Ch. 7 Hyperinflation Therapy Flashcards
Which of the following increases the delivered tidal volume to a patient taking an IPPB treatment?
- Increasing flow rate
- Increase inspiratory pressure
- Decreasing sensitivity
- Decreasing flow rate
2 and 4
During an IPPB treatment, the patient suddenly complains of chest pain and becomes short of breath. On assessing the patient, you auscultate the chest and hear decreased breath sounds on the left. These findings are consistent with which of the following?
A. atelectasis
B. left sided pneumothorax
C. Pulmonary embolism
D. pleural effusion
Left-sided pneumothorax
The RT is administering IPPB and the patient complains of feeling lightheaded and dizzy. What should the therapist do to correct this?
A. instruct the patient to pause longer in between breaths
B. instruct the patient to take deeper breaths
C. Increase the inspiratory pressure
D. decrease the inspiratory flow
Instruct the patient to pause longer between breaths
While the RT is administering IPPB, the patient begins coughing up large amounts of blood. The therapist should?
A. continue the treatment and notify the physician that a chest x-ray is needed
B. decrease the inspiratory pressure
C. Stop the treatment briefly and resume it when the patient is feeling better
D. stop the treatment and notify the physician
stop the treatment and notify the physician
Which of the following are hazards of IPPB therapy?
- Excessive ventilation
- Increased cardiac output
- Decreased ICP
1 only
The RT has received an order to deliver IPPB to a patient with head trauma. What modifications and therapy may benefit this patient?
- Use a higher flow rate
- Use lower peak pressures
- Set the sensitivity to - 5 cm h2o
1 and 2 only
IS is ordered for a patient after abdominal surgery. Which of the following statements by the respiratory care practitioner would be most appropriate in the initial explanation of the therapy to the patient?
A. you may experience pain and lightheadedness from this therapy
B. we are trying to improve your inspiratory capacity
C. This therapy will help you take deep breaths and expand your lungs
D. your doctor has ordered this therapy to prevent atelectasis
This therapy will help you take deep breaths and expand your lungs
Sustained maximum inspiratory maneuvers performed with an I S would be most effective in the:
A. treatment of pneumonia
B. prevention of pneumonia
C. Treatment of pre-existing atelectasis
D. prevention of atelectasis
prevention of atelectasis
The initial inspiratory goal for a patient receiving IS should be?
A. twice the patients measured tidal volume
B. equal to the patient’s measure total volume
C. At least 1500 mL
D. 5 mL/kg of body weight
twice the patients measured tidal volume
While evaluating a postoperative patient for whom IS has been ordered, the RT obtains a vital capacity of 6 mL/kg of body weight. The therapist should do which of the following?
A. Recommend IPPB in place of IS
B. start the treatment as ordered
C. Measure the patient’s tidal volume
D. recommended bronchodilator using a handled nebulizer
Recommend IPPB in place of IS
IPPB is defined as a short term breathing treatment in which pressures above atmospheric pressure are delivered to the patient’s lungs via a pressure-limited ventilator
KNOW
What are some indications for IPPB therapy? (2)
- I need for delivery of medication’s to a patient who cannot take a deep breath (<10 mL/kg IBW)
- Atelectasis, especially in sedated postop patients and patients recovering from chest or abdominal surgery who are reluctant to breathe deeply or cannot take deep breaths on their own
What are hazards of IPPB therapy? (5)
- Excessive Ventilation
- Decreased CO ( patient may experience tachycardia and a decrease and systemic blood pressure)
- Increased ICP
- Pneumothorax
- Gastric Distention
Contraindications to IPPB therapy (2)
- untreated pneumothorax
- pulmonary hemorrhage
If the pulse rate increases more than 20 bpm what should be done to?
The Tx should be stopped and notify the physician
Increased Raw results in
decreased Vt
Decreased Raw result in
increased Vt
Increased lung complaince results in
increased Vt
Decreased lung compliance rsults in
decreased Vt
Increased inspiratory pressure results in
increased Vt
Decreased inspiratory pressure results in
decreased Vt
Increased flow results in
decreased Vt
Decreased flow results in
increased Vt
Increased flow results in __________ inspiratory time
Decreased
Decreased flow results
Increased inspiratory time
Increased lung compliance results in
Increased inspiratory time
Decreased lung compliance resulting
Decreased inspiratory time
Increased Raw results in
Decreased inspiratory time
Decreased Raw results in
Increased inspiratory time
The patient is having difficulty cycling the IPPB machine into the inspiratory phase. How should this be corrected?
Adjust the sensitivity so that the patient has to generate a pressure of -0.5 to - 2 cm H2O to start inspiration
The patient complains of dizziness and tingling in the extremities during the treatment but has no appreciable increased Hr. What should be done to correct this?
Instruct the patient to breathe slower and to pause longer between breaths
During inspiration, the manometer needle stays in the negative area for the first half of the breath and then rises to the positive area during the last breath. How should this be corrected?
Increase the machine flow rate
IPPB machine repeatedly cycles on shortly after the patient has begun the expiratory phase. What should be done to correct this?
- Decrease the machine sensitivity
- Make sure rate control is off
When is EzPAP indicated?
Prevention or treatment of atelectasis for patients who do not meet the guidelines of IS, a vital capacity (VC) of > 10 mL/kg IBW
Indications for IS (3)
- presence of atelectasis
- pts prone to atelectasis such as preop patients following upper abdominal or thoracic surgery
- presence of restrictive lung condition and quadriplegic or impaired diaphragm
What are some complications of IS (5)
- hyperventilation: have a patient pause longer between deep breaths
- Fatigue
- Ineffective if not performed properly
- IS is inappropriate if used as the only treatment for atelectasis or consolidation
- Discomfort secondary to inadequate pain control
Requirements for effective IS (4)
- cooperative patient
- motivated patient
- patients RR should be less than 25 breaths/min
- patient’s vital capacity should be more than 10 mL/kg body weight ** IPPB or EzPAP may be indicated if vital capacity is <10 mL/kg or IC <1/3 of predicted value
What is a good starting point for IS for the pt?
Twice the pt’s Vt
After a normal exhalation, inhale slowly and as deeply as possible (inspiratory capacity). Hold the breath for 3 to 5 seconds, then remove the mouthpiece and exhale normally
KNOW how to perform IS
