ch 39 incentive spirometry Flashcards
(56 cards)
what is the purpose of IS
guide the patient to take a sustained maximal inspiratory effort resulting in a decrease in Ppl and maintain the patency of airways at risk for closure
what are IS devices designed for
mimic natural sighing by encouraging patients to take slow, deep breaths
how can IS can be performed
using devices that provide visual cues to patients when the desired inspiration flow or volume has been achieved
what should patients respiratory rate be to do IS
should be less than 25 breaths/min
what should patients vital capacity be for IS
should be more than 10 mL/kg of body weight
what type of attitudes should a patient have for IS
cooperative and motivated patient
what is the true benefit of IS
best achieved by repeated use and proper technique
what is the basic maneuver of IS
sustained maximal inspiration (SMI)
what is SMI
slow, deep inhalation from the functional residual capacity up to the total lung capacity, followed by a 5 second lung stretch
during the inspiratory phase of spontaneous breathing what happens
the decrease in Ppl caused by the breath is transmitted to the alveoli
lower the head of the bed what happens to vital capacity
vital capacity gets smaller, and the patient feels the pressure of their abdominal contents into their rib cage
what is the inspired volume goal set on
the basis of predicted values or observation of initial performance
what is the primary indication for IS
treat existing atelectasis
what are the 3 indications for IS
- presence of pulmonary atelectasis
- presence of conditions predisposing to atelectasis
- presence of a restrictive lung defect associated with quadriplegia or dysfunctional diaphragm
what are the 4 contraindications for IS
- patient can’t be instructed or supervised to ensure appropriate use of device
- patient can’t cooperate or understand
- patient can’t take a deep breath in
- presence of an open tracheal stoma requires additional equipment
What are some hazards and complications (5)
- hyperventilation and respiratory alkalosis
- discomfort secondary to inadequate pain control
- pulmonary barotrauma
- exacerbation of bronchospasm
- fatigue
what are the 3 assessment of needs for IS
- surgery with upper abdomen/thorax
- conditions that could lead to atelectasis – immobility, poor pain control, and abdominal binders
- presence of neuromuscular disease involving respiratory musculature
what is the assessment of outcome (7) not all are listed
- absence or improvement of atelectasis
- decreased respiratory rate
- resolution of fever
- normal pulse rate
- normal breath sounds
- normal chest x-ray
- return of FRC/VC to preoperative values
what is the most common problem when a patient performs IS too rapidly
acute respiratory alkalosis
what are the most frequently reported symptoms associated with respiratory alkalosis
dizziness and numbness
IS devices can be categorized into what 2 categories
volume oriented
flow oriented
flow-oriented devices measure and virtually indicate what
the degree of inspiratory flow
both flow oriented and volume oriented devices attempt to attempt what goal for the patient
sustained maximal inspiratory effort to prevent or correct atelectasis
what 3 phases does the successful application of IS include
- planning
- implementation
- follow-up
