treatments

Question 2

what are the indications for oxygen therapy?

Answer 2

documented hypoxaemia
severe trauma
acute MI
short term therapy
decrease the symptoms associated with chronic hypoxaemia

Question 3

what are the complications of oxygen therapy

Answer 3

oxygen toxicity
depression of ventilation
retinopathy of prematurity
absorption atelectasis
fire hazard

Question 4

what are the precautions for manual techniques

Answer 4

apply with care or avoid if
current large frank haemoptysis
severe clotting disorder
uncontrolled thoracic pain
rib fractures/flail segment/osteoporosis/cancer
active pulmonary TB
pneumothorax/surgical emphysema
over incisions, burns or frail skin
implanted venous access devices

Question 5

how do positions of ease reduce a patients WOB and sensation of breathlessness?

Answer 5

reducing the load
reducing energy demand

Question 6

name some strategies to encourage relaxation

Answer 6

mindfulness apps
positioning
breathing control

Question 7

what does pursed lip breathing do?

Answer 7

the positive pressure on exhalation prolongs expiratory time and reduces airway collapse in floppy airways of emphysema

Question 8

what are the indications for using NIPPY clearway?

Answer 8

used in the management of any patient in which cough effectiveness has been reduced and who are at risk of developing further respiratory complications

Question 9

how do adjuncts help

Answer 9

They help to keep your airways wide open to get air behind sputum to help move it towards the mouth. Minus PEP, they also provide vibrations that you will feel to thin and loosen the mucus in your lungs

Question 10

name some physical problems that can remain following an ICU stay

Answer 10

weakness
walking distance
fitness
lack of stamina
SOB
leg weakness
tiredness
aches and pains
muscle pain

Question 11

name some impactful sleep hygiene practices

Answer 11

get up and go to the sleep at the same time
establish a night time routine
limit caffeine
exercise
reduce stress
avoid large, fatty meals prior to sleeping
turn off electrics an hour before bed
create a healthy sleep environment

Question 12

what is some evidence for pulmonary rehabilitation

Answer 12

reduced mortality
low cost service run
reduces the financial burden on NHS
reduction in hospital admissions and length of stay
improves HRQoL e.g. reduced depression and anxiety
improves both functional and maximal capacity - walk further, do the things they enjoy

Question 13

what are the indications for CPAP

Answer 13

pneumonia
pulmonary oedema
flail chest
type 1 respiratory failure

Question 14

what are the contraindications for CPAP

Answer 14

risk of barotrauma
type 2 respiratory failure
excessive secretions
severe bronchospasm

Question 15

what are the precautions for CPAP

Answer 15

broncho pleural fistula
proximal airway tumour
raised intra cranial pressure/acute head injury

Question 16

what are the complications of suctioning

Answer 16

hypoxia/hypoxemia
atelectasis
bronchospasm
infection
increased intercranial pressure
pneumothorax
anxiety

Question 17

what are some contraindications for suctioning

Answer 17

suspected CSF leak
nasal fractures
stridor
severe bronchospasm

Question 18

what are some precautions for suctioning

Answer 18

pulmonary oedema
high intercranial pressure
nasal polyps
cancer high in respiratory tract
cancer high in the GI tract

Question 19

name the indications for nasal pharyngeal and oral suctioning

Answer 19

unable to clear secretions
secretions are audible/visible
secretions are persistent despite the patient’s best cough effort
secretions compromise oxygenation by decreasing SPO2/paO2 below what is acceptable for the patient

Question 20

what are the indications to ventilate a patient

Answer 20

respiratory failure
prolonged post op recovery
altered conscious level
inability to protect airway

Question 21

what are the complications with ventilation

Answer 21

CVS instability
barotrauma
V/Q mismatch
discomfort
excess secretions/infection
complications of high O2
gut and bowel dysfunction
weakened respiratory muscles

Question 22

How does IPPB work

Answer 22

positive pressure is delivered using a respirator and mouth piece or mask
the flow of gas is triggered by the patients own inspiratory effort. sustained positive pressure is applied to the patients airway to a pre-set level, set by the physio
this pushes the patient into IRV and increases inspiratory lung volume
once the pre set inspiratory pressure is reached, the machine ceases to flow and pressure returns to 0. the patient breathes out passively

Question 23

when should you consider IPPB

Answer 23

to open up collapsed alveoli

Question 24

what are the contraindications of IPPB

Answer 24

risk of barotrauma
severe bronchospasm
excessive secretions
inability to protect airway from aspiration

Question 25

what are the precautions of IPPB

Answer 25

proximal airway tumours
raised intracranial pressure/acute head injury
broncho pleural fistula