LESSON PLAN ON DEMONSTRATION ON

“CHEST PHYSIOTHERAPY”

Submitted to: - Submitted by: -

Mrs.Sarita B.Supriya Chhetry

Lecture , CON M.Sc. (N) 1st year, CON

ILBS ILBS
 LESSON PLAN

Topic : Chest Physiotherapy

Name : B. Supriya Chhetry

Year : M.Sc. Nursing 1st year

Date of presentation :

Time and duration of presentation :

Venue :

Name of the supervisor : Ms. Sarita

Group : M.Sc. Nursing 1st year

Method of teaching : Demonstration, Explanation, Discussion .

Subject : Advance Nursing Practice

 OBJECTIVES

General objectives: -
At the end of the demonstration, the students will be able to understand about Chest Physiotherapy and demonstrate skills in
performing in clinical practice.

Specific objectives: -
At the end of the demonstration, the students will be able to,

1. Introduce the topic chest physiotherapy.

2. Discuss the Purposes of the chest physiotherapy
3. Explain Indication of the chest physiotherapy
4. Enlist the contraindication of chest physiotherapy
5. List down the equipment used in chest physiotherapy
6. Discuss the procedure of chest physiotherapy
7. Discuss the Post Chest physiotherapy
8. List down the complication of chest physiotherapy
9. Describe the precaution
10. Summarizes the topic.
11. Conclude the topic.
Sl.n Time Specific Objective Content Teaching Learning Evaluation
o. Activity
1. To introduce the INTRODUCTION : Student teacher will What is the topic
topic Chest physiotherapy is a group of therapies used in introduce the topic to of health talk?
combination to mobilize pulmonary secretions. Chest group.
physiotherapy is the removal of excess secretions from
the lungs by physical means

2. To discuss the PURPOSES: - Student teacher discuss the What are the
Purpose of chest purpose of chest purposes of
physiotherapy  Assist in coughing physiotherapy chest
physiotherapy?
 Reeducate breathing muscles

 Improve ventilation of the lungs

Student and teacher Explain
3. Explain Indication INDICATION: - explain Indication of the Indication of the
of the chest chest physiotherapy chest
physiotherapy  Excessive sputum production physiotherapy?

 Reduced effectiveness of cough

 Adventitious breath sounds

 Change in vital signs

 Atelectasis

 Mucous plugging
  Pneumonia

 Inability of patient to change body position

 Artificial airway.
Student and teacher enlist Enlist the
4. Enlist the CONTRAINDICATIONS: the contraindication of contraindication
contraindication of chest physiotherapy of chest
Chest physiotherapy should not be performed on
chest physiotherapy?
physiotherapy people with

 Bleeding from the lungs

 Head and neck injuries

 Rib fracture

 Lung collapse Tuberculosis

 Heart attack

 Pulmonary embolism\

 Lung abscess
 Recent surgery

 Increased ICP, confused patient.

 Student teacher discuss list List down the
5. List down the EQUIPMENTS USED IN CHEST down the equipment used equipment used
equipment used in in chest physiotherapy in chest
chest PHYSIOTHERAPY physiotherapy?
physiotherapy
 Trendelenberg bed

 Pillows

 Patient gown and towel

 Tissue paper Basin

 Suction apparatus

 Mechanical percussor

 Stethescope

 Cardiac monitor

 Pulse oximeter

 Emergency airway
  Sterilized clothes

 Chest radiograph (Recent).

Discuss the Procedure of Chest Physiotherapy Student teacher discuss the Discuss the
6. procedure of chest procedure of chest procedure of
physiotherapy Assess the chest X-ray for pulmonary findings physiotherapy chest
physiotherapy
Assess respiratory rate of patient
Assess breathing, heart rate, rhythm, skin color, blood
pressure of patient
Assess the patient's
Consent
Explain the procedure to the patient
Perform chest physiotherapy

Monitor the following throughout the therapy

 Reaction

 Discomfort and dyspnea

 Heart rate and rhythm

 Respiratory rate

 Sputum production
  Breathe sound

 Skin color

 Mental status

 Oxygen saturation (Pulse oximetry]

 Blood pressure

 Modify the techniques of CPT according to

patient tolerance

 Techniques are.

TURNING

Turning from side permits lung expansion.

Patients who cannot turn themselves are turned
by a caregiver turning also improves arterial
oxygenation. Regular turning can be to either
side or the prone position. The head of bed is
also elevated to promote drainage.
COUGHING

 Coughing helps break-up secretions in

the lungs so that the mucous can be
suctioned out

 For the controlled cough, patient close

the lips and take a deep breath. After
holding the breath for some seconds,
patient exhale by using the stomach
muscles to push the air out.

POSTURAL DRAINAGE

• Postural drainage is the use of various

positions to draw secretions from specific
segments of the lungs and bronchi into the
trachea. The procedure for postural drainage
can include most lung segments. Positions
should generally be held for 3-15 minutes.
Chest drainage positions include.

 The patient seated with head back

 High fowler's position

 Supine with head elevated

 Side lying with right side of chest elevated on

pillows

 Side lying with left side of chest elevated on

pillow

 Patient lying face down with feet higher than

the head

 Prone with thorax and abdomen elevated

 Supine in Trendelenburg’s position

 Left lateral in Trendelenburg’s position

 Right side lying in Trendelenburg’s position

 Prone in Trendelenburg’s position with

abdomen and thorax elevated.
 PERCUSSION [CUPPING, CLAPPING,
TAPOTEMENT]

 Percussion involves rhythmically striking the

chest well with cupped hands. Mechanical
device can also be used
 The purpose of percussion is to intermittently
apply kinetic energy to the chest wall and
lungs.
VIBRATION

 Vibration involves the application of a fine

tremorous action over the draining area.
Vibration therapy is done for one minute after
percussion. The purpose of vibration therapy to
7. help break-up lung secretions.
 Ensure patient comfort and safety prior to
leaving patient
Student and teacher discuss Discuss the Post
Discuss the Post Post CPT the Post Chest Chest
Chest physiotherapy physiotherapy?
physiotherapy
 Patient should be advised to practice oral
hygiene procedure to decrease the bad taste and
odor

 Record the procedure Report all significant

findings
8.
 Disinfect all non disposable equipment useand
store appropriately

List down the COMPLICATIONS

complication of Student and teacher list List down the
chest  Hyposernia down the complication of complication of
physiotherapy chest physiotherapy chest
physiotherapy?
 Increased pressure

 Acute hypotension

 Pulmory hemorrahage

 Pain

 Injuries to muscles

 Vomiting and aspiration

 Bronchospasm

 Dysrrhythmias

 Excessive lung volume.

Sl.n Tim Specific Content Teaching Evaluation
o. e Objective Learning Activity

PRECAUTIONS:
9. Describe Student teacher Describe the
the  Keep suction apparatus and emergency airway and oxygen Describe the precaution?
precaution precaution
therapy while providing chest physiothera

 Patient should be monitored throughout therapy

 Adrenergic bronchodilators in solution should be available in

case of bronchospasm during therapie Provide coughing
instruction prior to therapy

 Suctioning of trachea is essential.

 .

SPECIFIC TEACHING
TIM OBJECTIV LEARNING EVALUATIO
SL. E E CONTENT ACTIVITY N
NO
Summarize Student teacher
the topic SUMMARY will summarize the
topic
1. Introduce the topic chest physiotherapy.
2. Discuss the Purposes of the chest physiotherapy
3. Explain Indication of the chest physiotherapy
5. Enlist the contraindication of chest physiotherapy
6. Describe the precaution
7. List down the equipment used in chest physiotherapy
8. Discuss the procedure of chest physiotherapy
9. Discuss the Nursing care of patient with chest physiotherapy
10. Enlist the complication of chest physiotherapy

CONCLUSION:

Chest physiotherapy (CPT) is a technique used to mobilize or

loose secretions in the lungs and respiratory tract.
This is especially helpful for patients with large amount of secretions or
ineffective cough.
Chest physiotherapy consists of external mechanical maneuvers, such as
chest percussion, postural drainage, vibration, to augment mobilization and
clearance of airway secretions, diaphragmatic breathing with pursed-lips,
coughing and controlled coughing.

īREFERNCES
Bibliography
 BIBLIOGRAPHY SONI, S. (2013). TEXTBOOK OF ADVANCE NURSING PRACTICE. JAYPEE.
 Frownfelter DL, Dean E. Principles and Practice of Cardiopulmonary Physical Therapy. 3rd edition. St. Louis: Mosby; 1996.