Chest Physiotherapy-is a group of therapies use in in combination to mobilize pulmonary

secretions, designed to help clear airway secretions and enhance the efficiency and conditioning of respiratory muscle.

Deep Breathing Exercise-are exercises that helps remove the mucus which can form and remain in

the lungs.

Coughing Exercise-it’s a sudden reflex, audible expulsion of air from the lungs.

Chest Tapping-a respiratory technique which include clapping or cupping over the chest

wall.

Chest Vibration-a series of vigorous shaking produce by the hands applied to the chest wall

only during expiration.

Postural Drainage-is the use of positioning technique that draws secretion from specific

segments of the lungs and bronchi into the trachea.

Nebulizer-is a process of adding moisture or medication to inspire air by mixing

particles of varying size with the air.

Blow Bottle Exercise-are two bottles half filled with water and connected by tubing. They

provide feedback about the water from the bottle to the first bottle.

Suctioning-is the use of reduce pressure to remove unwanted fluid or other material

through the tube disposal.

Incentive Spinometry-is a method of encouraging deep breathing by promoting visual feedback

to patient about respiratory volume.

CHEST PHYSIOTHERAPY-is an approach to mobilize and drain secretion.

IMPORTANCE To help clear excessive bronchial secretion from airway To promote efficient breathing To improve mobilization of secretion To clean the lungs from secretions. To maintain the patients airway. To improve the exercise tolerance in patients with lung problems.

PRINCIPES INVOLVED Anatomy and Physiology – Chest Physiotherapy promotes proper function

of respiratory system Microbiology and Parasitology – hand washing is performed before and

after handling patient to prevent spread of microorganism. Physics – pressure is applied in the different chest physiotherapy produced

and gravity, is involed in postural drainage for expectation of secretion. Time and Energy – preparation of patients and the materials saves time and

energy Body Mechanics – positioning the patient in a comfortable position to

prevent muscle cramps, spasm and any irritation and as well as to the care providers.

DEEP BREATHING EXERCISE-a technique to improve ventilation and oxygenation.-to promote lung expansion and ventilation and enhance blood

oxygenation.

IMPORTANCE Facilitates respiratory functioning by increasing lung expansion and

preventing alveolar collapse Encourage expectoration of mucus and secretion that accumulates in

the airway after general anesthesia and mobility. Creates resistance to air flowing out of the lungs. Increase pressure within the bronchi. Hel expel as much air as possible during expiration.

INDICATION Clients with restricted ling expansion Clients with chronic obstructive pulmonary disease. Client recovering from the thoracic surgery. Dypnea

CONTRAINDICATION Lung tumor Tracheostomy

TYPES of DEEP BREATHING EXERCISE Diaphragmatic Breathing Inspiratory Resistive Breathing Pursed-lip breathing

GUIDELINES Position the patient in a comfortable supine or semi-fowlers position

and sitting position with knees flexed to help abdominal muscle. Instruct patient to breath in through the nose and keep mouth

closed. Remind the patient to stay relaxed and not to arch the neck. If the patient has difficulty in raising his abdomen, instruct him/her to

take quick forceful inhalation through the nose.

NURSING RESPONIBILITIESBEFORE:

Check patient’s chart Do medical handwashing Explain the procedure

Auscultate the lung sound Place the patient in appropriate position

DURING Position the client in semi-fowler’s position Assist the client in breathing Place your palms down around the sides of the clients lower

ribs Instruct the client breathe in deeply through the nose, allowing

the chest and abdomen to expand. Have the client to hold his/her breathe for a count of 5

seconds. Tell the client to exhale completely through pressed lips

allowing the chest and abdomen to expand. Have the client to repeat the exercise five times consecutively.

AFTER: Evaluate clients response to determine how often exercise should be

performed Documentation.

COUGHING-is a natural clearance mechanism that aids in removal of mobilized

secretion.-purpose of this is to loosen, mobilize, and remove pulmonary seretions.

IMPORTANCE To help mobilize secretion To open collapsed alveoli Remove secretion from both upper and lower airways To maintain clean airways

INDICATION Presence of pulmonary secretion Emphysema

Patient at risk of pulmonary conditions

CONTRAINDICATION Neck/spinal injury Increased intracranial pressure / known intracranial aneurysm Patients who undergone tonsillectomy

GUIDELINES in PERFORMING COUGHING EXERCISE1. Place patient in semi-fowlers position, leaning forward2. Provide a pillow/folded bath blanket to use in spitting the incision3. Ask the patient to do the ff:

a. Inhale and exhale deeply slowly through the nose (3x)b. Take a deep breathe and hold it