Chest Fisiotheraphy

7/28/2019 Chest Fisiotheraphy

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Chest Fisiotherapy

oleh

Ayu Susanti S.Kep.Ners


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A. Definition

Physiotherapy is a way or form oftreatment to restore the functionof an organ of the body by using

natural energy such as electricity,light, water, heat, cold, massage,and exercises which use adapted to

the tolerance limit of tolerance sothat the obtained effects oftreatment.


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B. Purposes :

Restore and maintain the function of therespiratory muscles

Helps cleanse the bronchial secretions and

prevent the buildup of secret Improve the movement and flow of secret


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C. The motion of chest

physiotherapy : Drainage postural

Percussion

Vibrate


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D. Contra indications

Characteristically absoluteHeart failure

Asmaticus status

Renjatan and massive bleeding

Characteristically relative

Serious lung infection

Costae broken

New wound of operation trace

The possibility of malignant lung tumors

Sense convulsion


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1. Drainage Postural

Is one of the intervention to

remove secretions from the

various segments of the lung byusing the influence of gravity


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a. Indication

1. Prophylaxis to prevent accumulation of secretions,

for patients: Using ventilation

Long bed rest

Increase sputum production

Uneffective cough2. Mobilization of retained secretions, for patients

with:

Atelectasis

Lung abces

Pneumonia

Pre and post operative

General weakness and trouble with swallowing orcoughing


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b. Contra indicationsPneumotoraks tention

HemaptusisDisorders of the cardiovascular system

Lung edem

Extensive pleural effusions

c. Patient preparationLoosen clothing, especially around the neck and

waist

Explain how the treatment / action

Check the pulse and TD

Does the patient have a cough reflex or requiresuction to remove the secret


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d.Tools preparation

Pillow for positioning

The bed which can adjust theTrendelenburg position

Paper towels and sputum container


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e. Working procedures

Management approach in children & families

Adjust the head lower 30 degrees

Place the sputum in a position that places are easy to

reach by children

Instruct children to cough effectively, or if you needto do suctioning mucus

Encourage your child to do abdominal breathing


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Postural drainage done twice a day, when

performed in a position not more than 40

minutes, each of the positions 3-10 minutes Adjust the position of the child to the normal

position slowly

Perform oral hygiene and clean with a tissue Auscultation of breath sounds in all lung lobes


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f. Assessment of the action :

On auscultation,are breath sounds increasedand at the left & right

The inspection of both sides of the chest is

moving at the same time Have had productive cough, is very thin or

thick secretions

The condition of patients after action How visible effect on the vital sign

Is there improvement thoracic photo


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g. Criteria to discontinue the action

The patient is unfever within 24-48

hours

The sound is relatively clear ornormal breathing

Photos thoracic relatively clear Patients able to breathe deeply and

cough


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h. Position for postural drainage :

apical lobe bronchus and right anterior upper left:

Clients sit in a chair leaning against the pillows.

apical lobe bronchus and right posterior upper left:

Clients sit in a chair, leaning forward on a pillow or

a table

anterior lobe bronchus and right upper left:

Client lying flat with a small pillow under the knees

upper left lingual lobe bronchus:Clients lie on your side with the right arm above

the head in Trendelenburg position, feet elevated

30 cm


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the right center bronchus :The client lying on the left, elevate feet 30 cm

anterior lobe bronchus and right lower left:

The client lying supine with tredelenburgposition, legs elevated 45-50 cm, allow the kneeto bend over a pillow

lateral lobe bronchus bottom right:

Clients lie down to right at the position with feetelevated tredelenburg 25-50 cm

superior lobe bronchus right & bottom left:Clients lie on his stomach with a pillow under thestomach

posterior basal bronchus right and left:Clients lie prone in Trendelenburg position withlegs elevated 45-50 cm


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2. Clapping / percussion

a. meaning, is claping on the chest wall or back of

the hand shaped like a bowl

b. Goal, releasing the retained secretions or

attached to the bronchial

c. Percussion should be performed with caution incircumstances:

o Broken ribs

o Subcutaneous Emphysema neck area & chest

o New Skin grafto Burns, skin infections

o Pulmonary embolism

o Untreated tension pneumothorax


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d. Working procedures

Close the area to be made clappingwith a towel to reduce the

discomfort

Instruct the patient to relax, breath

in with a purse lips breathing

Percussion in each lung segment for

1-2 minutes with both hands to form

a bowl


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3. Vibrating

In general, done at the same time withthe clapping

Vibration held at the peak of inspiration

and continued until the end expiration

Vibration is done by laying hands on the

chest and then overlap with the

encouragement of vibrating

Contra indications: fractures and

hemoptysis


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Documents

Chest Fisiotheraphy