wwallace rt test 2
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| Pressure range for PEP | show 🗑
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| Pressure range for flutter valve | show 🗑
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| What type Pt benefit most for IPV | show 🗑
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| What is an IVP | show 🗑
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| show | mechanical insufflations exsufflation, artificial cough machine, used mostly for pts with neuromuscular, usually at home, press plus 30 to 50 1 to 3 secs then neg 30 to 50 2 to 3 secs, oral nasal mask or trach
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| What pt benefits most from MIE | show 🗑
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| 8 complications of CPT and actions to be taken | show 🗑
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| show | admin higher FIO2
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| What action should be taken if a pt becomes hypoxic during CPT | show 🗑
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| What action should be taken if a pt has increased intracranial press or gets hypotention during CPT | show 🗑
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| What action should be taken for a pt who has a pulm hemorrhage during CPT | show 🗑
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| show | stop, use care return to resting position, call doc
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| show | stop, clear airway (suction prn) admin O2, return to resting position, call doc
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| show | stop, return to resting position, admin or increase O2, call doc, admin bronchodilators
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| What action should be taken for a pt who has arrhythmias during CPT | show 🗑
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| show | pulm barotraumas, increased ICP, cardio probs (hypotention), rash, air swallowing, aspirations, increased WOB
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| show | 1. Full inspiration followed by breathing at low lung volume to unstuck periph 2. Breathing at low to middle volumes collects mucus in middle airways, 3 evacuation, middle to large volume then huff
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| 4 contraindications of PEP | show 🗑
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| show | 5-25 hz (vest)
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| show | 15 hz for flutter and 1.6 to 3.75 hz for IPV
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| show | mimics directed cough, shoulders forward, head and spine flexed, good teaching instruct on control and exercise muscles for neuro, splint for pain
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| What is manually assisted cough | show 🗑
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| show | short low output series of coughs, use splint, helps with pain
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| show | open glottis, say huuufff, used in CF, bronchiectisis and emphysema
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| 4 phases of a cough and what happens in each phase | show 🗑
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| show | irritation cns, inspiration pain or restriction, compression surgery or nerve damage, expulsion obstruction weakness copd
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| Absolute pre and post assessments for postural drainage | show 🗑
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| show | explain Huff, inspiration larger thatn normal, but not full, active exhale but not forcefull, pap of 10-20 (use nuemometer), I:E is 1 to 3 10 to 20 breaths if they are still alive, 2 to 3 huffs repeat 4 to 8 times or 20 minutes
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| show | active cycle breathing 1. relax and control breathing then 3 or 4 expansion breaths, 2 repeat, 3 repeat then 1 or 2 huff coughs relax control and done
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| Major factor in contributing to retained secretions | show 🗑
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| Frequency when using IPV | show 🗑
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| show | (used with bland aerosol or meds) pt or rt controls
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| How long does the vest therapy usually last | show 🗑
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| show | CF
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| show | dangling
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| clinical signs observed with retained secretions | show 🗑
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| show | tender areas, site of trauma or surgery or bony spot
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| Normal airway clearance requires | show 🗑
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| show | operates from respiratory bronchioles to larynx, we then swallow or spit
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| show | via coordinated wave toward the larynx
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| show | it is a protective reflex that keeps a patent airway
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| The 4 distinct phases of a normal cough are | show 🗑
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| show | any abnormality that alters patent airway, mucociliary escalatory, normal cough, or causes retained secretions
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| Partial airway obstruction can cause | show 🗑
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| show | all ￢ﾀﾓ retained secretions cause an ineffective clearance
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| show | anesthesia, cns depression
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| Mechanisms impairing the cough inspiration phase | show 🗑
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| Mechanisms impairing the cough compression phase | show 🗑
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| Mechanisms impairing the cough expulsion phase | show 🗑
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| show | tumor, abnormality, bronchospasm (asthma, bronchitis) CF, Dyskintic Syndrome (impaired cilia)bronchiectisis, poor cough reflex (ALS, MD, etc)
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| Most common conditions affecting cough reflex are | show 🗑
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| show | to mobilize and remove retained secretions with the ultimate goal of improving gas exchange and reducing WOB
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| show | acutely ill with copious secretions, acute respiratory failure with retained secretions, acute lobar atelectasis, and V/Q abnormalities caused by lung disease
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| Acute conditions that do not need bronchial hygiene therapy are | show 🗑
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| show | CF, bronchiectisis, ciliary dyskinetic Syndromes and chronic bronchitis
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| show | 25 to 30 mL or one fluid ounce
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| What are the best documented preventive uses of bronchial hygiene therapy | show 🗑
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| show | postural drainage and percussion vibration therapy
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| 5 methods of bronchial hygiene are | show 🗑
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| show | 1 turning 2 Percussion (on exhalation) 3 vibration
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| show | ration of the body on its longitudal axis, aka kinetic therapy or continuous lateral rotational therapy, pt can do it, care giver can or rotational bed, purpose is to expand lungs and improve oxygenation, mobilize secretions, never with traction, head or
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| show | severe diarrhea, agitation, increased ICP, decreased BP, dyspnea, hypoxia, arrhythmias
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| show | improves oxygentation w/o affecting hemodynamics and lower FIO2 press on vent, may also decrease further lung injury associated with positive pressure vent in ARDS pt
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| Plumbing problems and turning | show 🗑
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| show | the use of gravity to help move secretions from lobes or segments into central airway, by placing the segmental bronchi to be drained in a vertical position relative to gravity for 3 to 15 minutes
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| show | 3 to 15 minutes
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| How much sputum does effective postural drainage produce | show 🗑
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| Postural drainage technique | show 🗑
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| Initial assessment of need for bronchial hygiene therapy from medical records includes | show 🗑
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| show | posture and muscle tone, ineffective cough, sputum, breathing pattern, physical fitness, breath sounds and vitals
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| Percussion and vibration refers to | show 🗑
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| show | pt position, time in position, tolerance, objective and subjective response to tx, sputum color consistency, volume odor and any bad effects of treatments
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| Directed cough | show 🗑
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| What is the most effective way to clear the central airways | show 🗑
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| What is the most effective way to clear the peripheral airways | show 🗑
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| What are the three important factors for good patient teaching | show 🗑
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| Directed cough patient position | show 🗑
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| show | good deep inspiration, bear down against glottis (straining like stool)
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| Manually assisted cough | show 🗑
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| Forced expiratory technique | show 🗑
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| Active cycle of breathing | show 🗑
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| show | relaxation and breathing control, 3 to 4 thoracic exercises, relax and bc, 3 to 4 thoracic exercise, relax and bc, 1 or 2 huff coughs, relax and breath control
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| show | big expansive inhalation with relaxed exhalation (may include percussion, vibration or compression)
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| ACB breathing control involves | show 🗑
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| Autogenic drainage is | show 🗑
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| show | artificial cough machine, in at 30 to 50 for 1 to 3 seconds then abruptly reversed at negative 30 to 50 for 2 to 5 seconds
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| PAP adjuncts | show 🗑
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| show | positive expiratory pressure for post op atelectasis, good for cf and bronchiectisis exhale through valve at 10 to 20 cmh20
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| Therapeutic effects of PEP | show 🗑
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| Contraindication to PEP | show 🗑
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| How long for PEP therapy | show 🗑
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| show | PEP
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| show | disassembled after each use and rinsed in water wash in soap every 2 days and disinfect by soaking in 1 to 3 solution of vinegar and water for 15 mins dry and reassemble
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Created by:
williamwallace
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