Postural Drainage

Question 1

Precautions (5)

Answer 1

Pulmonary edema
Hemoptysis
Massive obesity
Large pleural effusion
Massive ascites

Question 2

Contraindications (6)

Answer 2

INC ICP
Hemodynamically unstable
Recent spinal fusion/injury
Recent head trauma
Diaphragmatic hernia
Recent eye surgery

Question 3

Trendelenburg position

Answer 3

BOTTOM of bed - raised 10-45 degrees

Question 4

Contraindications for Trendelenburg

Answer 4

ICP = greater than 20 mmHG
uncontrolled HTN

Don’t want to INC ICP

Esophageal surgery (bed must stay flat)

Distended abodmen

Hemoptysis related to lung carcinoma thats been recently treated

Uncontrolled airway, risk for aspiration - feeding tube (must be stopped at least 1 hr prior/after tx)

CHF

Cardiomegaly

Question 5

Reverse Trendelenburg

Answer 5

HOB lifted, feet DOWN

Question 6

Contraindications to Reverse Trendelenburg (3)

Answer 6

Hypotension
Hx - Orthostatic Hypotension
Vasoactive meds

Question 7

How many postural positions are there?

Answer 7

12 total

5 upper lobes
2 middle/lingular lobes
5 lower lobes

Question 8

ANT Upper segment - Upper lobe

Answer 8

Trap, b/w clavicle and scap

Reclined 30-45 degrees backward

Question 9

POST Apical segment - Upper lobe

Answer 9

Trap

Sit upright, lean forward w/ EXT elbows

Question 10

ANT segment - Upper lobe

Answer 10

Pectoralis major (right below clavicle)

Supine (flat)

Question 11

Upper lobe - R POST segment

Answer 11

Medial scap border

Prone, pillow under R shoulder (1/4 turn upward)

Question 12

Upper lobe - L POST segment

Answer 12

Scap

HOB elevated, Prone, pillow under L shoulder

Question 13

R Middle lobe

Answer 13

Thoracic wall - ANT in b/w armpit and nipple

L sidelying w/ R shoulder rotated back toward bed w/ pillow underneath, raise FEET 12 in (head is down)

Question 14

L Lingular

Answer 14

Thoracic wall, ANT b/w nipple and armpit

R sidelying, L shoulder is rotated back towards bed w/ pillow underneath, RAISE FEET 12 in (head is down)

Question 15

Lower lobe - Bilateral ANT segments

Answer 15

ANT Thoracic wall, jist above inferior border of rib cage

Supine, RAISE FEET 18 in (head down)

Question 16

Lower lobe - R Lateral segment

Answer 16

R Thoracic wall, mid-axiallry line at inferior border - thorax

L sidelying, FEET RAISED 18 in (head down)

Question 17

Lower lobe - L Lateral segment

Answer 17

L Thoracic wall, mid-axiallry line at inferior border - thorax

R sidelying, FEET RAISED 18 in (head down)

Question 18

Lower lobe - POST segments

Answer 18

POST Thoracic wall, just above inferior border of rib cage

Prone, FEET RAISED 18 in (head down)

Question 19

Lower lobe - Superior segments

Answer 19

POST Thoracic wall, Inferior angle - scap

Prone, foot of bed FLAT, pillow under hips