Which of the following is performed by rhythmically clapping on the chest wall with cupped hands?

Appeared in: UPUMS Nsg officer-2023

Explanation

Percussion is a manual chest physiotherapy technique specifically defined by the action of rhythmically clapping on the chest wall.
The hands are cupped to trap a cushion of air, which softens the impact and creates pressure waves that are transmitted to the lungs.
This mechanical energy helps to loosen and mobilize thick, sticky mucus from the smaller airways, making it easier for the patient to cough it out.
The procedure should produce a hollow sound, indicating correct technique, and should not be painful.

Option A: Vibration involves a fine, shaking pressure applied to the chest wall during exhalation, not rhythmic clapping. The hands are kept flat, not cupped.
Option B: Suctioning is an invasive procedure that uses a catheter and negative pressure to physically remove secretions from the airway. It does not involve any manual action on the chest wall.
Option D: Kneading is a type of massage movement (pétrissage) used to manipulate muscle and soft tissue. It has no role in airway clearance.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Chest Physiotherapy Techniques as background academic context rather than a clinical decision trigger.
Chest physiotherapy, including percussion, is a cornerstone of treatment for patients with conditions involving thick, tenacious secretions, such as cystic fibrosis, bronchiectasis, and certain types of pneumonia.
Nurses must know the contraindications for percussion, such as bleeding disorders, osteoporosis, and fractured ribs, to prevent patient harm. Always assess the patient before initiating CPT.
What if? If a patient has fractured ribs but requires airway clearance, percussion would be contraindicated. The nurse should advocate for alternative methods like vibration, high-frequency chest wall oscillation (HFCWO) vests, or positive expiratory pressure (PEP) devices.

How to Approach the Question

First, identify the key actions described in the question stem: 'rhythmically clapping' and 'cupped hands'.
Next, mentally review the definitions of the common airway clearance techniques provided in the options.
Match the described actions to the correct technique. 'Clapping' is the defining characteristic of percussion.
Differentiate this from the other options. 'Vibration' is shaking, not clapping. 'Suctioning' uses a machine, not hands on the chest wall. 'Kneading' is a massage term.
Confirm your choice. The use of 'cupped hands' is a specific detail of the percussion technique to create an air cushion.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 253-255

E6 Nursing Fundamentals Taylor p. 727-729

Practise the full UPUMS Nsg officer-2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.