Exam 2, Chapter 28 (Week 4): Supporting Ventilation Flashcards
Chest Physiotherapy is an important way to help patients with what kind of condition?
Chronic lung Disease
What would be the goal of Chest Physiotherapy for the treatment of a chronic lung disease?
The goal would be to keep their lungs clear, and loosen secretions.
Which method of Chest Physiotherapy involves the changing of positions to allow gravity to loosen secretions?
a.) Breathing Retraining
b.) Chest percussion
c.) Chest Vibration
d.) Postural drainage
e.) Cor Pulmonale
d.) Postural drainage is the changing of positions to allow gravity to loosen secretions
What is postural drainage?
Can you give an example?
Postural drainage is changing positions to allow gravity to assist in loosening secretions.
An example could be:
A patient with complaints of coughing and mucus buildup has been lying on their back all day. Because of this, all their mucus has been settling in the back/bottom of their lungs. So, you move them onto their left side to allow the mucus to move, and potentially be coughed out.
Cupping your hands together and lightly striking the chest wall is what type of Chest Physiotherapy?
Chest Percussions/Vibrations
True or False:
During Chest Percussions/Vibrations, you cup your hands together and firmly strike the chest wall to loosen secretions.
False
You LIGHTLY strike the chest wall to loosen secretions.
Where on the chest wall do you begin percussion/vibrations and which direction do you go?
You start at the base, and gradually move up towards the top of the sternum.
The nurse’s role should be to assess a patient’s what prior to chest physiotherapy?
Assess the patient’s lung status.
Which of the following does Postural Drainage work best on:
a.) Atelectasis
b.) Cystic Fibrosis
c.) COPD
d.) Pneumonia
e.) All of the above
f.) None of the above
e.) All of the above
What are the 4 respiratory diseases that postural drainage works best on?
-Atelectasis
-Cystic Fibrosis
-COPD
-Pneumonia
How long would you keep a patient in a single postural drainage position? (On average)
5 minutes
Which would be the best time to schedule a postural drainage?
a.) 1 hour before meals
b.) 3 hours after meals
c.) Every 4 hours
d.) All of the above
e.) A & B only
f.) B & C only
e.) A & B only
1 hour before a meal, or 3 hours after a meal.
What is the goal of Chest physiotherapy?
To keep the airway clear and to loosen secretions.
Screening the patient for lung effectiveness, giving chest physiotherapy treatment, and assessing the effectiveness of the Chest Physiotherapy after it is given are the roles of what health care professional?
The nurse
The chest physiotherapy method of “Breathing Retraining” involves the nurse teaching the patient what 2 breathing methods?
Pursed lip breathing, and diaphragmatic breathing.
A patient coughs up sputum into an emesis basin after utilizing pursed lip breathing techniques, alongside postural drainage. What would be the nurses next move for patient care after the sputum has been cleared?
a.) Document the characteristics of the sputum.
b.) Continue postural drainage for another 15-20 minutes.
c.) Offer Mucolytics to further loosen residual sputum.
d.) Clean the emesis basin and place the call light near the patient.
a.) Document the Sputum characteristics asap
In Spirometry, do you exhale or inhale?
How often should a patient use spirometry in a day?
Inhale and hold for 6 seconds.
Use a spirometer 10 times a day every 1-2 hours.
Hypoxia vs Hypoxemia
what’s the difference?
Hypoxia is a lack of oxygen to the tissues.
Hypoxemia is a lack of oxygen to blood cells.
What part of the brain senses a rise in CO2 levels, and triggers an increase in respiration to receive more O2?
The Medulla
COPD patients are often called “CO2 retainers” because they often suffer from Hypercarbia. What is Hypercarbia?
High Co2 levels
Gradually, the medulla of a patient with COPD becomes damaged and malfunctioning because of the consistent CO2 retention. What does this mean for the patients drive to breath?
How does this relate to Oxygen Therapy?
The drive to breath is gone and the body can only sense its need for O2 from its blood arterial levels. The body can’t rely on the medulla, and so it has to get the drive to breath from an outside source.
O2 therapy is used to replace the patient’s malfunctioning medulla. The O2 saturation levels are kept on the lower side, between 90-95% sat. Only when the Arterial O2 levels drop does the body force the drive to breath. So, if the Arterial O2 levels are kept on the lower side (90-95%), the drive to breath will remain working.
Oxygen Toxicity is a complication that can occur from Oxygen Therapy. What are some signs of Oxygen Toxicity?
-Restlessness
-Fatigue
-Pain
-Infection
Warmth and moisture are a breeding ground for bacteria. Because of this, infection is a great risk in patients on O2 therapy, especially if the instruments they are using are not cleaned thoroughly. What is the most common, colonized infection found in patients using O2 therapy?
Pseudomonas Aeruginosa
or
Pseudomonas
True or False:
Consistent use of Antibiotics is the only way to eliminate pseudomonas.
False
Pseudomonas only be treated for symptoms and pain, but once you have it, it will never go away.
There is nitrogen in the air we breathe, and this helps maintain a patent airway in the alveoli. But consistent high levels of O2 from oxygen therapy can dilute the nitrogen levels that we breath. This diluting of Nitrogen levels can lead to what O2 therapy complication in the alveoli?
Atelectasis: Alveolar collapse
Specifically, the complication of Oxygen therapy known as “Absorbtion Atelectasis.”
