20 Questions
What is the position of the patient while performing postural drainage for the Lower Lobes: Anterior Basal Segment?
Lying supine with head down and a pillow under knees
What is the purpose of elevating the foot of the table or bed by 18 inches or 30 degrees during postural drainage?
To aid in postural drainage
Why may a patient with congestive heart failure require modification to postural drainage positions?
Due to manifestations of orthopnea
What is the position of the patient while performing postural drainage for the Lower Lobes: Posterior Basal Segment?
Lying on abdomen with pillows under hips
Why may a patient who has undergone neurosurgery require modification to postural drainage positions?
Due to risk of increased intracranial pressure
What is the action performed by the clinician during postural drainage for the Lower Lobes: Anterior Basal Segment?
Clapping over lower portion of ribs
Why may a patient who has undergone thoracic surgery require modification to postural drainage positions?
Due to chest tubes and monitoring wires
What is the position of the patient while performing postural drainage for the Lower Lobes: right Lateral Basal Segment?
Lying on left side with upper leg flexed over a pillow
What is the purpose of using pillows under hips during postural drainage?
To aid in postural drainage
What is the position of the patient while performing postural drainage for the Lower Lobes: left Lateral Basal Segment?
Lying on left side with upper leg flexed over a pillow
What is the position of the patient for drainage of the Upper Lobes; anterior apical segment?
Leaning back on a pillow at 30 degrees angle
What is the position of the patient for drainage of the Upper Lobes; posterior apical segment?
Leaning over a folded pillow at 30 degrees angle
What is the position of the patient for drainage of the Upper Lobes; anterior segment?
Lying flat on back with a pillow under knees
What is the position of the patient for drainage of the Upper Lobe right posterior segment?
Lying on the left side with a quarter turn towards prone
What is the position of the patient for drainage of the Right Middle Lobe: lateral segment and medial segment?
Lying head down on the left side and rotates ¼ turn backward
What is the position of the patient for drainage of the Left Lingular Segment: superior and inferior?
Lying head down on the right side and rotates ¼ turn backward
What is the position of the patient for drainage of the Lower Lobes: Superior Segment?
Bed or table flat
What is the specific angle of elevation for the Trendelenburg position?
15 degrees
Where is the clapping area for drainage of the Upper Lobes; anterior apical segment?
Between the clavicle and top of scapula on each side
Where is the clapping area for drainage of the Right Middle Lobe: lateral segment and medial segment?
Over the right nipple area
Study Notes
Postural Drainage Positions
Upper Lobes
- Anterior apical segment: Patient leans back on a pillow at a 30-degree angle (High Fowler's position) and claps between the clavicle and top of scapula on each side.
- Posterior apical segment: Patient leans over a folded pillow at a 30-degree angle and claps over the upper back on each side of the chest.
- Anterior segment: Patient lies flat on their back with a pillow under their knees and claps between the clavicle and nipple on each side of the chest.
Upper Lobes (continued)
- Right posterior segment: Patient lies on their left side with a quarter turn towards prone and claps over the right scapula.
- Left posterior segment: Patient lies on their right side with a quarter turn towards prone, head and shoulders elevated 18 inches (30 degrees), and claps over the left scapula.
Middle Lobe
- Right middle lobe lateral segment and medial segment: Foot of the table or bed elevated 14 inches (about 15 degrees, Trendelenburg position), patient lies head down on the left side and rotates a quarter turn backward, with a pillow behind them from shoulder to hip and knees flexed, and claps over the right nipple area.
Lower Lobes
- Superior segment: Patient lies on their abdomen with pillows under their hips and claps over the middle of the back below the tip of the scapula on either side of the spine.
- Anterior basal segment: Foot of the table or bed elevated 18 inches (30 degrees, Trendelenburg position), patient is supine, head down, with a pillow under their knees, and claps over the lower portion of the ribs.
- Right lateral basal segment: Foot of the table or bed elevated 18 inches (30 degrees, Trendelenburg position), patient lies on their left side, upper leg can be flexed over a pillow for support, and claps over the lower aspect of the right rib cage.
- Left lateral basal segment: Foot of the table or bed elevated 18 inches (30 degrees, Trendelenburg position), patient lies on their right side, upper leg can be flexed over a pillow for support, and claps over the lower aspect of the left rib cage.
- Posterior basal segment: Foot of the table or bed elevated 18 inches (30 degrees, Trendelenburg position), patient lies on their abdomen, head down, with a pillow under their hips, and claps over the lower ribs close to the spine on each side of the chest.
Modified Postural Drainage Positions
- Patients who require postural drainage may not tolerate optimal positions due to:
- Congestive heart failure (manifestations of orthopnea)
- Neurosurgery (increased intracranial pressure with head-down position)
- Thoracic surgery (chest tubes and monitoring wires limiting positioning)
Learn about different patient positions for postural drainage, including upper lobes and apical segments. Understand how to position patients for effective drainage.
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