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44 Cards in this Set
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- Back
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What is the purpose of CPT?
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Facilitates the clearance of secretions in the lungs.
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What is the definition of Bronchial Hygiene Therapy?
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Maintenance of clear airways and removal of secretions from the lungs.
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What are the three techniques utilized in CPT?
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Postural Drainage
Chest Percussion Vibration |
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What are the goals of CPT?
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Aid brochial hygiene
Prevent acuumulation of pulmonary secretions Aid in mobilization of retained secretions. Improve distribution of ventilation Improve gas exchange |
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What are the indications of CPT?
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Pt. has excessive sputum production(>25-30ml day)
Pt. diagnosed with: Bronchiectasis Cystic Fibrosis Lung Abscess Difficulty clearing secretions Evidence of retained secretions Prolonged bed rest Preventive use on post op. pts. |
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How does postural drainage help to remove secretions from the airway?
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allows gravity to facilitate in the removal of the secretions.
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When a pt. is positioned with diseased lung down-what happens?
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Blood flows to gravity causing v/q mismatching, hypoxemia, & cardiopulmonary stress.
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If a pt. had pneumonia in the left lateral basal segment, which position would the pt. most likely become hypoxemic? Why?
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Right bilateral basal segment.
Blood would follow gravity. |
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What areas should you never percuss over?
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Clavicles, Scapulae,Sternum
Spine, Female breasts, Abdomen, Kidneys, Area where lung or lobe removed. |
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Explain what Vibration is and how it is performed?
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Helps to stimulate the movement of secretions.
Place hands firmly on on chest wall over lung segment being treated. Have pt. take deep breath then exert moderate pressure on the chest wall. On expiration initiate rapid vibrating motion of the hands. |
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During what part of the ventilatory phase is Vibration performed?
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At. expiration
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What is the purpose of a vibration manuever?
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To stimulate the movement of secretions.
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What are the contraindications of Percussion?
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Hemorrhagic conditions
Fragile Bones Bony Metasteses Undrained Empyema Untreated Pneumothorax Pulmonary Emboli Lg. Pleraul Effusion Recent epidural or anesthesia |
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What are the contraindications of Postural Drainage?
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Unstable cardiovascular system
Unstable pulmonary system Untreated Tuberculosis Increased ICP Spinal injury or surgery Head & neck injury |
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Would you do CPT on a pt. who is coughing up blood?
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No.
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Would you do CPT on a pt. who has a pneumothorax with a chest tube in place?
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Yes....modify
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Would you do CPT on a pt. who has a lung abscess?
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Yes.
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Would you do CPT on an undrained Empyema?
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No
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How is an empyema drained?
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Surgically
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If you position a pt. in trendelenburg could it cause hypoxemia?
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Yes.
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If a pt. suffers any adverse signs during CPT would you continue the tx until you are finished?
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******No.
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If you are performing trendelenburg on a pt. and they c/o of dizziness what is the first immediate action?
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Stop and take pt. to level.
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Is it ok to put a pt. who has an increased ICP or head injury in a tendelenburg posion for CPT?
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No
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How long should you wait to perform CPT on a pt. who has just eaten? Why?
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30 minutes.......
aspiration on vomiting |
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What platelet levels are considered to be dangerous levels for CPT and why?
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<150,000
Hemorrhaging |
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What needs to be checked in the pts. chart prior to starting CPT on pt.?
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Order
Past surgeries Cardiovascular problems CXR Lab data |
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What needs to be monitored during CPT?
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HR,RR,& Breathsounds
Blood pressure & EKG monitor Sputum Pulse Oximetry Skin color ICP level Subjective response of Patient |
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How can you assess the pt's oxygenation level during CPT?
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Pulse Oximeter
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How can you assess the pt's cardivascular status during CPT?
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EKG monitor
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What could you look at to assess the progress of your pt. who is recieving CPT?
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Auscultation-Changed or Improved
Inspection-Color, chest expansion Cough-Sputum amount & characteristics Toleration-Fatigue, Pain, WOB Vital signs- increase or decrease CXR-problem area improved Oxygenation-Imp. Pa02/SaO2 |
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How can you localize a disease process for regional CPT?
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CXR
Auscultation Percussion & Palpation |
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When is it appropriate to discontinue CPT?
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Clear breathsounds
Clear CXR Ambulating well Strong cough Afebrile for 24 hours Pt. can't tolerate CPT not working- no sputum Doctors orders |
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What are all the various coughing techniques and what are the used for ?
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Manually assisted cough-Used on pts. with spinal cord injury or MD.
Directed cough- Pts. w/ CF, Brochiectasis, Pulmonary infections, spinal cord injuries. Forced expiration cough- helps to clear secretions with less change in pleural pressures and less likelihood of bronchiolar collapse. Autogenic Drainage- Used on CF pt's. |
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What is PEP therapy and what is it used for?
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Positive expiratory pressure therapy.
Facilitate opening of the airways and to reduce residual volume. |
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What is Autogenic Drainage and what is it used for?
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Pt. uses diaphragmatic breathing to improve mucus clearance by varying lung volumes and expiratory airflow in 3 phases. Commonly used in patients with Cystic Fibrosis.
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What do oscillators do?
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Physical mucolytic enhancing clearance of secretions.
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What is Oscillation?
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The rapid vibratory movement of small volumes of air back and forth in the respiratory tract.
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What is one type of external chest wall oscillator and how does it work?
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HFCWO-application of pressure pulses to the thoracic cage via a pneumatic inflatable vest.
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What are the 4 types of oscillators?
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Chest wall oscillator
Flutter valve Acapello IPV |
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What is a flutter valve and how does it work?
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A device to loosen, mobilize, and eliminate mucus from your airways.
Exhalation causes airway vibrations that loosen mucus and creates a slight increase in pressure that aids in keeping airways open. |
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What is an Acapello and how does it work?
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It is a PEP device and operates by directing air through an opening which is periodically closed by a pivoting cone. The result is a vibrating pressure waveform tand also creates a positive pressure throughout the exhalation process.
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What is IPV and how does it work?
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Intrapulmonary Percussive Ventilation- Uses a pneumatic or electrical device to deliver a series of minibursts to clear and maintain airways. Assists in the mobilization and removal of secretions and assist in the resolution of atelectasis.
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What is an Acapello and how does it work?
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It is a PEP device and operates by directing air through an opening which is periodically closed by a pivoting cone. The result is a vibrating presuure waveform and crerate a positive pressure throughout the exhalation process.
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What is IPV and how does it work?
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Intrapulmonary Percussive Ventilation- Uses a pneumatic or electrical device to deliver a series of minibursts to clear and maintain airways. Assists in the mobilization and removal of secretions and assist in the resolution of atelectasis.
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