Therapeutic Procedures

Question 1

Patient Positioning

Answer 1

Changing a person position can help with oxygenation

Prone position = ARDS ( refractory hypoxemia)
Fowlers Position = CHF (45 degrees sitting up)
Lateral Fowlers = obese
Good lung down for unilateral lung disease
- allows the bad lung to have more space and there’s better air distribution.

Question 2

Hyperinflation/ lung expansion therapy

Answer 2

Prevention or treatment of atelectasis for patients who are willing and able to spontaneously take a deep breath

Question 3

Incentive Spirometry

Answer 3

Pt needs visual motivation and feedback

Should be performed hourly and 10 times an hour

Auscultate breath sounds before and after

Two types of IS
- volume
- flow

Troubleshooting : check connections and pts mouth seal

Question 4

Intermittent Positive Pressure Breathing (IPPB)

Answer 4

Indications
- prevent or correct atelectasis in patient unable or unwilling to take a deep breath
- prevent of decrease pulmonary edema
- decrease the pts WOB ( pts with COPD)
- distribute aerosols more evenly in the airways to better give medications
- improve and promote cough mechanisms

Contraindications
- unskilled practitioners and users
-Hypotension ( low BP, positive pressure messes up the venous return)
- untreated pneumothorax
- elevated intracranial pressure ( normal is 5-10)

Troubleshooting - check for a leak
Excessive pressure - obstruction or high flow
Fail to cycle- adjust sensitivity or tighten the seal