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Bronchial Hygiene Therapy - Unit 1 > Unit 1 - Bronchial Hygiene Therapy > Flashcards

Unit 1 - Bronchial Hygiene Therapy Flashcards

1
Q

Airway clearance therapy uses what?

A

Noninvasive techniques to improve gas exchange

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2
Q

Normal clearance requires three things:

A

Patent airway, Functional mucocilary escalator, effective cough

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3
Q

What can an effective cough do?

A

Move mucus from lower airways to upper airways (to be coughed out)

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4
Q

Abnormal clearance is any abnormality that alters: 5 factors:

A

Airway patency, Mucocilary function, Breathing muscle strength, secretion thickness, cough reflex

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5
Q

Normal clearance 4 steps to cough:

A

Irritation, Inspiration, Compression, Expulsion

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6
Q

Retention of secretions may result in two things:

A

Full obstruction or mucus plugging, partial obstruction that restricts airflow.

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7
Q

Full obstruction results in what?

A

Atelectasis - causes hypoxemia due to shunting.

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8
Q

Partial obstruction can do what?

A

Increase WOB, Air-trapping, lung over-distention, and V/Q imbalances.

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9
Q

Diseases associated with abnormal clearance:

A

CF, Bronchiectasis, Neuromuscular diseases

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10
Q

Intubated patients may have these factors associated with impaired mucocilary clearance:

A

Endo or trach tube, Tracheobronchal suction, Drugs, high FiO2 values, Opiates, underlying pulmonary diseases.

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11
Q

Indications for airway clearance therapy for ACUTE conditions?

A

copious secretions, inability to mobilize secretions, ineffective cough.

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12
Q

Indications for airway clearance for CHRONIC conditions?

A

CF, Bronchiectasis, ciliary dyskinetic syndromes, COPD patients with retained secretions.

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13
Q

Who could benefit from airway clearance therapy?

A

Acutely ill patients, CF

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14
Q

Physical findings that determine the need for airway clearance?

A

Loose, ineffective cough, Labored breathing pattern, Coarse inspir. & expir. crackles, Tachypnea/Tachycardia, Fever

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15
Q

Five ways or approaches to doing airway clearance?

A

CPT, Cough, Positive Airway pressure, High frequency compression, physical activity or mobilization.

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16
Q

What is Chest Physical Therapy (CPT)?

A

Use of positioning & gravity; cupped hand striking; mechanical vibrations.

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17
Q

What are some limitations to CPT?

A

May not tolerate Trendelenburg position (if dyspnea), dependent on appropriate positioning, requires help of caregiver.

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18
Q

How long does caregiver perform CPT?

A

3 - 5 minutes on each affected area/lobe.

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19
Q

Factors to assess Airway clearance methods? Did it work?

A

Change in: sputum production, breath sounds, dyspnea level, vital signs, chest radiograph, ABG results, ventilator variables.

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20
Q

What items need to be documented & followed up in airway clearance methods?

A

Positions used, time in positions, patient tolerance, indicators of effectiveness, any bad effects observed.

21
Q

What is a directed cough?

A

Deliberate cough that is taught, supervised, and monitored. Mimic the spontaneous cough.

22
Q

Who can’t use directed cough?

A

Obtunded, paralyzed, or uncooperative patients.

23
Q

What is Forced Expiratory Technique (FET)?

A

Modification of directed cough - “HUFF cough”; one or two forced expirations of middle to low lung volumes without closure of glottis.

24
Q

What is FET goal?

A

To clear secretions with less change in pleural pressure and less bronchial collapse.

25
Q

FET is most helpful to what patients?

A

COPD, CF, bronchiectasis

26
Q

What is Manual Assisted Cough?

A

External application of pressure to the thoracic cage or epigastric region with forced exhalation.

27
Q

Who benefits from Manual Assisted Cough?

A

Patients with neuromuscular conditions that cannot generate forceful expulsion.

28
Q

What are the steps to Active Cycle of Breathing Technique?

A

Relaxation & Breathing control, 3-4 thoracic expansion exercises, repeat twice, then at least 1 huff cough (FET), and repeat relaxation/breathing control.

29
Q

Positive Airway Pressure is used to treat?

A

Atelectasis and mobilize secretions.

30
Q

The three types of Airway pressure devices:

A

Continuous PAP (CPAP), expiratory PAP (EPAP), and positive pressure (PEP)

31
Q

Physical activity therapy should result in 4 things:

A

Increased tidal ventilation, increased heart rate, increased cardiac output, and improved physical conditioning.

32
Q

The PEP device uses what flow?

A

fixed or variable orifice expiratory flow restrictor to generate expiratory pressures of 10 to 20 cmH2O as patient actively exhales through device.

33
Q

What is high frequency Compression or Osscillation?

A

Vest: inflates/deflates, creating pressure pulses against the thorax that cause chest wall oscillations and move secretions forward.

34
Q

Intrapulmonary percussive ventilation does what?

A

Rapid series of pressurized gas minibursts to the airway at rates of 100 to 225 cycles per minute.

35
Q

What is bronchial hygiene therapy?

A

Non-invasive techniques to improve gas exchange and promote, mobilize, and remove secretions.

36
Q

Characteristics of CF?

A

Increased sputum viscosity, increased mucus volume & impaired clearance.

37
Q

Who typically gets CF?

A

Children and young adults

38
Q

Characteristics of Bronchiectasis?

A

Mucostasis, retained secretions, loss of mucuciliary escalator and repeated pneumonia.

39
Q

Who typically gets Bronchiectasis?

A

Adults with history of lung infection

40
Q

Three ways to rotate the body along the longitudinal axis?

A

Self-turning, caregiver turning, rotational beds

41
Q

Roto rest bed is done for two reasons if patient is?

A

Sedated, paralyzed

42
Q

Contraindications of Rotobed?

A

Morbidly obese, rib fractures, cervical spine injuries

43
Q

Dolphin Mattress does what?

A

Keeps mucus and secretions moving in the lungs.

44
Q

What position should the “good” lung be in?

A

Down always. “Good down, bad up”

45
Q

Contraindications of Chest PT?

A

Intercranial pressure, spinal cord injury, Feeding tubes, Burns/wounds, Combative, osteoporosis, rib fractures.

46
Q

What is Autogenic Drainage?

A

Modified coughing technique: breathing pattern that varies lung volume and expiratory flow in three different phases.

47
Q

Mechanical insufflation exsufflation (MIE) technique does what?

A

Blow first, then suck last. Pressure in then pull back out.

* Good for cardiac patients.

48
Q

Where is the flutter Valve used?

A

At-home patients

49
Q

Acapella is used for how long?

A

10 - 20 minutes

Bronchial Hygiene Therapy - Unit 1 (1 decks)

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