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where is the bed- flat
upper lobes
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where is the bed- down 15'
mid lobes
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where is the bed- down 30'
lower lobes
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what is the purpose of bronchial hygiene therapy
- improve mobilization of secretions
- prevent accumulation of secretions
-
indications of bronchial hygiene
ineffective cough
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consider bronchial hygiene for pt with
-
-
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fowlers, semi fowlers
- best position for hypoxic pt,
- obese w/ dyspnea,
- post op abdominal,
- pulm edema
-
tredelenburg is for pt with very
low bp
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indication for chest percussion
- combination with postural drainage
- secretions difficult to dislodge
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technique of chest percussion
cupped hands
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when pt does not tolerate manual percussion, what can be given
mechanical percussion or vibration
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purpose of vibration is to move secretions to
larger airways
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technique to use while doing vibrations
- hand over hand
- have pt inhale deep and exhale through pursed lip
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pressing pillows over incised area to enhance better cough is called
splinting
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applying expiratory positive airway pressure using a one way inspiratory valve and a one way expi flow resistor
PEP pos exp press therapy
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the exp flow resistor prevents
end exp pressure from falling to zero
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exp pressure on a PEP should range from
10-20 cmh20
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PEP therapy should be used for
15-20 min intervals, 3-4 times a day
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a combination of pos exp pressure therapy with a high frequency oscillations at the airways is what type of device?
vibratory/oscillatory PEP device
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HFCW
high freq chest wall - vest
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a combination of high freq pulse delivery (100/250 cycles/min) of a sub tidal vol and dense aerosol
IPV- intrapulm percussive ventilation
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what is the most common hazard of suctioning
trauma to mucosa- must lubricate cath
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most severe cause of suctioning
hypoxemia
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during suctioning, if you stimulate the ___ ____ you will make the pt be bradycardic
vagus nerve
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vacuum pressure for adult
100-120 mm hg
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vacuum pressure for child
80-100 mm hg
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vacuum pressure for infant
60-80 mm hg
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the Coude tip catheter is angled to help suction the
left main stem bronchus
-
a closed sys or inline suction cath allows the pt to
receive vent and oxy during suctioning
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the external diameter of the suction catheter should ideall be no greater than
1/2 the inside diameter (ID) of the ett or trach tube
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what is the formula for catheter size=
ID size/2
then multiply answer by 3
8.0 mm ID/ 2 = 4 X 3 = 12 Fr
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used to suction the mouth and throat, using aseptic tech
oral suction device/ Yankauer/ Tonsil suction device
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used to collect a sputum specimen
lukens trap/ sterile suction trap
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what can be instilled to dilute secretions too thick to aspirate through the suction cath
5-10 ml of normal saline
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suction cath should be in the airway no longer than
15 sec
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