Pulmonary Interventions Flashcards
what does “lay day” mean?
change in diaphragm position due to abdominal contents being manipulated
Precautions/Contraindications for diaphragmatic breathing
-Moderate/severe COPD with related hyperinflation of the lungs
-Pts with paradoxical breathing patterns
-Pts with inc dyspnea during diaphragmatic breathing
expected outcomes of diaphragmatic breathing
-Dec RR
-Dec reliance on accessory muscles of inspiration
-Inc TV
-Subjective improvement of dyspnea
-Improved activity tolerance
expected outcomes of pursed-lip breathing
-Dec RR and dyspnea
-Reduce PaCO2
-Improve TV and SaO2
-Prevent airway collapse in pts with emphysema (ex. atelectasis)
-Inc activity tolerance
indications for segmental breathing
-Dec lung volumes or chest wall compliance
-V-Q mismatch
expected outcomes of segmental breathing
-Inc chest wall mobility
-Expand collapsed alveoli
-Secretion loosening and clearance
-Can mobilize mucus out
-Inc tx expansion → get air throughout the lung better
expected outcomes of active cycle of breathing technique
-Loosen and clear secretions from lungs
-Improve ventilation in lungs
-Improve effectiveness of a cough → make it more productive
expected outcomes of autogenic drainage
-Mobilize secretions by creating shearing force induced by airflow
-Once mobilized → secretions transported from periphery of airways to central airways to be cleared
how does the incentive spirometer work?
-Maximizes alveolar expansion utilizing sustained maximal inspiration
-NOT an expiratory device!!
-Good for preventing atelectasis
how many breaths should a pt take per hour with the incentive spirometer when they’re awake?
5-10
what is the Acapella Flutter Device (flutter valve device) and how does it work?
-PEP device with mechanical oscillation
-Creates circuit with lungs to allow for secretion mobilization
-Inhalation/exhalation
-End with cough
-As pt breathes out it starts to vibrate to loosen mucus
-Ex. pneumonia
what is the Breather?
-Combines expiratory and inspiratory
-Can be used as a muscle retrainer
what is the Vest?
-Great for kids or those in need of more regular airway clearance (CF, COPD exacerbation, etc)
-Provides percussion over surface area of all bronchopulmonary segments
-Secretions are removed as they loosen → cough!!
contraindications to voluntary, forceful coughing (“A WASP”)
Aortic aneurysm (presurgical)
Wound dehiscence
Acute cerebral hemorrhage / surgery
Some surgical incisions (median sternotomy)
Patient tolerance
precautions/contraindications for huff cough (“O U FADE UP”)
OP
Unstable head or neck injury
Flail chest
Acute MI
Droplet precautions with inability to control secretions
Elevated ICP
Untreated pneumothorax
Potential aspiration
