Question

A 72-year-old man who has COPD from working as a coal miner has pneumonia in his right lower and middle lobes. To help mobilize and drain the secretions, CPT is prescribed. The patient only wants to sit in bed because it is easier for him to breathe when in the semi-Fowler’s position.

What positions are the most important for successful CPT? What can you do to aid him during the treatments?

Make asimple illustration of the patient’s position and list down the ways you can assist him during these treatments (minimum of 5).

Answer 1

Following are the positions required for successful CPT for the drainage of the segment of the lobes:-

We can aid the CPT in following ways:-

We will make the patient positioned so that the affected area is in a near vertical position, so that gravity can assist the drainage of specific segment.

We will make sure that the exercises are done 2-3 times a day, before meals and bedtime and every position is performed for 3-15 minutes

If tachycardia, palpitations, dyspnea occurs the procedure must be stopped.The se symptoms may indicate hypoxemia.

Before postural drainage and chest percussion bronchodilators, mucolytics agents, water, or saline may be nebulised and inhaled to reduce bronchospasm, lower thickness of mucus and sputum, and fight edema of the bronchial walls,so that the secretion removal is enhanced.

Secretion removal procedures must be performed before eating.

We will make sure patient is comfortable before and throughout the procedure.

We will auscultate the chest to find out the areas where drainage is needed.

We will give support to the patient to deep breathe and cough after performing in each position.

We will give support the patient for diaphragmatic breathing during postural drainage.