chest physiotherapy for nursing students.pptx

Nursing College

1. Chest physiotherapy Dr . Hoda Al- Kamali

2. Definition _ Chest physiotherapy is a group of therapies used in combination to mobilize pulmonary secretions . These therapies include : chest percussion , vibration and postural drainage . CPT should be followed by productive coughing or suctioning . _Chest physiotherapy is the removal of excess secretions from the lungs by physical means . Dr . Hoda Al- Kamali

3. CPT is followed by productive coughing or suctioning of a patient who has decreased ability to cough __ this is especially helpful for patients with large amount of secretions or ineffective cough Dr . Hoda Al- Kamali

4. Note : A treatment intervention employed for improving pulmonary hygiene including positioning , chest percussion , vibration and manual hyperinflation to assist in mobilizing secretions in the lungs from the peripheral airways into the more central airway so that they can be expectorated or suctioned out . Dr . Hoda Al- Kamali

5. The aims of chest physiotherapy are to : __ 1- remove bronchial secretions . 2- improve ventilation of the lungs . 3- increase the efficiency of the respiratory muscles . Dr . Hoda Al- Kamali

6. __ Postural Drainage ( - ( S egmented B ronchial Drainage Definition :- Is a specific position that allow the force of gravity to assist in the removal of bronchial secretions. The secretions drain from the affected bronchioles into the bronchi and trachea and are removed by coughing or suctioning . Dr . Hoda Al- Kamali

7. Postural drainage positions and the areas of lung drained by each position. * Frequently , six position are used , one for drainage of each lobe ; head down , prone , supine ,right and left lateral ,and sitting upright. Dr . Hoda Al- Kamali

8. Objectives of postural drainage : _ used to prevent or relieve bronchial obstruction caused by accumulation of secretions . __ because the patient usually sits in an upright position, secretions are likely to accumulate in the lower parts of the lungs . With postural drainage , different positions are used so that the force of gravity helps to move secretions from the smaller bronchial airways to the main bronchi and trachea . The secretions then are removed by coughing or suctioning . Dr . Hoda Al- Kamali

9. Contraindications of chest physiotherapy _ Massive hemorrhage . _ Hypertensive patients . _ Neurological patients as head injury . _ Old patients . _Patients with cardiovascular disorders. Dr . Hoda Al- Kamali

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16. Chest Percussion and vibration _ The thick secretions that are difficult to cough up my be loosened by tapping (percussing ) and vibrating the chest . Chest percussion and vibration help to dislodge mucus adhering to the bronchioles and bronchi . _ NOTES : percussion over chest drainage tubes , the sternum , spine ,liver , kidneys, spleen ,or breast (in women ) is avoided . _ Percussion is performed cautiously in the elderly because of their increased incidence osteoporosis and risk of rib fracture . Dr . Hoda Al- Kamali

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19. Nurse’s role and procedure Equipment : - Gloves - Stethoscope - Sputum container - Adhesive tap - Mouth wash - Tissue paper - Pillow Dr . Hoda Al- Kamali

20. Nurse’s role and procedure 1-Hand washing to avoid microorganisms 2- Prepare equipment 3-Provide privacy and Explain the procedure to the patient to gain cooperation and relieve anxiety and if patient use bronchodilators or mucolytic instruct him to use it also the nurse explain to patient how to cough to remove secretions ,if the patient can not cough the nurse may need to suction the secretions mechanically 4-Wearing gloves 5-Put patient in appropriate position according to auscultation of chest sound to know the secretion (Auscultation patient chest) where?? 6- The nurse instruct patient to remain in each position for 10-15 minutes Dr . Hoda Al- Kamali

21. 7-performed postural drainage 2-4 time per day before feeding and at bedtime to avoid nausea and vomiting and aspiration . 8-The nurse use chest percussion and vibration 9 - Ask the patient to cough to the container and note the secretion for amount , color , viscosity , and character of sputum . 10- Label the container 11- Auscultation of the chest after procedure to assess effectiveness of treatment 12- Assess pulse and skin color of patient and respiratory status 13- Give patient mouth wash and tissue paper 14-Put patient in comfortable position 15- Remove gloves and Hand washing 16- Documentation Dr . Hoda Al- Kamali

22. Nursing Management When performing chest physiotherapy , the nurse ensures that the patient is comfortable , is not wearing restrictive clothing ,and has not just feeding . The nurse gives medication for pain , as prescribed , before percussion and vibration and splints any incision and provides pillows for support as needed . The positions are varied , but focus is placed on the affected areas . The uppermost area of the lung are treated first . Dr . Hoda Al- Kamali

23. Nursing Management _ On completion of the treatment , the nurse assists the patient to assume a comfortable position . _ The nurse must stop treatment if any of the following occur: increased pain , increased shortness of breath , weakness , light headedness , or hemoptysis. _ Therapy is indicated until the patient has normal respirations , can mobilize secretions , and has normal breath sounds , and when the chest X-ray findings are normal . Dr . Hoda Al- Kamali

24. - breathing retraining and coughing exercise s 1- breathing retraining Definition: _ breathing retraining is exercises and practiced designed to achieve more efficient and controlled ventilation and to decrease the work of breathing . Dr . Hoda Al- Kamali

25. Objectives - Promote maximal alveolar inflation and muscle relaxation . - Relieve anxiety. - Eliminate ineffective patterns of respiratory muscle activity. - Slow the respiratory rate . - Decrease the work of breathing . Dr . Hoda Al- Kamali

26. General Instructions Breathe slowly and rhythmically to exhale and empty the lungs completely . Inhale through the nose to filter , humidify , and warm the air before it enters the lungs . Dr . Hoda Al- Kamali

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