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Developing Physiotherapy Practice 3 > P7 - Gas Exchange 2 (Basic Adjuncts) > Flashcards

P7 - Gas Exchange 2 (Basic Adjuncts) Flashcards

1
Q

What are the primary goals of positioning/mobility in respiratory care?

A

Increase lung volumes and optimize ventilation/perfusion (V/Q) ratio.

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2
Q

What is ACBT and what techniques can be added to enhance its effectiveness?

A

Active Cycle of Breathing Technique (ACBT) is a breathing exercise that can be enhanced by adding holds and sniffs to deep breaths.

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3
Q
A
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3
Q

What manual techniques can physiotherapists perform for patients with sputum retention?

A

Percussion, vibrations, and shakes.

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4
Q

What is the main function of a flutter device in airway clearance?

A

It aids sputum clearance by producing oscillations and positive expiratory pressure (PEP).

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4
Q

Which respiratory conditions can benefit from the use of a flutter device?

A

COPD, Asthma, Bronchiectasis, and Cystic Fibrosis (CF).

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5
Q

What is the PEP range generated by the flutter device?

A

10-25 cm H2O.

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6
Q

Name two conditions where the flutter device is contraindicated.

A

Undrained pneumothorax and large bullae.

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7
Q

Describe the correct technique for using a flutter device.

A

Sit comfortably, inhale through the nose beyond normal tidal volume, then exhale through the flutter device with lips tightly sealed around the mouthpiece for 10-15 breaths, followed by FET (Forced Expiratory Technique) and coughing to clear secretions.

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8
Q

What are the primary uses of an incentive spirometer?

A

To prevent atelectasis, encourage lung expansion, and aid in sputum clearance.

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9
Q

How does the incentive spirometer increase lung volumes?

A

By encouraging slow, deep inhalations which increase transpulmonary pressure and inspiratory volumes.

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10
Q

What are some common indications for using an incentive spirometer?

A

Postoperative risk of pulmonary complications, atelectasis, weak respiratory muscles, and conditions predisposing to pulmonary atelectasis.

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11
Q

What are some contraindications for using an incentive spirometer?

A

Patient inability and poor cognition.

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12
Q

Explain how Positive Expiratory Pressure (PEP) works.

A

PEP provides resistance during exhalation, preventing airway collapse and encouraging collateral ventilation.

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13
Q

For which patients is PEP therapy particularly useful?

A

Patients with COPD, Asthma, bronchiectasis, or cystic fibrosis, and those unable to clear secretions effectively.

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14
Q

What is the correct technique for using a PEP mask?

A

nhale to maximal tidal volume, exhale through the mask for 3-5 seconds while maintaining a constant pressure of 20 cm H2O on the manometer.

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15
Q

What are the main indications for using a flutter or acapella device?

A

Excessive/retained secretions, atelectasis, and chronic respiratory conditions like CF, bronchiectasis, and chronic bronchitis.

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16
Q

What is the difference between the flutter and acapella devices?

A

The flutter uses a metal ball to generate oscillations, while the acapella uses a plastic reed to create oscillatory resistance during exhalation.

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17
Q

How often should the acapella device be used for optimal sputum clearance?

A

8-10 breaths, combined with FET/huff, repeated 2-3 times per day.

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18
Q

What are the contraindications for using PEP therapy?

A

Undrained pneumothorax, large bullae, active TB, cardiac instability, and frank haemoptysis.

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19
Q

How does oscillatory PEP help with sputum clearance?

A

The oscillations shake the airway walls, loosening mucus, while the PEP splints open the airways to prevent collapse.

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20
Q

What does “collateral ventilation” mean in the context of PEP therapy?

A

It refers to air moving into poorly ventilated areas of the lungs through smaller airways, improving lung inflation and sputum clearance.

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21
Q

What is the role of end-inspiratory holds in using an incentive spirometer?

A

They maintain airway patency, preventing or reversing atelectasis and aiding sputum clearance.

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22
Q

What is the proper technique for using an incentive spirometer?

A

Sit upright, breathe out normally, seal lips around the mouthpiece, inhale slowly and deeply, hold the breath for 5 seconds, then exhale slowly.

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23
Q

What are the steps in respiratory treatment related to positioning and mobility?

A

Positioning and mobility aim to increase lung volumes and optimize ventilation-perfusion (V/Q) matching.

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24
Q

What is the purpose of adding “holds” and “sniffs” to deep breaths in ACBT?

A

Holds and sniffs can enhance the effectiveness of deep breathing by promoting greater lung expansion and aiding sputum clearance.

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25
Q

What are the main indications for using an Acapella device?

A

Excessive secretions, atelectasis, chronic respiratory conditions (CF, bronchiectasis, chronic bronchitis), and difficulty clearing secretions independently.

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26
Q

How does the Acapella device work during exhalation?

A

A plastic reed inside oscillates, creating pressure changes that combine oscillatory resistance with positive expiratory pressure (PEP).

27
Q

What is the difference in use between the flutter and Acapella devices?

A

The flutter must be held in a specific angle to change oscillation frequency, whereas the Acapella can be used in any position, including lying down.

28
Q

What is the role of a manometer in PEP therapy, particularly when using devices like Aerobika?

A

A manometer measures the expiratory pressure, ensuring it stays within the therapeutic range of 10-25 cm H2O.

29
Q

How many breaths are typically performed when using the Aerobika device for airway clearance?

A

Between 5-10 breaths, combined with FET or huffing, repeated cycles for 10-15 minutes, 2-4 times per day.

30
Q

What feature of the Aerobika device allows it to be used with nebulisers?

A

The Aerobika device can attach to a nebulizer to deliver medication while performing airway clearance therapy.

31
Q

What are the common conditions treated using an Aerobika device?

A

COPD, asthma, bronchiectasis, cystic fibrosis, and any condition where mucus clearance is impaired.

32
Q

What is the purpose of the equal pressure point (EPP) in PEP therapy?

A

The EPP ensures that airway pressures are equalized at a point that prevents collapse, promoting sputum clearance without airway compression.

33
Q

Why is PEP therapy recommended for patients with chronic bronchitis?

A

PEP therapy helps to clear mucus, prevent airway collapse, and improve lung ventilation in patients with excessive mucus production and obstructive conditions like chronic bronchitis.

34
Q

What are some hazards or complications of using an incentive spirometer incorrectly?

A

Hyperventilation, discomfort from pain, hypoxia due to interruption of oxygen therapy, and bronchospasm.

35
Q

What is the role of collateral ventilation in PEP therapy?

A

Collateral ventilation allows poorly ventilated lung areas to receive airflow through smaller airways, enhancing lung expansion and sputum clearance.

36
Q

What is a common postoperative use for the incentive spirometer?

A

The incentive spirometer is used to prevent pulmonary complications, such as atelectasis, after upper abdominal or thoracic surgeries.

37
Q

What types of patients may not be suitable candidates for using an incentive spirometer?

A

Patients with poor cognition or inability to follow instructions are contraindicated for incentive spirometer use.

38
Q

What is Forced Expiratory Technique (FET) and when is it used?

A

FET is a controlled breathing maneuver used after performing airway clearance exercises (e.g., after using flutter, acapella, or aerobika devices) to clear mucus by huffing or coughing.

39
Q

In PEP therapy, why is it important to maintain a pressure of 20 cm H2O on the manometer?

A

Maintaining this pressure ensures optimal PEP, which helps keep the airways open, preventing collapse and aiding sputum clearance.

40
Q

What are some key precautions when using PEP or oscillatory devices?

A

Avoid use in patients with undrained pneumothorax, large bullae, active TB, cardiac instability, or frank haemoptysis.

41
Q

How should a patient be positioned when using a flutter, acapella, or aerobika device for best results?

A

The patient should ideally be seated, with a forward lean if needed, but these devices can also be used in lying or side-lying positions.

42
Q

Why is dynamic compression of the airways a concern during forced expiration, and how do PEP devices address this?

A

Dynamic compression can collapse small airways, making it harder to clear mucus. PEP devices create back pressure that prevents airway collapse during expiration.

43
Q

What are the recommended breath cycles when using flutter, Acapella, or Aerobika devices for airway clearance?

A

Typically, 10-15 breaths are performed, followed by FET or a huff, then coughing to clear secretions.

44
Q

What is the primary goal of breathing exercises in respiratory care?

A

To increase lung volumes and improve oxygenation by optimizing ventilation-perfusion (V/Q) matching.

45
Q

What are the key benefits of using manual techniques like percussion, vibrations, and shaking in patients with sputum retention?

A

These techniques help loosen and mobilize mucus, making it easier for the patient to clear their airways

46
Q

What is the primary function of Positive Expiratory Pressure (PEP) devices?

A

PEP devices help splint open the airways, preventing collapse and aiding in sputum clearance by producing positive expiratory pressure.

47
Q

What is the importance of maintaining a PEP of 10-25 cm H2O during therapy?

A

It prevents airway collapse while allowing the Equal Pressure Point (EPP) to help with sputum clearance and collateral ventilation.

48
Q

How does PEP therapy prevent dynamic airway compression?

A

By providing positive pressure during exhalation, PEP keeps the airways open, preventing their collapse and aiding mucus movement upwards.

49
Q

What is the correct inhalation technique when using an incentive spirometer?

A

Breathe in slowly and deeply through the mouthpiece, ensuring the piston rises steadily, followed by an end-inspiratory hold for at least 5 seconds.

50
Q
A
51
Q

Why should a patient take brief 3-second rests between breaths while using an incentive spirometer?

A

To avoid hyperventilation and allow for better control over lung expansion without causing fatigue or discomfort.

52
Q

What is the significance of the “outer yellow indicator” in an incentive spirometer?

A

It marks the patient’s best effort, which serves as a goal to achieve or surpass during subsequent breathing exercises.

53
Q

Why is PEP therapy particularly useful for patients with chronic respiratory conditions like cystic fibrosis or bronchiectasis?

A

PEP therapy helps to maintain open airways and promotes effective mucus clearance, which is crucial in managing chronic conditions with frequent mucus buildup.

54
Q

What are the contraindications for the use of a flutter device?

A

Undrained pneumothorax, large bullae, active tuberculosis (TB), cardiac instability, and frank haemoptysis.

55
Q

What technique should be used to clear secretions after using a flutter or acapella device?

A

The Forced Expiratory Technique (FET) or a huff, followed by a cough, to effectively clear loosened secretions.

56
Q

Why is the flutter device effective in airway clearance?

A

It combines oscillatory resistance with PEP, which loosens mucus and prevents airway collapse, making it easier for the patient to clear their airways

57
Q

What is a key difference in technique between using a flutter and an Acapella device?

A

The flutter device needs to be held at specific angles to adjust oscillations, while the Acapella device can be used in any position, including lying down.

58
Q

How does the plastic reed inside an Acapella device function during exhalation?

A

It oscillates to create pressure changes that combine with PEP, helping to mobilize secretions for easier clearance.

59
Q

What is the purpose of attaching a manometer to a PEP device like the Aerobika?

A

To measure and ensure the patient is maintaining the correct expiratory pressure during therapy.

60
Q

Why is it important to inhale to maximal tidal volume before exhaling through a PEP device?

A

Inhaling maximally ensures that the lungs are fully inflated, which optimizes the effectiveness of the PEP in clearing secretions.

61
Q

What are the main indications for using PEP devices in respiratory therapy?

A

Excessive or retained secretions, atelectasis, and chronic respiratory conditions like cystic fibrosis, bronchiectasis, and chronic bronchitis.

62
Q

What are the key hazards or complications associated with improper use of an incentive spirometer?

A

Hyperventilation, discomfort due to pain, hypoxia from interrupted oxygen therapy, bronchospasm, and fatigue.

63
Q

How does PEP therapy encourage collateral ventilation in the lungs?

A

By keeping the airways open, PEP allows air to move into poorly ventilated areas of the lungs, promoting better overall ventilation.

64
Q

What is the Equal Pressure Point (EPP) in PEP therapy, and why is it important?

A

EPP is the point where intrapleural and alveolar pressures equalize, preventing airway collapse and promoting effective sputum clearance.

65
Q

What technique is used to prevent airway collapse during PEP therapy?

A

Resisted expiration through the PEP device helps prevent airway collapse by maintaining positive pressure throughout exhalation.

66
Q

What are some common hazards or complications of using PEP devices if not used correctly?

A

Discomfort, hyperventilation, exacerbation of bronchospasm, and airway instability if pressures are not monitored correctly.

67
Q

What should patients do between breath cycles when using a flutter, Acapella, or Aerobika device?

A

Take brief rests and perform forced expiratory techniques (FET) or huffing to help clear secretions effectively.

Developing Physiotherapy Practice 3 (23 decks)

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