Positioning (C/R)

Question 1

Possible c/r problems

Answer 1

SOB
Sputum
Reduced oxygen levels
Reduced lung volume - FRC and closing volume

Question 2

What is functional residual capacity and how does it change with position?

Answer 2

amount of air left in lungs after normal tidal exhalation

FRC increased when standing and decreased when supine, post surgery and obesity

Question 3

What is closing volume

Answer 3

Lung volume at which airway collapse occurs during expiration

Increases with age, smoking, lung disease

Question 4

What is ventilation and how does positioning effect it

Answer 4

Movement of air in and out of the lungs
Gravity dependant
Lower lungs ventilate better as gravity holds lungs open
So most ventilation when upright

Question 5

What is perfusion

Answer 5

Blood flow in capillary beds
Dependent on gravity
Changes with exercise and posture
Perfusion increases lower in the lungs

Question 6

Positioning to optimise respiratory function

Answer 6

Place good lung lower

Avoid slumping - knee upright

Question 7

Positioning to decrease WOB

Answer 7

decrease active fixation of shoulder girdle
E.g. Lean against a table in a tripod position (leaning on arms)
E.g. High side line

Question 8

Positioning for sputum clearance

Answer 8

Gravity Modified positions so:
If secretions in left lung lie on right side so you get drainage

Used alongside massage and breathing techniques

Question 9

What is therapeutic positioning?

Answer 9

Placement of patient to promote physiological and or psychological wellbeing