RCP 250 - Cardio/Pulmonary Therapeutics

1. Contrast methods to accomplish lung hyperinflation
   1. Describe the process of normal ventilation
   2. Classify designated aspects of normal ventilation
   3. Describe the mechanisms which prevent alveolar collapse during exhalation
   4. Explain the rationale for hyperinflation therapy
   5. List methods by which hyperinflation may be accomplished
   6. Identify advantages for each method of lung hyperinflation
   7. Describe hazards and limitations of methods of lung hyperinflation
   8. Describe how methods of lung hyperinflation impact on deficiencies of the mechanisms which normally maintain alveolar patency
   9. Determine the correct method of lung hyperinflation for given clinical situations
2. Administer Sustained Maximal Inspiration (SMI) therapy
   1. Explain the rationale for SMI
   2. Describe pulmonary effects of SMI
   3. Describe cardiovascular effects of SMI
   4. Compare effects of SMI with normal ventilation and IPPB
   5. State the indications for SMI
   6. Explain the hazards and contraindications to SMI
   7. Contrast the function of two general classes of devices used for SMI
   8. Explain how goals for SMI may be established
   9. Perform SMI to achieve stated clinical goals
   10. Describe necessary monitoring of persons receiving SMI
   11. Explain how the effectiveness of SMI may be evaluated
   12. Describe how SMI goals are modified as therapy progresses
3. Administer Intermittent Positive Pressure Breathing (IPPB) therapy
   1. Explain the rationale for IPPB
   2. Describe pulmonary effects of IPPB
   3. Describe cardiovascular effects of IPPB
   4. Compare effects of IPPB with normal ventilation and SMI
   5. Explain the equipment needed to perform IPPB
   6. Assemble functioning circuits for IPPB using a variety of circuit components
   7. State the indications for IPPB
   8. Explain the hazards and contraindications to IPPB
   9. Demonstrate use of the Bird Mark - 7 and the Bennett PR-2 to
   10. Perform volume oriented IPPB therapy to accomplish stated therapeutic goals perform IPPB the
   11. Describe necessary monitoring of persons receiving IPPB
   12. Explain how the effectiveness of IPPB may be evaluated
   13. Explain how IPPB therapy may be modified as a result of evaluation of its effectiveness
4. Administer Postural Drainage and Percussion (PD&P) therapy
   1. Explain the rationale for PD&P
   2. Describe indications for PD&P
   3. Describe side effects which may be caused by PD&P
   4. Identify contraindications for PD&P
   5. State limitations to PD&P
   6. Identify the lung lobes and segments
   7. Explain how a person would be positioned to use gravity to drain each lung segment
   8. State the rationale for using chest percussion and vibration in conjunction with postural drainage
   9. Describe side effects and contraindications to chest percussion and vibration
   10. Utilize proper body mechanics in moving patients into positions for PD&P
   11. Perform PD&P to accomplish specific therapeutic goals
   12. Describe necessary monitoring of persons receiving PD&P
   13. Explain how the effectiveness of PD&P is evaluated
   14. Describe how performance of PD&P may be modified based on evaluation of effectiveness
5. Teach persons to perform breathing exercises which will improve ventilation
   1. Describe the rationale of various breathing exercises
   2. Identify the limitations of each type of breathing exercise
   3. Determine exercises which will accomplish stated therapeutic goals
   4. Teach exercises to persons
   5. Evaluate ability of persons to perform exercises
   6. Monitor persons for compliance with breathing exercise program 
6. Maintain airway patency
   1. Explain the necessity for maintaining airway patency
   2. Explain methods by which airway patency may be maintained
   3. Compare advantages and limitations to the methods by which patency of the airway may be maintained
   4. Identify the type of oropharyngeal airways which may be used
   5. Insert and maintain oral and nasal airways
   6. Explain indications and hazards for artificial airways
   7. Describe how caregivers can replace functions of the normal airway when it is bypassed by an artificial one
   8. Compare advantages and disadvantages to oral and nasal routes for endotracheal intubation
   9. Describe techniques for intubation of the trachea
   10. Explain how proper placement of an endotracheal tube is determined
   11. Contract advantages and hazards of endotracheal tubes and tracheostomies
   12. Explain how the hazards of artificial airways may be minimized
   13. Describe the procedure for endotracheal extubation
7. Clear secretions from the airway
   1. Describe indications for tracheobronchial suctioning
   2. Explain hazards of tracheobronchial suctioning
   3. Describe how the hazards may be minimized
   4. Explain how suction catheter size is determined
   5. State suction pressure which would be used for any age person
   6. Demonstrate nasotracheal, endotracheal and tracheostomy suctioning
   7. Explain how persons should be monitored during suctioning
   8. Describe how the effectiveness of suctioning is evaluated
   9. Describe the indications and limitations to tracheal lavage
8. Explain modifications to respiratory care procedures which are needed to provide respiratory care outside the acute care hospital
   1. Explain the advantages and limitations to care outside the hospital
   2. Describe methods of infection control in the home care setting
   3. Describe the options available for oxygen in the home setting and how the choice would be made between these
   4. Define pulmonary rehabilitation
   5. Identify the expected outcomes of a pulmonary rehabilitation program
   6. Describe the inputs needed to promote success of a rehabilitation program
   7. Explain the modifications which must be made to common therapies for them to be performed in settings other than the acute care hospital