Exam 3: Wk 10: Pulmonary PT Interventions

Question 1

What precaution are patients on when they have failure to transport oxygen? what are their discharge options?

Answer 1

bed rest –> then they lose muscle strength and endurance

discharge options: home, snf

Question 2

results of immobilization on cardiac blood flow

Answer 2

• orthostatic hypotension
• decreased max hr and O2 uptake
• increased risk of thrombus
• decreased hemoglobin

Question 3

results of immobization on the respiratory system

Answer 3

• decreased vital capacity and residual volume
• decreased PaO2
• impaired ability to clear secretions

Question 4

interventions for pts with impaired O2 transport

Answer 4

• mobilization and exercise
• body positioning
• breathing control maneuvers
• coughing maneuvers
• Patient education
• energy conservations

Question 5

breathing positining

Answer 5

seated: feet flat on floor, arms supported, back rest

Sidelying: assist lung expansion and secretion removal

ProneL mobilizing secretions (COVID and ARDS)

Trendelenburg: for drainage from lower lobes of lungs

Question 6

Paired use UE exercise with inhalation

Answer 6

• shoulder flexion, abduction, and er with upward eye gaze

Question 7

Paired use UE exercise with exhalation

Answer 7

• shoulder extension, adduction, internal rotation, downward gaze

Question 8

what pelvic tilt will encourage a diaphragmatic breathing pattern

Answer 8

posterior

Question 9

effects of pursed lip breathing

Answer 9

• keeps airways from collapsing
• decrease dyspnea, SOB, wheezing
• improve exercise tolerance

Question 10

how to pursed lip breath

Answer 10

inhale for 2
exhale for 4

Question 11

Paced breathing definition

Answer 11

volitional coordination of breathing during activity (walking/ADLs)

Question 12

how to paced lip breathe

Answer 12

exhale slowly and comfortably, not forcefully

breathe out 2x as long as in

2:4 ratio

Question 13

Inspiratory Muscle Training

Answer 13

for pts with decrease strength or edurance of the diaphragm and intercostal muscles

• incentive spirometry
• diaphragmatic breathing
• stacked breaths

Question 14

Incentive spirometer

Answer 14

to prevent or reverse atelectasis and stimulate cough

10x /every hr

Question 15

what patients are incentive spirometry used for?

Answer 15

pts with trouble breathing in
- usually post surgery

Question 16

dia[hragmatic breathing

Answer 16

manage dyspnea and prevent/reverse atelectasis

Question 17

how to diaphragmatic breathe

Answer 17

breathe in = stomach out

Question 18

stacked breathing

Answer 18

series of inhalations that build on previous breath

for pts unable to take deep breaths, hypoventilation, atelectasis, ineffective cough

Question 19

progressive volume breaths

Answer 19

small breath in then let to
bigger breath in then out
bigggerr breath in then out

Question 20

t or f: thorax exercises improve inhale and exhale

Answer 20

TRUE

Question 21

indications for airway clearance techniques

Answer 21

• impaired mucocoliary transport
• excessive pulmonary secretions
• ineffective or absent cough

Question 22

Goals of airway clearance

Answer 22

• optimize airway patency
• increase ventilaation and perfusion matching
• promote alveolar expansion
• increase gas exchange

Question 23

explain coughing techniques

Answer 23

1. inspiration > than tidal volume
2. closure of glottis
3. contraction of abdominal and intercostals muscles, producing positive intrathoracic pressure
4. sudden opening of glottis and the forceful expulsion of the inspired air

Question 24

huffing airway clearance

Answer 24

EXPIRATORY TECHNIQUE

while sitting upright, take deep breath, hold and then forcefully and quickly exhale 2-3 burts of air w/o glottis closure

Question 25

splinted coughing

Answer 25

pillow across stomach

Question 26

stacked vs progressive cough

Answer 26

stacked: one big breath in, 3 coughs in same exhalation

progressive: progressively larger coughs in 3 DIFFERENT breaths

Question 27

active cycle breathing??????

Answer 27

normal breathing = breathing control /tv breaths 20/30 sec

3-4 deep breaths

huffing

Question 28

autogenic drainage technique

Answer 28

Forved vital capacity divided into low, mid, normal

• low volume breaths
• repeat 10-20 breaths
• suppress urge to cough and take 10-20 larger breaths
• go even LLARGERRR (near vital capacity)
• huff coughs

Question 29

how long should pt stay in postural drainage position?

Answer 29

5-10 min