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. Ensure that the area to be percussed is covered. Ask patient to beath slowly and deeply. Cup your hands hold your fingers and thumb together, and flex slightly to form a cup, as you would to scoop cup water. Relax your wrists, and flex your elbow. With both hands cupped, alternately flex and extend the wrists rapidly to slap the chest. Percuss each affected lung segment for 1-2 minutes. The percussing action should produce a hollow, popping sound when done correctly. 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.
