Therapeutic Procedures Flashcards
To enhance a patient’s oxygenation, what are the positions you would recommend for the following patient diagnosis or conditions?
ARDS-CHF-obesity-unilatleral lung disease
Prone
Fowlers
Lateral Fowlers
Good lung down
What procedure benefits patients by increasing their muscle, strength and endurance, decreases dyspnea, the need for medication and hospital visits
Inspiratory muscle training or IMT
You should instruct a patient to use an inspiratory muscle training device twice per day for 10 to 15 minutes per session, building up to 30 minutes. You want to increase the resistance until their results are what percentage of their measured MIP?
30%
What is the therapeutic procedure you would recommend for the prevention of atelectasis
Sustained maximal inspiration (SMI)
Compared to preoperative inspiratory capacity, what is the postoperative goal in incentive spirometry?
1/2
What are the five indications for IPPB therapy?
Prevention, or correction, of atelectasis in a patient, unable to take a deep breath
Prevention or correction of pulmonary edema.
Decrease the work of breathing (accessory muscles in COPD)
Distribute aerosols more evenly
Improved and promote the cough mechanism
What are contraindications for IPPB?
Hypotension
Elevated intracranial pressures
Untreated pneumothorax
What are five hazards of IPPB?
Hyperventilation
Impede venous return
Gastric distention
Pneumothorax
Excessive oxygenation and increased air trapping in patients with COPD
You should adjust the IPPB sensitivity setting to be in what range
1.0 to 2.0 cm of H2O
Decreasing the flow in IPPB will have what impact on the volume
It will increase the volume as the flow becomes more laminar 
What is the three reasons to provide bronchial hygiene therapy?
Improve mobilization of secretions
Prevent accumulation of secretions
Improve ventilation
What does ciliary dyskinesia mean and what would be a therapy you could recommend?
Dysfunction of normal movement of the cilia
Bronchial hygiene therapy
What are the four hazards or contraindications to bronchial hygiene therapy?
Unstable cardiovascular system
Unstable pulmonary system
Unstable, postoperative status
untreated tuberculosis
What position would you recommend in bronchial hygiene therapy for the following? Patient conditions: hypoxic patients, obese patients with dyspnea, postop, abdominal surgery, patients, and patients with pulmonary edema.
Reverse trendelenburg or semi-fowlers
What position in bronchial hygiene therapy would you recommend for a patient with very low blood pressure or who are obese and don’t have dyspnea
Trendelenburg’s
Why would you use lateral Fowlers in bronchial hygiene therapy?
Very obese patients with air hunger
What is the best position to prevent aspiration in bronchial hygiene therapy?
Lateral flat
What is the position of the bed during bronchial hygiene therapy in patients with lingular or middle lobe consolidation?
Incline 12 to 14 inches or 15%
What incline and positions should the patient be for postural drainage of the upper lobes?
Flat
Apical-semi fowlers with bed flat
Anterior-supine with pillow under butt
Posterior-sitting but leaning forward
How high should you raise the bed for postural drainage of the lower lobes?
18 to 20 inches or 30%
Please describe the patient position with respect to the bed for drainage of the superior segment to the lower lobes
Head of bed flat and patient prone with a pillow under their midsection
What are hazards and contraindications to chest percussion?
Metastatic conditions
Pulmonary emboli
Tuberculosis
untreated pneumothorax
Pleural effusion
Hemolysis/pulmonary hemorrhage
Rib, fractures
soft tissue trauma
If a patient does not tolerate manual percussion, what should be considered?
Mechanical percussion or vibration devices
Vibration techniques can be used instead of just percussion, but I have the following associated contradictions?
Rib fracture or trauma
soft tissue trauma
What type of cough is it when the therapist applies pressure on a patient’s abdomen during exhalation
Quad cough
What is the type of coughing with an open glottis and who is it recommended for?
Huff cough
More effective impatience with COPD or head trauma to prevent increased intracranial pressures
What are some cough control techniques a respiratory therapist could recommend
Position
relax between efforts
Volume building -multiple inhalations
Multiple cough with single exhalation
Serial coughs-incremental depth and force
Splitting over incision site