Breathing exercises

Question 1

diaphragmatic breathing indications

Answer 1

• post surgical patient with pain in the chest wall or abdomen or restricted mobility
• patient learning active cycle of breathing or autogenic drainage airway clearance techniques
• dyspnea at rest or with minimal activity
• inability to perform ADLs due to dyspnea or inefficient breathing pattern

Question 2

DB precautions/contraindications

Answer 2

• mod to severe COPD and marked hyperinflation of the lungs without diaphragmatic movement
• patients with paradoxical breathing patterns, or who demonstrate increased inspiratory muscle effort, and increased dyspnea during DB

Question 3

DB expected outcomes

Answer 3

• decrease respiratory rate
• decrease use of accessory muscles of inspiration
• increase tidal volume
• decrease respiratory flow rate
• subjective improvement of dyspnea
• improve tolerance to activity

Question 4

Inspiratory muscle training indications

Answer 4

• impaired inspiratory muscle strength and/or a ventilatory limitation to exercise performance

Question 5

IMT precautions/indications

Answer 5

• tachypnea
• reduced tidal volume
• increased PaCO2
• bradypnea and decreased minute ventilation

Question 6

IMT expected outcomes

Answer 6

• increase inspiratory muscle strength and endurance
• decrease dyspnea at rest and during exercise
• increase functional exercise capacity

Question 7

paced breathing and exhale with effort

Answer 7

Paced breathing- a strategy to decrease the work of breathing and prevent dyspnea during activity

Exhale with effort- employed during activity to prevent a patient from holding their breath

Question 8

Paced breathing and exhale with effort indications

Answer 8

• patients with dyspnea at rest or with minimal activity
• inability to perform activity due to pulmonary limitation
• inefficient breathing pattern during activity k

Question 9

paced breathing and exhale with effort precautions/contraindications

Answer 9

• avoid valsalva maneuver during activity

Question 10

pace breathing and exhale with effort procedure

Answer 10

walking
- inhale through nose with walking two steps and then pause; exhale through pursed lips while walking four steps

climbing stairs

• inhale through nose while standing
• exhale through pursed lips while stepping up one or two steps
• remain on the step until breath control is restored

lifting

• inhale through the nose while standing or sitting; exhale through pursed lips while bending to reach the object
• pause
• inhale through the nose while grabbing the object; exhale through pursed lips while standing up

Question 11

pace breathing and exhale with effort expected outcomes

Answer 11

• complete activity without dyspnea

- decrease patient’s fear of becoming short of breath during activity

Question 12

pursed lip breathing

Answer 12

• reduce respiratory rate, reduce dyspnea, and maintain a small positive pressure in the bronchioles

Question 13

PLB indications

Answer 13

tachypnea

dyspnea

Question 14

PLB precautions/contraindications

Answer 14

• forcing exhalation

Question 15

PLB expected outocmes

Answer 15

• decrease respiratory rate
• relieve dyspnea
• reduce arterial partial pressure of carbon dioxide
• improve tidal volume
• improve oxygen saturation
• prevent airway collapse in patients with emphysema
• increase activity tolerance

Question 16

segmental breathing

Answer 16

• localized breathing or thoracic expansion exercise

- improve regional ventilation and prevent and treat pulmonary complications after surgery

Question 17

SB indications

Answer 17

• decreased intrathoracic lung volume
• decreased chest wall lung compliance
• increased flow resistance from decreased lung volume
• ventilation; perfusion mismatch

Question 18

SB precautions/contraindications

Answer 18

• none

Question 19

SB expected outcomes

Answer 19

• increase chest wall mobility
• expand collapsed alveoli via airflow through collateral ventilation channels
• assist with secretion removal

Question 20

Sustained max inspiration with incentive spirometer

Answer 20

• a max inspiratory effort is held for three or more seconds before exhalation
• also called incentive spirometry

Question 21

SMI indications

Answer 21

• decreased intrathoracic lung volume
• deceased chest wall lung compliance
• increased flow resistance from decreased lung volume
• ventilation:perfusion mismatch
• atelectasis or risk of atelectasis due to thoracic and upper abdominal surgery
• restrictive lung defect associated with quadriplegia and/or dysfunctional diaphragm

Question 22

SMI precautions/contraindications

Answer 22

• patient is not cooperative or is unable to understand or demonstrate proper use of the incentive spirometer
• patient is unable to deep breathe effectively
• patients with moderate to severe COPD with increased respiratory rate and hyperinflation

Question 23

SMI expected outcomes

Answer 23

• absence of or improvement in signs of atelectasis
• decreased respiratory rate
• resolution of fever
• normal pulse rate
• normal chest x ray
• improved PaO2
• increased forced vital capacity and peak expiratory flows