Patient Care: Chest Physiotherapy and Post-Operative Instructions
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Questions and Answers

What is the significance of the acronym 'BLUE' in chronic bronchitis?

  • It represents the skin color change 'cyanosis' indicating hypoxia. (correct)
  • It indicates the peripheral edema due to cor pulmonale.
  • It signifies the long-term cough and sputum production.
  • It refers to the unusual lung sounds like crackles and wheezes.

    • What is a common sign of COPD known as 'clubbing hingers' caused by according to the text?

  • Long-term hypoxia (correct)
  • Obstruction of ABGs
  • Hypoxemia
  • Increased RBC levels

    • Which respiratory failure type presents with symptoms like restlessness, decreased LOC, and confusion?

  • Hypercapnic respiratory failure (correct)
  • Low O2 and high Co2
  • Hypoxemic respiratory failure
  • Obstructive respiratory failure

    • What is the recommended initial intervention for a patient with hypercapnic respiratory failure?

    <p>Administer BiPAP</p> Signup and view all the answers

    What is advised to patients experiencing dry mouth in terms of diet according to the text?

    <p>Avoid gassy foods like carbonated drinks</p> Signup and view all the answers

    What should patients avoid doing 1 hour before or after meals, as stated in the patient education section?

    <p>Engaging in strenuous exercise</p> Signup and view all the answers

    What is a recommended fluid intake suggestion for thinning mucous in COPD patients?

    <p>Drink 8 glasses of fluids daily</p> Signup and view all the answers

    Which vaccine should be administered every year according to the text?

    <p>Flu vaccine every year</p> Signup and view all the answers

    What is a common complication that should be monitored for in patients with COPD?

    <p>Mental status changes such as restlessness and confusion</p> Signup and view all the answers

    Study Notes

    Patient Care

    • Mobilize secretions and expand lungs through chest physiotherapy, turn, cough, and deep breath, using huff coughing technique.
    • Avoid cough suppressants and position patient with head of bed (HOB) up.
    • For unilateral pneumonia with hypoxia, position good lung down.
    • Encourage fluid intake of 2-3L/day.

    Post-Operative Care

    • Promote early ambulation (within 8 hours after surgery) and provide analgesia.
    • Encourage coughing with splinting and hand washing.
    • Perform mouth care every 12 hours with chlorhexidine swab.
    • Use an incentive spirometer every hour to expand lungs, without pursed-lip breathing.

    Discharge Teaching

    • Mobilize secretions by avoiding cough suppressants and using cool mist humidifier at night.
    • Increase fluid intake to prevent reinfection.
    • Finish oral antibiotics at home and receive pneumonia vaccine every 5 years.
    • Promote smoking cessation and hand washing, and schedule follow-up for chest X-ray.
    • Report any increase in fever or shortness of breath.

    Atrial Fibrillation (AFib)

    • Characterized by uncoordinated electrical activity in the atria, causing rapid, disorganized, and twitching of atrial musculature.
    • This leads to pooling of blood in the atria, increasing the risk of clots.
    • The heart's main pacemaker (SA node) goes "rogue," causing around 350-600 erratic beats, but the AV node blocks most of these beats, protecting the ventricles.
    • Atrial musculature is not squeezing, resulting in less cardiac output and less oxygen delivery to the body.

    Pharmacology for AFib

    • Use ACE inhibitors (e.g., Lisinopril) or ARBs (e.g., Losartan) to lower blood pressure.
    • Use beta blockers (e.g., Atenolol) to lower heart rate and blood pressure.
    • Use calcium channel blockers (e.g., Nifedipine, Cardizem, Verapamil) to lower heart rate and blood pressure.
    • Use digoxin to lower heart rate.
    • Use dilators (vasodilators) such as nitroglycerin and diuretics.

    Pneumonia

    • Pathophysiology: Infection causes severe inflammation in the lungs, leading to alveoli filling with mucous, fluid, and debris.
    • This causes dyspnea and impaired gas exchange, resulting in hypoxia and acidosis.
    • Signs and symptoms include altered mental status, fever, and respiratory distress.

    Chronic Bronchitis

    • Signs and symptoms: big and blue skin (cyanosis), long-term cough and sputum, unusual lung sounds, and edema peripherally.
    • Mnemonic: "BLUE"

    Deadly Complications

    • Respiratory failure: hypoxemic (low O2) and hypercapnic (high CO2) respiratory failure.
    • Monitor for mental status changes, such as restlessness, decreased LOC, and confusion.
    • Priority: BiPAP therapy.

    COPD Exacerbation

    • Pharmacology: Avoid opioids and benzodiazepines.
    • Nursing care: Focus on patient education and diet.

    Patient Education

    • Diet: Eat small, frequent meals, high in calories and proteins, and avoid high-carb diet.
    • Fluids: Increase fluid intake to thin mucous and avoid drinking fluids while eating.
    • Infection: Report increases in sputum, fever, and worsening dyspnea.
    • Vaccines: Receive pneumonia vaccine every 5 years and flu vaccine every year.

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    Description

    This quiz covers techniques for mobilizing secretions, expanding lungs, and post-operative care instructions including early ambulation, coughing with splinting, and hygiene practices. Test your knowledge on optimal patient care practices.

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