Respiratory rehabilitation/SŠ (nurse)

The basic goal of respiratory rehabilitation is to support lung ventilation and cough up secretions from the airways. It can also be used to increase the effect of nebulization. Respiratory rehabilitation is not only the task of the physiotherapist, the nurse's role is significant.

Content

 * 1The nurse's job is to
 * 2An active cycle of breathing techniques
 * 3Autogenous drainage
 * 4PEP system
 * 4.1CPAP therapy
 * 4.2Oscillating PEP system
 * 4.3Manual assistance in coughing
 * 4.4Intrapulmonary percussive ventilation
 * 5Links
 * 5.1References

A nurse's job is to [ edit | edit source ]

 * Cooperation with a physiotherapist (FT).
 * Control activity P/K.
 * Education and stimulation of P/K to perform exercises even without the presence of FT.
 * Implementation of some respiratory rehabilitation techniques.

Active cycle of breathing techniques [ edit | edit source ]

 * 3 separate breathing techniques,
 * P/K exercises under the guidance of a physiotherapist or nurse.
 * P/K is sitting or lying down.


 * 1) Exercises to increase chest flexibility :
 * Slow maximal inhalations through the nose or mouth → slow exhalation through the mouth or nose. The goal of this exercise is to activate collateral alveolar ventilation.
 * 1) Forced exhalation and huffing technique :
 * Accelerated exhalation technique → accelerated, forceful, active exhalation through the slightly open mouth.
 * Finished with expectorant huffing → serves to mobilize secretions from the lungs → remove mucus without coughing.
 * 1) Controlled breathing :
 * inhales are calm, relaxed, directed to the abdominal area → exhalation is passive, without activating the abdominal muscles.

Autogenous drainage [ edit | edit source ]

 * Indications: P/K with COPD with excessive bronchial secretion.
 * Exercise performed sitting or lying down.
 * P/K breathes consciously and completely controls breathing with his mind. The inhalation is slow and smooth, after its completion, P/K makes an inspiratory pause, the pause is followed by a slow, long and fully controlled exhalation with the involvement of the respiratory muscles through the slightly open mouth.

PEP system [ edit | edit source ]
PEP = positive expiratory pressure P/K exhales against the increased pressure given by the device.

CPAP therapy [ edit | edit source ]
P/K is an oxygen mask attached to the face, which has an exhalation brake, so-called PEEP, on the exhalation valve. The value of positive pressure is adjusted according to the needs and health status of P/K.



Oscillating PEP system [ edit | edit source ]

 * Aids with oscillating or vibrating effects affecting the respiratory tract.


 * P/K exhale into the device, where shaky vibrations are formed, which are transferred to the bronchioles, a resistance of 5 to 20 cm H 2 O is created in the airways.


 * Aids include, for example:


 * Acapella®
 * TriFlow®
 * https://www.asker.cz/thera-pepl/ Thera PEP®]
 * Flutter®
 * RC-Cornet®

Manual cough assistance [ edit | edit source ]

 * Some P/K need help to cough up.


 * P/K breathes in and when exhaling, the nurse squeezes the chest hard at least twice. Pressing can be done either with one or two hands using a folded mat or a towel under the chest.


 * If the P/K has an endotracheal cannula (see endotracheal intubation ) or a tracheostomy, the nurse must not forget to suck out the loosened mucus!

Intrapulmonary percussive ventilation [ edit | edit source ]

 * This therapy uses a jet ventilator.


 * P/K wears a face mask for non-invasive artificial lung ventilation or mouthpiece. The ventilator pushes the breathing mixture into the airways with pressure pulses. Inside the airways, pressure waves are created that expand the bronchioles and thus facilitate the passage of the respiratory mixture to the alveoli and ensure its better distribution, the mucus is still moved in the oral direction and thus facilitates coughing.

References [ edit | edit source ]

 * KOLÁŘ, Pavel, et al. Rehabilitation in clinical practice. 1st edition. Prague: Galén, 2009. 713 pp.  ISBN 978-80-7262-657-1.

Category :


 * high school
 * Nurse