CPT I - PRACTICAL 2 Flashcards
Indications for Chest PT?
Need aid to move secretions
Atelectasis
Prophylaxis against postop pulmonary complications
Routine bronchial hygiene in certain patients
Sputum specimens for diagnostic analysis
What is the problem?
Secretions?
Ventilation?
Elimination?
Diaphragmatic breathing
1 hand on stomach, 1 hand on chest
In through the nose, out through the mouth
Normal and deep breaths
Mirror/supine if difficult
Why ventilation exercises?
Increase ventilation, mobility, aerobic capacity
Segmental breathing exercises?
Enhance ventilation to specific segment
Manual cue: hand over area, firm pressure at expiration, release on inhalation (“Breathe into my hand”)
Inhale and hold 3-5 seconds
Contraindications
COPD - no diaphragmatic breathing
Ventilation Exercises - incisions, hyperventilation
Postural drainage - ICP, heart failure
Percussion - hemoptysis, atelectasis, osteoporosis, bronchospasm, fracture
Monitoring
Patient response: pain, discomfort, dyspnea
Sputum following cough to note color, consistency, odor, volume
Breath sounds
Adverse neurologic signs/symptoms
Cardiac dysrhythmias or alterations in hemodynamics
Pulmonary mechanics: vital capacity, peak inspiratory pressure, peak expiratory pressure, peak expiratory flow, airway resistance
Frequency
As frequently as needed
Cough recommended every 2-4 hours while awake post-op
Cough during and at conclusion of therapy
Assessment of outcome
Presence of sputum specimen following cough
Clinical observation of improvement
Patient’s subjective response to therapy
Stabilization of pulmonary hygiene in patients with chronic pulmonary disease and history of secretion retention
Position:
Upper Lobe - apical
Sitting; reclined 30 deg
Position:
Upper Lobe - Anterior
Supine
Flat
Pillow under knees
Position:
Upper Lobe - Posterior
Sitting
Hunched over pillow
Position:
Middle Lobe
1/4 turn upward
Head down 15 deg
Position:
Lower Lobe - Anterior
Sidelying
Head down 30 deg
Position:
Lower Lobe - Posterior
1/4 turn down
Head down 30 deg
