CHEST PHYSIOTHERAPY (MPP pdf).Ghana Baptist Universitypdf

CHEST PHYSIOTHERAPY

1. GHANA BAPTIST UNIVERSITY COLLEGE,
ABUAKWA CAMPUS
SCHOOL OF HEALTH AND ALLIED SCIENCES
DEPARTMENT OF NURSING
ADVANCE NURSING I
NURSING 231
GROUP 2 PRESENTING ON
CHEST PHYSIOTHERAPY
LECTURER: MR. BENJAMIN AMOA-MENYA
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2. GROUP 2 MEMBERS
•SAKINATU NUHU ADAMS = NUR-24-098.
•DELPHINE SANU = NUR-24-146
•FATIMA ISSAH = NUR-24-097
•GLORIA ATTA OWUSUA = NUR-24-233
•ASAMOAH BRIDGET = NUR-24-144
•ACHIAA ESTHER = NUR-24-036
•EKYIA LINDA = NUR-24-236
•PATRICIA APPIAH = NUR-24-216
•MARY FOSUAA BADU = NUR-24-138
•DOROTHY ASANTE = NUR-24-234
•JOSEPHINE ODURO KYEI = NUR-24-235
•HASSANA MUSTAPHA = NUR-24-263
•JOSEPHINE ABEREMA ESSIEN = NUR-24-226
•HANNAH COBBINAH = NUR-24-232
•ANNING MARY = NUR-24-249
•ASARE FLORENCE = NUR-24-240
•PAULINA OSEI ACHEAMPOMAA = NUR-24-205
•OPPONG SEKYERE CONSTANCE = NUR-24-037
•ROSE KUMA = NUR-24-132
•AUGUSTINE OFORI MANU = NUR-24-173
•THEODORA PADIKI NARH = NUR-24-068
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3. OUTLINE
•Definition of Chest Physiotherapy
•Uses of Chest Physiotherapy
•Indications of Chest Physiotherapy
•Contraindications of Chest Physiotherapy
•Precautionary measure of Chest Physiotherapy
•Therapies of Chest Physiotherapy
•Equipment used in Chest Physiotherapy
•Procedure of Chest Physiotherapy
•Post Chest Physiotherapy measures
•Affected Lobes/Segments of the lung and its recommended position.
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4. CHEST PHYSIOTHERAPY
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5. DEFINITION
•Chestphysiotherapy(CPT)isagroupoftherapiesusedin
combinationtomobilizepulmonarysecretions.Chest
physiotherapyistheremovalofexcesssecretionsfromthe
lungsbyphysicalmeans.Thesetherapiesincludechest
percussion,vibrationandposturaldrainage.
•CPTisfollowedbyproductivecoughingorsuctioningofpatient
whohasadecreasedabilitytocough.
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6. USES
•Assistincoughing
•Reeducatebreathingmuscles
•Improveventilationofthelungs
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7. INDICATION
•Itisindicatedforpatientsinwhomcoughisinsufficienttoclearthick,
tenacious,orlocalizedsecretions.
•Examples:
•Cysticfibrosis
•Bronchiectasis
•Atelectasis
•Lungabscess
•Pneumonia
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8. CONTRAINDICATION
•IncreasedICP
•Unstableheadorneckinjury
•Activehemorrhageorhemoptysis
•Recentspinalinjury
•Ribfracture
•Flailchest
•Uncontrolledhypertension
•Anticoagulation
•Thoracicsurgeries
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9. PRECAUTION
•Keepsuctionapparatus&emergencyairway&oxygentherapywhile
providingchestphysiotherapy.
•Patientshouldbemonitoredthroughouttherapy.
•Adrenergicbronchodilatorsinsolutionshouldbeavailableincaseof
bronchospasmduringtherapies.
•Providecoughinginstructionpriortotherapy.
•Suctioningoftracheaisessential.
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10. COMPLICATION
•Hypoxemia
•Increasedintracranialpressure
•Acutehypotension
•Pulmonaryhemorrhage
•Pain
•Injuriestomuscles
•Vomitingandaspiration
•Bronchospasm
•Dysrhythmias
•Excessivelungvolume
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11. THERAPIES INCLUDE IN CHEST PHYSIOTHERAPY
•Chestpercussion
•Vibration
•Posturaldrainage
Chestphysiotherapyshouldbefollowedbyproductivecoughing&
suctioningofthepatient.chestphysiotherapyshouldneverbedone
straightafteramealordrink.
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12. PERCUSSION /CLAPPING
•Chestpercussioninvolvesrhythmicallyclappingonthechestwalloverthe
areabeingdrainedtoforcesecretionsintolargerairwaysforexpectoration.
•Positionthehandsothefingersandthumbtouchandthehandsare
cupped.
•Perform chest percussion by vigorously striking the chest wall alternately
withcupped hands.
•The procedure should produce a hollowsound and should not bepainful.
•Perform percussion over a single layerof clothing, not over buttons
or zippers.
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13. •Percussioniscontraindicatedinpatientswithbleedingdisorders,
osteoporosis,fracturedribsandopenwoundsandsurgeries.
•Don’tpercussoverthespine,sternum,stomachorlowerbackastrauma
canoccurtothespleen,liver,orkidneys.
•Typically,eachareaispercussedfor30to6osecondsseveraltimesaday.
•Ifthepatienthastenacioussecretions,theareamustbepercussedfor3-5
minutesseveraltimesperday.
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16. VIBRATION
•Vibrationisagentle,shakingpressureappliedtothechestwalltomove
secretionsintolargerairways.
•Thenurseusesrhythmiccontractionsandrelaxationsofarmandshoulder
musclesoverthepatient’schest.
•Duringvibration,placeyourflathandfirmlyagainstthechestwall,onthe
appropriatelungsegmenttobedrained.
•Vibratethechestwallasthepatientexhalesslowlythroughthepursedlips.
•Aftereachvibration,encouragetheclienttocoughandexpectoratesecretions
intothesputumcontainer.
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17. POSTURALDRAINAGE
•Posturaldrainageisatechniqueinwhichdifferentpositionsareassumed
tofacilitatethedrainageofsecretionsfromthebronchialairways.
•Gravityhelpstomovethesecretionstothetracheatobecoughedupeasily.
•Thegoalofposturaldrainageistohelpdrainmucusfromtheaffectedlobes
intothelargerairwaysofthelungssoitcanbecoughedupmorereadily.
•Allthepatientsdonotrequireposturaldrainageforallthelung
segments.Sotheproceduremustbebasedontheclinicalfindings.
•Inposturaldrainage,thepersonistiltedorproppedatanangletohelp
drainsecretionsfromthelungs.
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18. •Thelowerlobesrequiredrainagemostfrequentlybecausetheupperlobes
drainbygravity.
•Beforeposturaldrainage,theclientmaybegivenabronchodilator
medicationornebulizationtherapytoloosensecretions.
•Posturaldrainagetreatmentsarescheduledtwoorthreetimesdaily,
dependingonthedegreeoflungcongestion.
•Thebesttimesincludebeforebreakfast,beforelunch,inthelateafternoon,
andbeforebedtime.
•Itisbesttoavoidhoursshortlyaftermealsbecauseposturaldrainageat
thesetimescanbetiringandcaninducevomiting.
•Helpthepatientassumetheappropriateposition,basedonthelungfield
thatrequiresdrainage.
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19. EQUIPMENT'S USED IN CHEST PHYSIOTHERAPY
•Trendelenburgbed
•Pillows,Patientgownandtowel
•Sterilizedclothes
•Basin,Stethoscope
•Suctionapparatus
•Mechanicalpercussor
•Cardiacmonitoring,Pulseoximeter
•Chestradiograph
•Emergencyairway
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20. PROCEDURE OF CHEST PHYSIOTHERAPY
•Assessthechestx-rayforpulmonaryfindings.
•Assessrespiratoryrateofpatient.
•Assessbreathing,rhythm,skincolour,BP,HRofpatient.
•Assessthepatient`sabilitytotakedeepbreath
•Performchestphysiotherapy
•Afterpositioningtheclienthavethepatientremaininthedesiredpositionfor10to15
minutes,iftolerated.
•Performpercussionandvibrationbykeepingtheclientinposition.
•Thesequenceforchestphysiotherapyisusuallyasfollows:
•Positioning,percussion,vibration,andremovalofsecretionsbycoughingorsuction
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21. •Monitorthefollowingthroughoutthetherapy
Reaction
Discomfortanddyspnea
Heartrateandrhythm
Respiratoryrate
Sputumproduction,Breathesound
Skincolor
Mentalstatus
Oxygensaturation
Bloodpressure
•ModifythetechniquesofCPTaccordingtopatienttolerance
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22. POST CPT
•Patientshouldbeadvisedtopracticeoralhygieneprocedureto
decreasethebadtasteandodor.
•Recordtheprocedure
•Reportallsignificantfindings
•Disinfectallnondisposableequipmentusedandstoreappropriately
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23. LUNG LOBES ANDSEGMENTS
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30. REFERENCE
•CoyerFM,WheelerMK,WetzigSM,CouchmanBA(2007).NursingCareof
themechanicallyventilatedpatient:Whatdoestheevidencesay?
•PasquiropP,TremerM,WalderB(2007).Prophylacticrespiratoryafter
cardiacsurgery:systematicreview
•StarJA(1992).ManualTechniquesofChestPhysicalTherapyandAirway
ClearanceTechniques:ClinicsinPhysicalTherapyPulmonaryManagement
inPhysicalTherapy.NewYork,NY:ChurchchillLivingstoneInc.
•StapheA,RajeevA,GeelaniAM,MoizJA(2011).Effectofdifferentmodess
ofchestphysiotherapyonarterialbloodgasesfollowingpaediatric
cardiacsurgery.
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