intrapleural pressure it at its ____ leading to ___

Answer 19

most negative

decreases compliance

Question 20

at the base intrapleural pressure it at its ____ leading to ___

Answer 20

least negative

increased compliance

Question 21

restrictive disease

Answer 21

compliance reduced
decreased lung volume
increase WOB

Question 22

whats WOB

Answer 22

work of breathing

Question 23

whats abnormal ventilation

Answer 23

non dependent lung is better ventilated

Question 24

standing supine and side lying whats abnormal ventilation

Answer 24

standing: apices
supine: anterior areas
side lying: lung up

Question 25

treatment principles ventilation

Answer 25

sitting upright or

bad lung up

Question 26

the higher the area away from the heart the ___ blood pressure

Answer 26

less

Question 27

in the apex capillaries collapse because

Answer 27

super inflated alveoli

Question 28

treatment principles perfusion

Answer 28

edematous limbs elevated
bed exercises
compression stockin
mobilize

breathing exercises with exercises