Lung Expansion Therapy Flashcards
Indications for lung expansion therapy
to prevent or correct atelectasis
Who needs lung expansion therapy
any patient who cannot or does not take periodic deep breaths
passive atelectasis
caused by persistent small tidal volumes
-use of sedatives, bed rest, painful deep breaths(broken ribs, surgery, no sighs)
Resorption atelectasis
due to lesions or mucus plugs blockig ventilation to affected regions
-gas distal to obstruction is absorbed by passing blood causing non-ventilated alveoli to collapse
Highest risk for atelectasis
postop abdominal surgery with abnormal preop spirometry
treatments for atelectasis
deep breathing/directed cough, incentive spirometry, continuous positive airway pressure, positive expiratory pressure, intermittent positve airway pressure
compression atelectasis
results when pt does not take deep breath and expand lungs fully
the closer the incision is to the diaphragm…
the greater risk for postoperative atelectasis
clinical signs of atelectasis
RR increases, fine late inspiratory crackles, bronchial breath sound, tachycardia
Relationship between RR and atelectasis
as atelectasis progresses respiratory rate increases proportionally
Direct signs of volume loss on CXR
displacement of the interlobar fissures, crowding of pulmonary vessels, and air bronchograms, indirect- elevation of the diaphragm, shift of trachea, heart, mediastinum, narrowing between ribs
transpulmonary pressure gradient
(PL) difference between the alveolar presure (Palv) and the pleural pressure (Ppl)
The purpose of incentive spirometry
to guide the pt to take a sustained maximal inspiratory effort resulting in a decrease in Ppl and maintain the patency of airways at risk for closure
Benefits of IS
efficient and effective prophylaxis agains postop atelectasis in high-risk pt
Indications for Incentive Spirometry
Presence of pulmonary atelectasis.
Presence of conditions predisposing to atelectasis- upper abd surg, thoracic surg, surg with pt with COPD
Presence of a restricive lung defec associated with quadriplegia or dysfuncitional diaphragm
