Interventions Flashcards
Diaphragm aids in —– ?
innervation ?
inspiration
C3, C4, C5 keep the diaphragm alive
Diaphragmatic Breathing Training utilizes —– and limits —– while during inhale
utilize diaphragm and limits accessory muscles
Diaphragmatic Breathing Training is used for —- patients, —– at rest and —– during ADLs? ( 3 patient populations)
- **post surgical **patients
- Dyspnea at rest
- SOB with ADLs ( inefficient breathing)
Diaphragmatic Breathing Training (DBT) is not for this those with 1) this condition/ severity , 2) this type of breathing pattern, and 3) increase —- during DBT
- moderate/ severe COPD ( due to hyperinflated lungs)
- paradoxical breathing patterns
- dyspnea during DBT
3 Expected outcomes for DBT
decreases x and y
increases z
x= dec. respiratory rate
y = dec. reliance on accessory muscles
z = inc. tidal volume
Pursed Lip breathing reduces x and decreases y by maintaining z pressure in the bronchioles
x= respiratory rate
y = dyspnea
z = positive pressure
Pursed lip breathing is used for this conditions?
2 other indication
COPD
indications:
1. tachypnea
2. dyspnea
Expected outcomes for pursed lip breathing:
reduces —–
improves —– stats
prevents —- —— in pts with emphysema
reduces PaCO2
improves O2 stats
prevents airway collapse
Segmental breathing goal: —- / —— chest mvmts similar to this technique from neuro
facilitates and inhibitis chest wall mvmts
similar to PNF
segmental breathing improves —- ventilation
improves regional ventilation
Segmental breathing is used for decreased —- and —,
and ——–
decreased lung volumes and chest wall compliance
V-Q mismatch
treats hypomobility of lung due to chest wall compliance
There are no contraindications for segmental breathing
T or F
True
precaution for pain and tenderness may be due to broken rib or chest tube
basal atelectasis position for segmental breathing
sitting
What side should patient be on when sidelying?
contralateral side ( affected lung facing up)
bilateral expansion positions for segmental breathing
sitting or supine
when should therapist apply pressure during segmental breathing technique
When: end of exhale
where: area that needs expansion
3 outcomes for segmental breathing:
increased —– —— —–
expands —- ——
—- secretions and —- airway
- increased chest wall expansion
- expands collapsed alveoli
- loosens secretions and clears airway
This is very important to aid in airway clearance to help reduce risk of pneumonia.
cough
What are the 5 stages of a cough?
know this
- deep inhalation
- glottis closes
- increased pressure gradient
- glottis opens
- forceful movement
Directed Cough can compensate for patient’s inability to elicit —- —– —–
maximum forced exhalation
Huff cough uses forced —- maneuver with glottis ——
forced expiratory maneuver with glottis open
What is the purpose of huff cough
decreases risk of airway collapse
pt. inhale with mouth open, contracts abs and with rapid exhale they say ha ha ha
contraindications/ precautions for Huff cough
think nature of the intervention
- droplet precautions **( COVID) **
- doesn’t tolerate intracranial pressure ( Valsalva)
- untreated pneumothorax
- osteoporosis
- flail chest
there’s more
Percussion/ vibration uses patient posioning so that gravity can help with ———–
drainage of bronchial secretions
percussion procedures ( 2 steps)
- therapist rhythmically strikes the chest with a cupped hand for **2 -3 minutes **
- patient coughs after
vibration procedure is performed in direction of rib movement during inhale - T or F
false - done during exhalation
pt. coughs after
precautions/ contraindications for percussion & vibration
why would you not want to decline pt.
1.** pulmonary edema related to CHF **( don’t have pts decline head bc it increases workload on heart)
2. rib fracture
3. prolonged corticosteroid use
4. osteoporosis
autogenic breathing and active breathing cycle would be good for what patient population? may not be as good in this population?
Good for those who don’t need assistance with breathing/ secretion clearance
Not as effective in Cystic Fibrosis
outcomes: active breathing will —- secretions and improve —- in lungs, and improve effectiveness of —–
- loosen / clear secretions
- ventilation
- cough
autogenic drainage is —– breathing at different —– —–
staged breathing
different lung volumes
autogenic breathing outcomes:
1. mobilize secretions by creating —- forces induced by airflow
2. speed of — flow helps mobilize secretions
3. secretions travel from — airways to —- airways
- shearing force
- expiratory flow
- peripheral to central airflow
Incentive Spirometer is for this patient population
post surgical patients and those on prolonged bed rest
Incentive Spirometer maximizes —– expansion during sustained maximal —–
alevolar expansion during sustained maximal inspiration
Inspiratory/ expiratory muscle trainer works on these muscles? creates —- pressure when —- to decrease air trapping
inspiratory muscles
positive pressure when exhalaing
Flutter device creates — with lungs to allow for secretion mobilization.
creates circuit with lungs to allow for —- ——
end with ——
positive expiratory pressure with mechanical oscillation
**secretion mobilization **
end with cough
The vest is great for this patient population
Great for children along with those in need of more regular airway clearance (CF, COPD exacerbation, etc.)
