Red flags

what are some of the adverse effects of coughing

syncope, headache, nausea, haemoptysis, SOB, chest pain, stress incontinence, fatigue

What are the benefits of FET compared to cough

less tiring, less airway collapse, less desaturation, less airway damage

what are the effects of PEP

splints open airways, temporarily increases FRC, promotes collateral ventilation

describe how aerobic exercise may be beneficial in the management of impaired airway clearance

increases expiratory flow = shearing of sputum, bronchodilatory effect, stimulate cough, increase water content in mucus

what are some of the cautions and contraindications to ACTs

haemoptysis, pneumothorax, chest wall pain/trauma, GORD, increased ICP, nausea, vomiting

describe how ICCs should be assessed and the significance of each observation

swinging = drainage is good

bubbling = air coming through is bad

suction = having trouble draining it

volume drained = is it constant and adequate/expected

in addition to PPCs what needs to be addressed in thoracic surgical patients

pneumothorax, subcutaneous emphysema, pleural effusion, empyema

symptoms of hypoxaemia

BP and HR changes, cardiac arrhythmias, cyanosis, increased RR, drowsiness, headache, disorientation, nausea, decreased cognitive function

ventilation in side lying diaphragm function

weight of mediastinum slightly stretches diaphragm improving the length tension relationship and allowing it to contract harder

what factors influence rate fo diffusion

thickness of wall, surface area for gas exchange, air-blood contact time

hypercapnia from oxygen therapy in COPD

Oxygen takes over haemoglobin, which means CO2 cannot be released as esaily, making it build up in the bloodstream = hypercapnia

physiological principles of ACTs

two phase liquid gas flow, equal pressure point, collateral ventilation, interdependence

polycythaemia

increased production of red blood cells to try transport more oxygen, makes the blood more viscose

inertial impaction

meds require different inspiration rates to work optimally without just hitting the back of the throat

gravitational sedimentation

holding breath when taking meds to ensure particles settle in lungs and don’t get breathed back out

causes of hypoventilation

neurological deficits, muscular dysfunction/fatigue, chest wall trauma

hazards and misuses of oxygen therapy

carbon dioxide retention, decreased MCC, drying up secretions

benefits of breathing control

reverse restrictive effects of TEE and FET, reduce WOB, improve control over breathing

constructs of dyspnoea

sensory (intensity)

affective (distress)

impact of daily life

oblique lung fissure

T3 SP to 5th intercostal space in midaxilla, 6th costochondral joint

horizontal fissure of lungs

5th intercostal space at midaxilla to sternum (right side only)

pathophysiology of dyspnoea in COPD

airflow limitation causes hyperinflation which causes increased work of breathing, which fatigues respiratory muscles, further increasing work of breathing.

Arm and leg deconditioning decreases the lactic acid threshold which increases ventilatory drive