A 40-year-old male is diagnosed with bronchiectasis. On auscultation, you hear the bilateral rhonchi on lower chest areas. Radiological investigation shows the presence of haziness in the lower posterior basal segments. How should you position him for postural drainage?
Explanation
Answer: C - Prone lying, pillow under hips, foot end of bed raised to 18 inches, chest tilted to 20 degrees is the position for postural drainage of lower posterior basal segments.
Bronchiectasis is defined as a permanent abnormal dilatation of one or more bronchi, due to elastic and muscular components of bronchial wall. The hallmark of bronchiectasis is chronic cough with sputum production. Cough is worse in the mornings and brought on by postural changes. Sputum is characteristically copious, purulent, and foul-smelling. A honeycomb appearance in a chest x ray is seen in saccular bronchiectasis.
Prone lying, pillow under hips is used for lower lobe apical segments drainage.
Supine lying, pillow under back, knees bent, foot end of bed raise to 46 cm, chest tilt to 20 degrees is used for lower lobe anterior basal segments drainage.
Upright sitting, with slight leaning backward is used for upper lobe apical segment drainage.
