Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CI1 > Treating Lung Collapse > Flashcards

Treating Lung Collapse Flashcards

1
Q

What is the physiological rationale for positioning for lung collapse?

A

Improving

  • Regional volume (i.e. uppermost lobe will stretch open the most due to gravity pulling down)
  • Lung volumes (e.g. FRC)
  • V/Q matching
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does positioning to increase regional lung volume involve?

A
  • Imposes stretching force on alveoli
  • Placing the collapsed segment of the lung uppermost
  • Causes passive increase in lung volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does positioning to increase lung volume involve?

A
  • Increasing FRC by standing patient (or as close as possible)
  • Keeping FRC above closing capacity at all times (to prevent collapse)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the best way to increase a patient’s FRC?

A

Stand them up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does positioning to improve V/Q matching involve?

A
  • Placing the collapsed segment of the lung uppermost
  • Results in the V/Q occurring in the good lung due to gravity
  • Improves the patient’s O2 sats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the precautions for positioning?

A
  • Pain
  • Anxiety
  • Limitations due to recent surgery e.g. hip, vascular
  • Pneumonectomy (upright only)
  • Attachments, esp ICC
  • Orthopaedic injuries, e.g. pelvic/spinal fractures
  • Intracranial injury (raised IC pressure)
  • Recent angiography (avoid hip flexion)
  • Critically ill/unstable patients
  • Head down position
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the practical considerations of positioning?

A
  • Can’t stay in one position all day
  • Educate patients, carers, nursing staff
  • Manual handling ‘no lift’ policy
  • Safety of staff & patient
  • Equipment
  • Prepare the environment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the physio techniques for improving lung volume?

A
  • Positioning
  • Mobilisation
  • PEP
  • Deep breathing & thoracic expansion exercises
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does mobilisation include?

A
  • Tilt table
  • SOOB
  • Standing
  • Marching on spot
  • Walking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the aim of mobilisation?

A

Stimulate increase in ventilation (TV x RR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the other benefits of mobilisation?

A
  • Cardiovascular
  • Musculoskeletal
  • Functional treatment, important ADL
  • Independence
  • Psychological
  • One requirement for discharge from hospital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What has evidence found in regards to mobilisation and PPCs?

A

Patients 3 times more likely to develop PPCs for each day they do not mobilise away from bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the precautions for mobilisation?

A
  • Respiratory: PaO2/FiO2 ratio <300
  • Attachments
  • CV status
  • WB status
  • Nausea & vomiting
  • Patient cooperation
  • Environmental risks (prepare space, chair, slippers)
  • Prepare for emergency situation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the practical considerations for mobilisation?

A
  • Know/assess patient’s pre op level of mobility
  • Dose & intensity (need to increase TV & RR)
  • Prepare self, patient, environment
  • Walking frames are useful in early post op period, esp for attachments
  • Always have assistance, esp at the start
  • Includes transfers from bed/chair
  • Stairs prior to discharge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the physiological rationale of using PEP for lung collapse?

A

Same as sputum clearance

  • Uses positive pressure of blowing to create back pressure in airways
  • Uses collateral ventilation to re-open collapsed airways
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the contraindications for PEP?

A
  • Undrained pneumothorax
  • Frank haemoptysis
  • Extensive bullae or cysts
  • Recent pneumonectomy
17
Q

What are the precautions for PEP?

A
  • Altered consciousness, confusion (risk of drinking the water)
  • Paediatric patients (risk of drinking, aspirating)
  • Patients requiring high/continuous O2 therapy
18
Q

What is the physiological rationale for deep breathing exercises?

A
  • Slow deep inspiration from FRC to TLC
  • Results in increased alveolar filling time, encourages ventilation to dependent lung regions
  • Inspiratory hold/sustained max inspiration redistributes gas via collateral channels, sustained alveolar stretch
19
Q

What are the benefits of deep breathing exercises?

A
  • Increase lung volumes, FRC, minute ventilation
  • Increase surfactant secretion
  • Increase lung compliance
  • Decrease dead space ratio
  • Improve regional ventilation, V/Q matching, oxygenation
20
Q

What are the precautions for deep breathing exercises?

A
  • Pneumothorax without chest drain
  • Recent insertion of central line until CXR assessment
  • CV instability (low BP)
  • Pain
  • Extreme SOB
  • Dizziness
  • Hyperventilation
21
Q

What are the practical considerations for deep breathing exercises?

A
  • Recommendations from literature (5 deep breaths, 3s inspiratory hold hourly)
  • Manual feedback (hands for LBE)
  • Verbal coaching
  • Independent practice of correct technique
22
Q

What was the physiological rationale behind incentive spirometry?

A
  • Device that provides visual feedback on inspiratory flow & volume during a deep breathing manoeuvre
23
Q

Why should incentive spirometry not be used?

A

11 studies about incentive spirometry, evidence shows that it has no effect in the prevention of PPCs

24
Q

What are the practical considerations for incentive spirometry?

A
  • Does not encourage inspiratory hold
  • Some devices can encourage fast inspiratory flow
  • Therapist needs to monitor pattern of breathing
  • Can increase WOB
  • Some doctors still request routinely
  • Disposable
25
Q

What is pre op IMT for cardiac & major abdominal surgery associated with?

A
  • Reduced incidence of pneumonia
  • Reduced incidence of atelectasis
  • Reduced LOS

CI1 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions