wwallace rt test 2
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show | 10 to 20 cmH2O
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show | 10 to 25 cmH2O
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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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show | neuromuscular ie muscular dystrophy myasthenia gravis etc. caustion with spinal shock and avoid abdominal distention with decreased insufflations pressure
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8 complications of CPT and actions to be taken | show 🗑
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What action should be taken for pt who has potential for hypoxemia during CPT | show 🗑
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show | stop, return to resting position, give 100 percent O2, call doc
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show | stop, return to resting position, call doc
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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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show | stop, return to resting position, admin or increase O2, call doc
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4 complications of PEP | show 🗑
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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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show | no absolutes, sinusitis, ear infection, epitaxis (nose blead, recent head or face surgery
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Frequency range for high frequency chest wall oscillation | show 🗑
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show | 15 hz for flutter and 1.6 to 3.75 hz for IPV
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Describe directed cough | show 🗑
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What is manually assisted cough | show 🗑
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Describe staccado cough | show 🗑
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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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show | ineffective cough, absent or increased sputum production, lobored breathing, decreased BS, crackle, rhonki, tachypnea, tachycardia, fever
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show | 1.6 to 3.75 hz
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Who controls percussive cycle in IPV | show 🗑
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How long does the vest therapy usually last | show 🗑
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Vest therapy may not be as effective as postural drainage or percussion in what pt | show 🗑
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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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Mucociliary clearance mechanism | show 🗑
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Ciliated epithelial cells move secretions | show 🗑
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Why is the cough important | show 🗑
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The 4 distinct phases of a normal cough are | show 🗑
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Abnormal airway clearance is | show 🗑
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show | increase WOB, air trapping, over distention, and V/Q mismatch (vent/perfusion imbalance)
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Which one of the 4 phases of a normal cough can retained secretions interfere with ? | show 🗑
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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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Diseases associated with abnormal clearance of mucus | show 🗑
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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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show | COPD, pneumonia and uncomplicated asthma
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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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show | 1 postural drainage, 2 coughing and expulsive techniques, 3 PAP adjunct (PEP, CPAP and EPAP), 4 high frequency compression oscillation (vest and flutter) 5 mobilization and exercise
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The 3 types of postural drainage are | show 🗑
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Turning | show 🗑
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show | severe diarrhea, agitation, increased ICP, decreased BP, dyspnea, hypoxia, arrhythmias
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Proning and acute lung injuries | show 🗑
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Plumbing problems and turning | show 🗑
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Postural drainage is | show 🗑
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How long should the position be held in postural drainage | show 🗑
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show | 25 -30 mL/day (1 fluid ounce or 1 shot glass)
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show | identify lobe or segment, position pt, avoid aspiration wait 1.5 hrs after food, coordinate treatment with pain meds, explain procedure, take baseline (HR, RR, SPO2, BS), check wiring tubing ect rail up, pt comfortable, restore pt posit,document/follow up
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Initial assessment of need for bronchial hygiene therapy from medical records includes | show 🗑
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Initial assessment of need for bronchial hygiene therapy from Patients include | show 🗑
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Percussion and vibration refers to | show 🗑
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Documentation and follow up includes | show 🗑
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show | mimics spontaneous cough, helps voluntary control reflex, compensate for physical limits
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What is the most effective way to clear the central airways | show 🗑
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show | cilia
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What are the three important factors for good patient teaching | show 🗑
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show | place pt in sitting position, shoulders rotated inward, head and spine slightly flexed, forearms relaxed or supported, support feet (raise head of bed if needed)
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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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show | (HUFF cough) a modification to the directed cough, one or two forced expirations of middle to low lung volumes with out closure of glottis, followed by diaphragmatic breathing and relaxation
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show | FET including breathing exercises, and thoracic expansion.
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ACB sequence | show 🗑
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show | big expansive inhalation with relaxed exhalation (may include percussion, vibration or compression)
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show | repeated cycles of breathing control, thoracic expansion and huff or FET
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Autogenic drainage is | show 🗑
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Mechanical insufflation exsuffation | show 🗑
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PAP adjuncts | show 🗑
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PEP | show 🗑
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show | improves distribution of inspired volume, prevents airway collapse, generates pressure distal to mucus obstruction
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Contraindication to PEP | show 🗑
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show | no more than 20 mins, active but not forcible breathing
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What is an effective alternative to postural drainage and percussion that a pt can perform independently with few side effects? | show 🗑
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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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