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PHTH 524 > Secretion Clearance > Flashcards

Secretion Clearance Flashcards

1
Q

Why is secretion clearance so important? (educate)

A

aid in respiratory status

  • increase ventilation
  • decrease work of breathing and thus O2 consumption
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2
Q

Indications for secretion clearance

A

hyper secretory lung disease
inability to clear secretions
risk of secretion retention
disease that impairs cough

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3
Q

precautions/contraindications for airway clearance techniques

A 
coughing up blood (hemoptysis) 
pneumothorax 
raised ICP 
headache 
sinusitis 
GERD 
Nausea and or vomiting 
pregnancy 
hypertension 
rib fracture/osteoporosis 
chest wall pain/discomfort 
chest wall surgery 
coagulation disorders
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4
Q

what are some adjunct treatments to enhance airway clearance ?

A 
inhalation therapy
physical activity 
noninvasive ventilation 
analgesia 
Humidification
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5
Q

What should be apart of every secretion clearance technique

A

the basic cough

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6
Q

Describe Huffing (forced expiratory technique FET

A

Huff (2 reps ) then deep breath (3 reps)
huff is 2 secs more than inspiration
arms bent and placed at side
mouth in O
tighten chest wall and abdomen
huff is forced not violent
FET changes the equal pressure point in the airway thereby stabilizing the airway and improving clearance

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7
Q

what is assisted cough especially good for?

A

quads
duchenne muscular dystrophy
ALS
neuromuscular disease

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8
Q

Active Cycle of Breathing Basics

A

Normal Breath
Thoracic Expansion
Huff (FET)
should be done in sitting or in postural drainage positions

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9
Q

how long should you be in a postural drainage position for?

A

3- 10 mins per broncho

pulmonary segment

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10
Q

how many postural drainage positions for RUL

A

3 (apical, posterior, anterior)

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11
Q

how many postural drainage positions for RML

A

1 ( lateral/medial)

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12
Q

how many postural drainage positions for RLL

A

superior, medial basal, anterior basal, lateral basal

posterior basal

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13
Q

how many postural drainage positions for LUL

A

4 (apical, posterior, anterior, lingula

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14
Q

how many postural drainage positions for LLL

A

anterior , lateral , posterior

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15
Q

what lobes drainage position is head of bed or sitting at 90 degrees supine

A

Right & left upper lobe apical segment

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16
Q

what lobes drainage position is just supine

A

RUL - anterior

17
Q

what lobes drainage position is prone

A

RLL superior

LLL superior

18
Q

prone with quarter turn with right lung up

A

RUL- posterior

19
Q

30-45 degrees downward tilt side lying with right side up ?

if left side was up?

A

RML - medial & lateral segments
RLL- lateral

RLL- medial &
LUL lingula
LLL- lateral

20
Q

30-45 degrees downward tilt and prone

A

RLL - posterior

LLL - posterior

21
Q

30-45 degrees downward tilt supine

A

RLL & LLL-anterior segment

22
Q

head of bed at 45 degrees and supine

A

LUL anterior

23
Q

sitting/leaning over bed/chair

A

LUL - posterior

24
Q

percussion technique

A

cupped hands
30-60 secs at a time
slow breaths

25
Q

vibrations technique

A

during exhalation
in direction of ribs and soft tissue
usually done with 3 deeper breaths than normal post percussions followed by coughing

26
Q

rib springing technique

A

chest compression followed by overpressure and quick release at end expiration
only a few reps

27
Q

precautions/contraindications

A 
fractured ribs 
prone to hemorrhage
osteoporosis 
metastatic bone cancer 
burns/recent skin graft
subcutaneous emphysema of neck/thorax  
pneumothorax 
chest wall surgery
28
Q

Positive Expiratory Pressure (PEP) Mask

A

one way breathing valve
patient presses face against mask and slowly inhales through
inspires 5-20 times with active exhalations ratio of 1:3 or 1:4 usually followed by FET
go until patient has expelled all secretions usually about 15-20 mins
Good for children with CF

29
Q

What is collateral channel;s

A

the ventilation of alveolar structures through passages or channels that bypass the normal airways

30
Q

oscillating pep

A

handheld device which one breath into the device and it oscillates/vibrates the small/large airways
no difference between PEO for evidence based practice

PHTH 524 (15 decks)

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