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Chest Physiotherapy and Postural Drainage

1. Chest physiotherapy and postural drainage are techniques used to help clear secretions from the lungs of a 38-year old female patient admitted with compromised lung conditions. 2. The techniques include percussion, vibration, and positioning the patient in various postures to drain secretions using gravity. 3. The nurse assesses the patient, ensures comfort and safety during the procedure, and monitors for signs of improvement or complications until secretions are cleared and breathing and chest exam are normal.

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Riza Angela Barazan
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105 views

Chest Physiotherapy and Postural Drainage

1. Chest physiotherapy and postural drainage are techniques used to help clear secretions from the lungs of a 38-year old female patient admitted with compromised lung conditions. 2. The techniques include percussion, vibration, and positioning the patient in various postures to drain secretions using gravity. 3. The nurse assesses the patient, ensures comfort and safety during the procedure, and monitors for signs of improvement or complications until secretions are cleared and breathing and chest exam are normal.

Uploaded by

Riza Angela Barazan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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CHEST PHYSIOTHERAPY

and Postural Drainage

Facilitators:
Asst. Prof. Mary Nathalie Cataal
Asst. Prof Veveca V. Bustamante
Learning Objectives
The learners will be able to :
• assess the patient for postural drainage.
• apply the principles and demonstrate different
positions of patients for postural drainage.
• manifest adequate skills in chest physiotherapy.
• document and record about the procedure and
the patient's response.
Scenario
A 38 year old female patient is admitted in
the surgical ward with lung compromised
conditions, inability to breathe well and with
thick tenacious secretions.
For chest physiotherapy as ordered by Dr.
Sy.
Percussion
The manual application of light
blows to the chest wall
Cupping -used for the manual
percussion of lung areas to loosen
pulmonary secretions
VIBRATION
• Rhythmic contraction and relaxation
of the arm and shoulder muscles
while holding the hands flat on the
patient’s chest wall
• Ask the patient to exhale after a
deep inspiration and vibrate as the
patient’s exhales
Postural Drainage
• Positioning the patient so that the force
of gravity helps the lungs drain secretions
from specific segments into the major
bronchi where they can be removed by
coughing.
Percussion sounds
• Resonance
• Hyperresonance
• Tympany
• Dull
• Flat
Contraindications
• Rib fracture
• Pain
• Severe dyspnea
• Osteoporosis
When performing percussion
The nurse ensures that:

• Patient is comfortable
• Not wearing restrictive clothing
• Splints any incision
• Provides pillows for support
• Empty stomach
Therapy is indicated until the
patient has:

• Normal respirations
• Can mobilize secretions
• Has normal breath sounds
• When chest x-rays are normal
The Nurse most Stop treatment
if any of the following occur
• Increased pain
• Increased shortness of breath
• Weakness
• Light headedness
• Hemoptysis
ASSESSMENT
1. Assess breathing pattern
2. Identify signs and symptoms
3. Identify and assess rib cage
4. Assess patients understanding and
ability to cooperate
Nursing Diagnoses
• Ineffective airway clearance related
to excessive accumulation of
secretions in the lungs
• Ineffective breathing pattern related
to excessive production of sticky
secretions
• Impaired gas exchange related to
accumulation of tenacious secretions
• Knowledge deficit related to the
techniques of chest therapy
IMPLEMENTATION
The sequence of Percussion, Vibration and
Postural Drainage
• Postioning( to assume position for 10-15
mins.Kozier and Erb's,2012)
• Percussion (percuss each lung segment
for 1-2 mins.Kozier and Erb's,2012)
• Vibration
• Removal of secretions by coughing or
suction.
UNEXPECTED OUTCOMES AND
RELATED INTERVENSIONS
1. Those with status asthmaticus
2. Those with severe exacerbation of
chronic bronchitis
3. Hemoptysis occurs
4. No secretions are obtained
5. There is no improvement in chest
assessment
6. Patient experiences rib fracture, rib
pain or tenderness of rib wall
Underlying Principles
1. The force of gravity help drain lung
secretions
2. Because of branching structure of the
lungs a variety of positions must be used
to drain all the lung segments
adequately.
3. Not all positions are necessary for every
patient
4. The patient is made as comfortable as
possible.
The Procedure selected usually
depends on:

1. Age
2. General condition
3. Lobes / lobe of the lungs where
secretions have accumulated
CONTRAINDICATED TO:
1. Heart disease
2. Hypertension
3. Increased ICP
4. Extreme dyspnea
5. Osteoporosis
6. Advanced age
References
• Kozier and Erb's, Fundamentals of Nursing
Concepts,Process and Practice. 9th
Edition.2012.
• https://www.youtube.com/watch?
v=MGrsdLzhhvE
• https://www.youtube.com/watch?
v=vxFUPdFc1eM

https://www.youtube.com/watch?v=oKpaN15YN0I
Thank you….

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