PT intervention

Question 1

Postural drainage

Answer 1

positioning the pt in varying positions for optimal gravity drainage of secretions and inc expansion of the involved segment

Question 2

Indication for use of postural drainage

Answer 2

Inc pulmonary secretions
Aspiration
Atelectasis or collapse?

Question 3

Percussion

Answer 3

force rhythmically applied with PT hand cupped to specific area of chest wall corresponding to lung segment

Question 4

Percussion is used to

Answer 4

increase the amount of secretions cleared from the tracheobronchial tree
Usually used in conjunction with postural drainage

Question 5

Indications for percussion

Answer 5

Excessive pulm secretions
Aspiration
Atelectasis or collapse due to mucous lugging obstructing the airways

Question 6

Shaking/Vibration

Answer 6

Following a deep inhalation, a bouncing maneuver is applied to the rib cage throughout exhalation
Commonly used following percussion in the postural drainage position

Question 7

Indications for shaking/vibration

Answer 7

Excessive pulm secretions
Aspiration
Atelectasis or collapse due to mucous lugging obstructing the airways

Question 8

Airway clearance techniques - cough

Answer 8

Pt should be asked to cough in upright sitting position

coughing clears secretions from major central airways

Question 9

Airway clearance techniques - Huffing

Answer 9

more effective in pts with collapsible airways (COPD)
Prevents high intrathoracic pressure that causes premature airway close
Ha, Ha, Ha

Question 10

Airway clearance techniques - assisted cough

Answer 10

PT hand or fist become the force behind the pts exhaled air

Used when pt abdominal mm can’t generate en effective cough

Question 11

Airway clearance techniques - Tracheal stimulation

Answer 11

used with patients who are unable to cough on command like infants or patients with TBI or stroke

Question 12

Airway clearance techniques - Endotracheal suctioning

Answer 12

Used only when other airway clearance techiques fail to remove secretions

Question 13

Independent secretion removal - Active cycle of breathing

Answer 13

An ind. program to assist in removal of more peripheral secretions that a cough may not clear

Question 14

Independent secretion removal - Autogenic draining

Answer 14

an indp program used to sense peripheral secretions and clear them without tracheobronchial irritation from coughing

Question 15

Independent secretion removal - Autogenic draining phases

Answer 15

Unstick phase - quiet breathing at low lung volumes
Collect phase - breathing at mid lung volumes
Evacuation phase - breathing from mid to high lung volumes

Question 16

Independent secretion removal - FLUTTER or Acapella device

Answer 16

Pt uses an external device that vibrates the airways on exhalation to improve airway clearance
Pt breathes in normal TV, exhales through device

Question 17

Independent secretion removal - Low pressure positive expiratory pressure mask

Answer 17

Pt uses positive expiratory resistance via face mask to help remove airway secretions

Question 18

Independent secretion removal - High pressure expiratory pressure mask

Answer 18

Pt with an unstable airway uses a high expiratory pressure with the face mask to assist in removal of airway secretions

Question 19

Breathing exercises - Diaphragmatic breathing used to

Answer 19

inc ventilation
improve gas exchange
dec work of breathing
facilitate relaxation
maintain or improve mobility of chest wall

Question 20

Breathing exercises - Segmental breathing used to

Answer 20

improve ventilation to hypoventilated segments
alter regional distribution of gas
maintain or restore functional residual capacity
maintain or improve chest wall mobility
prevent pulmonary compromise

Question 21

Breathing exercises - Sustained maximal inspiration used to

Answer 21

increase inhaled volume
sustain or improve alveolar inflation
maintain or restore functional residual capacity

Question 22

Breathing exercises - pursed lip breathing used to

Answer 22

reduce RR
inc TV
Reduce dyspnea
Dec mechanical disadvantages of impaired vent. pump
Improve gas mixing
Facilitate relaxation

Question 23

Breathing exercises - abdominal strengthening used when

Answer 23

Used when abdominal mm are too weak to provide effective cough

Question 24

Activities for increasing functional abilities

Answer 24

General conditioning
Inspiratory muscle trainer
Paced breathing
Energy conservation