Page 2538 - Saunders Comprehensive Review For NCLEX-RN

FIG. 69-20 Surgical shunting diverts portal venous blood flow from the liver to decrease
portal and esophageal pressure.

Box 69-12

Chest Physiotherapy: Contraindications and
Interventions

Contraindications

▪ Unstable vital signs
▪ Increased intracranial pressure
▪ Bronchospasm
▪ History of pathological fractures
▪ Rib fractures
▪ Chest incisions

Interventions

▪ Assess for contraindications for performing chest physiotherapy (CPT)

▪ Perform CPT in the morning on arising, 1 hour before meals, or 2 to 3 hours after
meals.
▪ Stop CPT if pain occurs.

▪ If the client is receiving a tube feeding, stop the feeding and aspirate for residual
before beginning CPT.
▪ Administer the bronchodilator (if prescribed) 15 minutes before the procedure.

▪ Place a layer of material (gown or pajamas) between the hands or percussion
device and the client’s skin.
▪ Position the client for postural drainage based on assessment.

▪ Percuss the area for 1 to 2 minutes.
▪ Vibrate the same area while the client exhales 4 or 5 deep breaths.

2538