Nursing
care and selection of CPT skills are based on specific assessment findings. The
following are the assessment criteria:
• Know the normal range of patient’s vital signs. Conditions requiring CPT,
such atelectasis, and pneumonia, affects vital signs.
• Know the patient’s medications. Certain medications, particularly diuretics
antihypertensive cause fluid and haemodynamic changes. These decrease patient’s
tolerance to positional changes and postural drainage.
• Know the patient’s medical history; certain conditions such as increased ICP,
spinal cord injuries and abdominal aneurysm resection, contra indicate the
positional change to postural drainage. Thoracic trauma and chest surgeries
also contraindicate percussion and vibration.
• Know the patient’s cognitive level of functioning. Participating in
controlled cough techniques requires the patient to follow instructions.
• Beware of patient’s exercise tolerance. CPT maneuvers are fatiguing. Gradual
increase in activity and through CPT, patient tolerance to the procedure
improves.