Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pulmonary Dx > PT Interventions Lab > Flashcards

PT Interventions Lab Flashcards

1
Q

Direct Contact transmission occurs when? Example? (2)

A

(occurs when microorganisms are transferred from one infected person to another without a contaminated intermediate object or person)
i. Example: blood via a needle stick; scabies via skin to skin contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Indirect Contact transmission involves? Example? (5)

A
  • (involves the transfer of an infectious agent through a contaminated intermediate object or person)
  • Example: improper hand hygiene, improper cleaning of medical device (ie stethoscope) between patients
  • VRE, c diff, MRSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Droplet transmission occurs when? Respiratory droplets are generated when? (9)

A
  • respiratory droplets carrying infectious pathogens transmit infection when they travel directly from the respiratory tract of the infectious person to susceptible mucosal surfaces of the recipient, generally over short distances, necessitating facial protection)
  • Respiratory droplets are generated when an infected person coughs, sneezes, or talks or during procedures such as suctioning, endotracheal intubation, cough induction by chest PT and cardiopulmonary resuscitation
  • Influenza virus, rhinovirus, SARS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Airborne transmission occurs by? Examples? (4)

A
  • (occurs by dissemination of either airborne droplet nuclei or small particles in the respirable size range containing infectious agents that remain infective over time and distance)
  • TB, aspergillus, varicella (chicken pox), rubeola (measles)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Personal protective equipment (PPE) for contract precautions? Droplet? (2) Airborne?

A
  • Contact Precautions (wear a gown and gloves for all interactions that may involve contact with the patient or potentially contaminated areas in the patient’s environment)
  • Droplet Precautions (wear a mask for close contact with infectious patient)
  • →Patients on Droplet Precautions who must be transported outside of the room should wear a mask if tolerated
    Prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions
  • Airborne Precautions (wear a mask or respirator, depending on the disease-specific recommendations)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pulmonary PT Goals may include? (10)

A
  • Improve breathing pattern and effectiveness
  • decrease RR (at rest or with activity)
  • increase depth of respiration
  • decrease WOB (at rest or with activity)
  • improve chest wall mobility
  • improve functional mobility with decreased SOB
  • Improve airway clearance
  • improve hydration
  • improve mucocilliary clearance
  • improve cough effectiveness
  • Improve exercise tolerance
  • ADL tolerance, fitness, wellness
  • Improve patient awareness of CP problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Postural Drainage uses? Position should be maintained how long? If done in conjunction with percussion and vibration? Not necessary to? The pt should be educated in? Secretions may mobilize when? The pt should be educated on?

A
  • Uses gravity to remove secretions from involved lung segment
  • Position should be maintained for 5-10 minutes each involved lung segment (as tolerated)
  • If done in conjunction with percussion and vibration, 3-5 minutes in each position is sufficient
  • Not necessary to treat each involved lung segment in each treatment session, as it may be too fatiguing for the patient.
  • The most affected areas should be addressed first.
  • The patient should be educated in deep breathing and coughing after each position.
  • Secretions may mobilize immediately or up to 1 hour later.
  • The patient should be educated in managing secretions later and the nursing staff should be aware that CPT has been performed.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Contraindications (8) and precautions for postural drainage (5)? Should not be done when?

A

Contraindications: Increase ICP, hemodynamic instability, recent esophageal anastomosis, recent spinal fusion or injury, recent head trauma, diaphragmatic hernia, recent eye surgery or any other contraindication to a Trendelenburg position.

Precautions: pulmonary edema, hemoptysis, severe obesity, large pleural effusion, massive ascites

*Should not be done within 30 min of eating (before or after) including tube feeding or continuous tube feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Percussion goal is to? How? Not over?

A
  • Goal is to loosen retained secretions from the airways so they may be removed by expectoration or suctioning.
  • Rhythmical force applied to the chest wall over the affected lung segment by clapping with cupped hands
  • NOT over bony prominences or over breast tissue.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Vibration/Shaking goal? What is it? How?

A
  • Goal is to move secretions from the lung periphery to the larger airways where they may be suctioned or expectorated.
  • Vibration: gently, high frequency force
  • Therapist’s hands are placed side by side or top of one another. Patient takes a deep breath, at the peak of inspiration therapist applies a gentle steady co-contraction of the upper extremities to vibrate the chest wall.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Shaking directions? (3)

A
  • more vigorous
  • Patient takes a deep breath in. At the peak of inspiration, apply a slow, rhythmic bouncing pressure to the chest wall until the end of expiration.
  • The hands follow the movement of the chest wall as air is exhaled.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Contraindications (4) and Precautions (4) for Percussion and Vibration?

A

Contraindications: hemoptysis, low platelet count (

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

4 Phases of an Effective, Controlled Cough?

A
  • Inspiration greater than tidal volume (often combined with trunk extension)
  • Closure of the glottis (momentary hold)
  • Increase intrathoracic pressure by contacting abdominal and intercostal mm
  • Sudden opening of the glottis with forceful expulsion of inspired air (sharp cough 2-3 times while moving into trunk flexion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a splinted cough?

A

use towel or pillow over incisions on painful areas by applying pressure during expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a huff cough - kids? Adult instructions? Might want to use for? (2)

A
  • without glottal closure, has less velocity but decrease possibility for airway
  • Kids: fog mirror
  • Adults: use tissue
  • osteoporotic, high BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is breath stacking?

A

breath in , a little more, a little more, like sneezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Manual assisted cough - define Heimlich type
Anterior Chest compression
Costophrenic assist (supine or side lying)
Counter-rotation assist
Quadruped

A
  • Under ribs, push up and in - quad, C4
  • One arm perpendicular over chest and on lower ribs
  • Hands at base of ribs, following pts breathing, when she coughs you push down and in
  • Counter- rotation to spine - increase pressure intrathoracically. Breath in, back. Cough push forward
  • Quad- CF pt, lean forward, cough with child’s pose
18
Q

Self-assisted cough - define short sitting, long sitting, prone on elbows, quad/hands-knee rocking

A
  • Put arms around abdomen, look up, compress and flex and cough (self-heimlich)
  • Long sitting crunch with hands behind head
  • Look up and bring head down (weakest cough of all) - higher cervical, no control of LE
  • same as in manual
19
Q

What is Active Cycles of Breathing (ACB)? Steps?

A
  • Forced expiratory technique for airway clearance, pair breathing with huff cough
    1) Breathing control: diaphragmatic breathing for 5-10 sec at normal tidal volume
    2) Thoracic expansion exercises (can be in postural drainage position)
    3-5 reps, may include 2-4 sec breath hold
    3) Breathing control for 5-10 seconds
    4) Thoracic expansion exercises
    5) Breathing control for 5-10 seconds
    6) Forced expiratory technique (recommend using a huff cough)
    7) Breathing control
20
Q

ACB was developed for whom? Why?

A

Asthma

Huff less likely to induce bronchospasm

21
Q

Autogenic drainage works how? More for whom?

A
  • Controlled breathing to mobilize secretions by using a variety of expiratory air flows
  • Long term pts like CF or CA pts
22
Q

Autogenic drainage phases? (3) Continue for?

A
  • Phase 1: Unsticking. Breathes at tidal volume inhalation, go into expiratory reserve
    →”unstick” mucus in smaller airways by breathing at low lung volumes
  • Phase 2: Collection. Breathes slightly above tidal volume and into expiratory reserve
    →”collect” mucus in middle airways by breathing at low to mid lung levels (increasing inspiration and expiration)
    ⇒moving breathing from lower to higher lung area and moving mucus with it
  • Phase 3: Evacuation. Breaths into inspiratory reserve and just to end tidal volume
    →”evacuate” secretions from central airways by breathing at mid to high lung levels (breathing at higher lung volumes)
  • Continue for 3-4 cycles and encourage patient not to cough until complete or if they hear a ‘mucus rattle’.
23
Q

Suctioning - What are the two techniques?

A
  • Open technique (need to use sterile field) – catheter only goes to level of carina, so need to use other techniques to get secretions from the peripheral airways first.
  • Closed technique (through ventilator tubing)
24
Q

Facilitating Ventilatory Patterns - you want to do what for controlled breathing?

A

Try to increase length of expiration.

25
Q

3 techniques for diaphragmatic breathing?

A

Sniff
Scoop
Upper chest inhibition

26
Q

Pursed Lip Breathing – used to?

A

prevent derecruitment and increase length of expiration

27
Q

Glossopharyngeal breathing? For?

A
  • gulping air with tongue like a frog

- SCI

28
Q

Normal inspiration paired with? Expiration?

A
  • Normal inspiration – paired with UE flexion, abduction, ER with upward eye gaze
  • Normal exhalation – paired with UE extension, adduction, IR and downward eye gaze
29
Q

PPT facilitates? APT?

A
  • Posterior pelvic tilt facilitates diaphragmatic breathing

- Anterior pelvic tilt facilitates upper chest breathing

30
Q

Upper Extremity Position for upper breathing? Diaphragm and lower chest mm? Subtle changes?

A
  • Flex, abd, ER facilitates upper accessory mm
  • Ext, Add, IR facilitates diaphragm and lower chest mm

Subtle changes
Scapular retraction/protraction
Forearm supination/pronation

31
Q

What does hook lying accomplish?

A

PPT -> diaphragmatic breathing

32
Q

Paced breathing - inhalation paired with? Exhalation? Can be incorporated into? Examples? (2)

A
  • Inhalation: paired with extension, concentric activity, moving against gravity, eyes up
  • Exhalation: paired with flexion, eccentric activity, coming back into gravity, eyes down
  • Can be incorporated into functional mobility skills including transfers, ambulation, stair climbing

Examples:

  • Breathe out while rolling to side
  • Inhale with trunk extension when coming to an erect sitting position
33
Q

Inspiratory Muscle Training for what pts? Exam findings include? Goal is to? Must be? Will lose?

A
  • For patients with weak diaphragm or poor endurance
  • Examination findings may include decreased chest wall mobility, decreased breath sounds, SOB.
  • Goal is to increase ventilatory capacity and decrease dyspnea
  • Must be specific to the mm you are training
  • Will lose training effects if exercise is discontinued
34
Q

How do you strengthen the diaphragm? (2)

A
  • Resisted inhalation (for patients with Vt > 500) – can give resistance manually or with weights on the abdomen
  • Inspiratory mm trainers – up to 30% max inspiratory pressure helpful with vent weaning
    If
35
Q

Two types of strengthening?

A
  • flow resisted breathing: breathing into a mouthpiece and adapted that has adjustable diameter; the smaller the diameter, the harder
  • Threshold breathing: building up neg pressure before flow happens thru a valve, it opens at a set pressure regardless of RR
36
Q

Good test for abdominals?

A

Forward Lean Test - + test is a good indication for abdominal strengthening

37
Q

Endurance = ?

A

Endurance: (overload – low load over long time period)

38
Q

x

A

x

39
Q

What is an incentive spirometer (IS)? P-Flex? Therapep? Flutter? Acapella? Thairapy Vest? Abdominal binder?

A

Incentive Spirometer (IS) –early mobilization may be just as effective. IS best for post-op patients, SCI, neuro. Can be OK for COPD, but not long term.
P-Flex – provides inspiratory resistance
Therapep – positive expiratory pressure
Flutter – positive expiratory pressure and oscillations
Acapella – like the flutter, but the device is not position dependent.
Thairapy Vest – a ‘jacket’ that provides percussion
Abdominal binder – must be tight enough to provide support, but not too tight to inhibit diaphragmatic excursion

40
Q

Patient Education? (6)

A 
Monitoring SOB, RPE, HR
Hydration!
Smoking cessation!
Prevention!
Relaxation Exercises (Jacobson’s)
Be Upright and Moving!

Pulmonary Dx (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions