Assessment:
Listen to breath sound. Assess patient respiratory status. Observe the quality or characteristic of secretions. Identify what are the underlying complications. Note time of eating.
Planning/Implementation:
Gather materials needed, as follows: Pillows, Container for sputum, Hospital bed and towel. Establish the location of such lung segment. If the entire lung is to undergo chest physiotherapy, the most affected lobe or segment should be drained first. Protect patient from falling by keeping side rails up when possible. If possible, arrange for privacy during procedure. Stay with the patient during initial procedure. Administer treatment every two to four hours as ordered. Prepare patient by discussing certain exercises. Explain the importance of practicing PVD exercise after an operation to counteract affect of hypoventilation and to prevent complications. Demonstrate steps, allowing time fore patients practice. Place towel over skin to prevent reddened areas when performing. Instruct patient especially those with COPD, to perform diaphragmatic breathing with daily activities (sitting/walking) and to practice graded exercises to improve general physical fitness. Auscultate all lobes for adventitious sounds – prior to initiating PVD. Place your flattened hands, one over the other ( or side by side) against the affected chest area. Ask the client to inhale deeply through the mouth and exhale slowly through pursed lips of the nose. During the exhalation, straighten your elbow, and lean slightly against the clients chest while tesing your arm and shoulder muscles in isometric contractions. Vibrate during five rxhalations over one affected lung segment. Encourage the client’s lung and compare the findings to the baseline data. Auscultate the client’s lung and compare the findings to the baseline data. Document the percussion and vibration. Note the amount, color and character of expectorated secretions. Return the patient to a comfortable position after mouth care, and allow for a rest period.
Evaluation:
Coughing is more productive and effective. Lungs cleared for any breath sounds upon auscultation. Complications are prevented. Patient resting comfortably.
