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Topics of Respiratory Care > Test 1 Ch.44 Eagans Airway Clearance Therapy > Flashcards

Test 1 Ch.44 Eagans Airway Clearance Therapy Flashcards

1
Q

Any abnormality that alters airway patency, ______________ function, strength of ____________ muscles, thickness of ____________, or effectiveness of the cough reflex, can impair airway clearance leading to ______________of secretions

A

mucociliary;
breathing;
secretions;
Retention

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2
Q

What can result from full or partial airway obstruction?

A

Retention of secretions

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3
Q

Full obstruction, or _________ __________ can result in ____________ which causes hypoxemia due to ____________

A

mucous plugging;
atelectasis;
shunting

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4
Q

This causes increased WOB and possibly leading to air trapping, lung distention, and V/Q mismatch

A

Partial obstruction

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5
Q

Full obstruction ——->atelectasis—>

A

shunt——>v/q mismatch

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6
Q

partial obstruction —-> increased WOB——>

A

air trapping——>v/q mismatch

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7
Q

What are some causes of impaired mucociliary clearance in intubated pts (8) (EDON)

A
  • ETT or TT
  • Tracheobronchial suction
  • Inadequate humidification
  • High Fio2 values
  • Drugs
  • Opiates
  • Narcotics
  • Underlying pulmonary disease
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8
Q

Uses non-invasive technique designed to assist in mobilizing secretions and removing secretions to improve gas exchange, is referred to as?

A

Airway clearance therapy (ACT)

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9
Q

Examples of strength of breathing muscles

A

any neuromuscular disease:
MG
GB
muscular dystrophy
paralysis of diaphragm
restrictive diseases

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10
Q

Example of mucociliary function

A

smokers (destroying cilia b/c of the breathing in of tar)

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11
Q

Examples diseases for having thickness of secretions (2)

A
  • CF
  • bronchiectasis
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12
Q

When Mucous plugging happens it blocks the entire alveoli and now

A

it does not expand properly

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13
Q

What are some indications for ACT in acute conditions? (3)

A
  • Copious secretions
  • Inability to mobilize secretions
  • Ineffective cough
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14
Q

What are some indications for ACT in chronic conditions? (4)

A
  • CF
  • Bronchiectasis
  • Cilary dyskinetic syndromes
  • COPD pts w/ retained secretions
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15
Q

What is the primary goal of ACT?

A

To assist pts to mobilize and remove retained secretions

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16
Q

Removal of these retained will improve (3)

A
  • gas exchange
  • promote alveolar expansion
  • reduce WOB
17
Q

How do you determine the need for ACT?

A

Depends on the reviewal of the chart, medical history, CXR, Labs, assessing the pt’s current symptoms

18
Q

What is the initial assessment of the need for ACT: medical record?

A
  • History of pulmonary problems
  • Increase secretions
  • Admission for upper abdominal or thoracic surgery:
    *Age (elderly)
    *History of COPD
    *Obesity
    *nature of procedure
    *Type of anesthesia
  • PFTs
  • CXR
  • ABG values/ o2 sats
19
Q

What is the initial assessment of he need for ACT: patient (7)

A
  • posture, muscle tone
  • effectiveness of cough
  • sputum production
  • breathing pattern
  • general physical fitness
  • breath sounds
  • vitals, HR rhythm
20
Q

What are 5 general approaches to ACT, which can be used alone or in combination?

A
  1. CPT
  2. coughing and related expulsion techniques (mechanical insufflation- exsufflation)
  3. positive airway pressure (PAP) adjuncts
  4. HFCWO
  5. mobilization and physical activity
21
Q

Contraindications to use of Use of Chest Physical Therapy (CPT)

A
  • Head and neck until stabilized (A)
  • Active hemorrhage w/ hemodynamic instability (A)
  • ICP greater than 20 mm Hg (R)
  • Active hemoptysis (R)
  • Pulmonary embolism (R)
  • Empyema (R)
  • Osteomyelitis of the ribs (R)
  • Distended abdominal
22
Q

HFCWO devices are

A

passive oscillatory devices

23
Q

The generator for a HFCWO _________ and deflates the vest creating _____________ pulses against the thorax, resulting in chest wall ____________ and moving __________ forward.

A

inflates;
pressure;
oscillations;
secretions

24
Q

What are some key factors in selecting an airway clearance strategy

A
  • pt’s motivation
  • pt’s goals
  • pt’s ability to comprehend—- literacy cognitive levels/ can they follow directions?
  • physical limitations
  • physician/ caregiver goals
  • effectiveness of technique
  • ease of learning and teching
25
Q

What are some assessment outcome after ACT

A
  • change in sputum production
  • change in breath sounds of lung fields being drained
  • pt’s subjective response to therapy
  • change in vitals
  • chest xray
  • change in ABG values and sats
  • change in ventilators variables

Topics of Respiratory Care (20 decks)

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