MANILA CENTRAL UNIVERSITY

COLLEGE OF NURSING
NCM 103 SKILLS LABORATORY
CHECKLIST
Chest Physiotherapy
(Cupping or Clapping Technique)

Name:__________________________________ Date:____________ Score: _______________

Direction: Please rate the student’s performance using the scale below.
4 – EXEMPLARY (provides complete and accurate evidence in demonstrating knowledge, skills and
attitude necessary to facilitate client examination, assessment and intervention)
3 – PROFICIENT (provides clear evidence in demonstrating knowledge, skills and attitude necessary to
facilitate client examination, assessment and intervention)
2 – DEVELOPING (provides limited evidence in demonstrating knowledge, skills and attitude necessary
to facilitate client examination, assessment and intervention)
1 – BEGINNING (provides little or no evidence in demonstrating knowledge, skills and attitude necessary
to facilitate client examination, assessment and intervention)

Procedure 4 3 2 1 Remarks
1. Verifies the order
2. Confirms the client's identification. Compares the name with the name on
the client's ID bracelet.
3. Provide privacy and explains the procedure to the client.
4. Have paper tissue and receptacle for secretions within reach of the client.
5. Washes hands, dons gloves, a face shield, and a gown if needed and follows
standard precautions.
6. Auscultates the client's lungs.
7. Positions client correctly (Fowler’s for the ret dem). Spine should be
straight to promote rib cage expansion.
8. Instructs the client to remain in the position for 10 to 15 minutes. During
this time, performs percussion as ordered.
9. Instructs the client to breathe slowly and deeply, using the diaphragm, to
promote relaxation.
10. Holds hands in a cupped shape, with fingers flexed and thumbs pressed
tightly against the index fingers. The hand is cupped to create a cushion of
air against the chest wall. Raises hands 3-4 inches above the chest wall and
rhythmically clap lungs to create shock waves in the lungs to break up thick
secretions. Clapping should be vigorous but not painful. Cupping/Clapping
is never done on bare skin or performed over surgical incisions.
11. Percusses each lung segment on the chest wall anteriorly over the area of
lung for 1 to 2 minutes at a time by alternating the hands against the client
in a rhythmic manner. Listens for a hollow sound on percussion to verify
correct performance of the technique. Avoid clapping below the ribs, over
the liver (on the right), kidneys (on the lower back), spleen (on the right),
breast, scapula, clavicle, or sternum. Work from lower ribs to the top of the
chest in the front.
12. Repeat step #9 to the posterior segment of the lungs avoiding clapping over
the spine. Work from lower ribs to shoulders in the back.
13. After chest percussion, tells the client to inhale deeply through the nose and
then exhale in three short huffs. Then, have the client inhale deeply again
and cough through a slightly open mouth. Three consecutive coughs are
highly effective. An effective cough sounds deep, low, and hollow; an
ineffective one sounds high pitched.
14. Have the client perform coughing exercises for about 1 minute and then rest
for 2 minutes. Gradually progress to a 10-minute exercise period four times
daily. Try to schedule the last session just before bedtime.
15. Monitors the client's response to the treatment. Be alert for significant color
changes, particularly if the client becomes dusky.
16. Disposes secretions appropriately.
17. Provides oral hygiene.
18. Auscultates the client's lungs.
19. Records the date and time of chest physiotherapy; which chest segments
were percussed; the color, amount, odor, and viscosity of any secretions
produced and the presence of any blood; any complications and nursing
actions taken; and the client's tolerance of treatment.
20. Maintains body mechanics throughout the performance of the procedure.
21. Manifests neatness in the performed procedure
22. Shows calmness while performing the procedure.
TOTAL:

Comments:
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_________________________________________________________________________________________________________________
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Done by: Graded by:

_______________________________ _______________________________________
Student’s Printed Name and Signature Clinical Instructor’s Printed Name and Signature
Date: __________________________ Date:_______________________