Exam 3: Wk 10: Pulmonary PT Interventions Flashcards
What precaution are patients on when they have failure to transport oxygen? what are their discharge options?
bed rest –> then they lose muscle strength and endurance
discharge options: home, snf
results of immobilization on cardiac blood flow
- orthostatic hypotension
- decreased max hr and O2 uptake
- increased risk of thrombus
- decreased hemoglobin
results of immobization on the respiratory system
- decreased vital capacity and residual volume
- decreased PaO2
- impaired ability to clear secretions
interventions for pts with impaired O2 transport
- mobilization and exercise
- body positioning
- breathing control maneuvers
- coughing maneuvers
- Patient education
- energy conservations
breathing positining
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
Paired use UE exercise with inhalation
- shoulder flexion, abduction, and er with upward eye gaze
Paired use UE exercise with exhalation
- shoulder extension, adduction, internal rotation, downward gaze
what pelvic tilt will encourage a diaphragmatic breathing pattern
posterior
effects of pursed lip breathing
- keeps airways from collapsing
- decrease dyspnea, SOB, wheezing
- improve exercise tolerance
how to pursed lip breath
inhale for 2
exhale for 4
Paced breathing definition
volitional coordination of breathing during activity (walking/ADLs)
how to paced lip breathe
exhale slowly and comfortably, not forcefully
breathe out 2x as long as in
2:4 ratio
Inspiratory Muscle Training
for pts with decrease strength or edurance of the diaphragm and intercostal muscles
- incentive spirometry
- diaphragmatic breathing
- stacked breaths
Incentive spirometer
to prevent or reverse atelectasis and stimulate cough
10x /every hr
what patients are incentive spirometry used for?
pts with trouble breathing in
- usually post surgery
dia[hragmatic breathing
manage dyspnea and prevent/reverse atelectasis
how to diaphragmatic breathe
breathe in = stomach out
stacked breathing
series of inhalations that build on previous breath
for pts unable to take deep breaths, hypoventilation, atelectasis, ineffective cough
progressive volume breaths
small breath in then let to
bigger breath in then out
bigggerr breath in then out
t or f: thorax exercises improve inhale and exhale
TRUE
indications for airway clearance techniques
- impaired mucocoliary transport
- excessive pulmonary secretions
- ineffective or absent cough
Goals of airway clearance
- optimize airway patency
- increase ventilaation and perfusion matching
- promote alveolar expansion
- increase gas exchange
explain coughing techniques
- inspiration > than tidal volume
- closure of glottis
- contraction of abdominal and intercostals muscles, producing positive intrathoracic pressure
- sudden opening of glottis and the forceful expulsion of the inspired air
huffing airway clearance
EXPIRATORY TECHNIQUE
while sitting upright, take deep breath, hold and then forcefully and quickly exhale 2-3 burts of air w/o glottis closure
