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Respiratory Care Seminar > Ch. 7 Hyperinflation Therapy > Flashcards

Ch. 7 Hyperinflation Therapy Flashcards

1
Q

Which of the following increases the delivered tidal volume to a patient taking an IPPB treatment?

  1. Increasing flow rate
  2. Increase inspiratory pressure
  3. Decreasing sensitivity
  4. Decreasing flow rate
A

2 and 4

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2
Q

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

A

Left-sided pneumothorax

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3
Q

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

A

Instruct the patient to pause longer between breaths

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4
Q

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

A

stop the treatment and notify the physician

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5
Q

Which of the following are hazards of IPPB therapy?

  1. Excessive ventilation
  2. Increased cardiac output
  3. Decreased ICP
A

1 only

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6
Q

The RT has received an order to deliver IPPB to a patient with head trauma. What modifications and therapy may benefit this patient?

  1. Use a higher flow rate
  2. Use lower peak pressures
  3. Set the sensitivity to - 5 cm h2o
A

1 and 2 only

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7
Q

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

A

This therapy will help you take deep breaths and expand your lungs

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8
Q

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

A

prevention of atelectasis

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9
Q

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

A

twice the patients measured tidal volume

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10
Q

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

A

Recommend IPPB in place of IS

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11
Q

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

A

KNOW

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12
Q

What are some indications for IPPB therapy? (2)

A
  1. I need for delivery of medication’s to a patient who cannot take a deep breath (<10 mL/kg IBW)
  2. 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
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13
Q

What are hazards of IPPB therapy? (5)

A
  • Excessive Ventilation
  • Decreased CO ( patient may experience tachycardia and a decrease and systemic blood pressure)
  • Increased ICP
  • Pneumothorax
  • Gastric Distention
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14
Q

Contraindications to IPPB therapy (2)

A
  • untreated pneumothorax
  • pulmonary hemorrhage
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15
Q

If the pulse rate increases more than 20 bpm what should be done to?

A

The Tx should be stopped and notify the physician

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16
Q

Increased Raw results in

A

decreased Vt

17
Q

Decreased Raw result in

A

increased Vt

18
Q

Increased lung complaince results in

A

increased Vt

19
Q

Decreased lung compliance rsults in

A

decreased Vt

20
Q

Increased inspiratory pressure results in

A

increased Vt

21
Q

Decreased inspiratory pressure results in

A

decreased Vt

22
Q

Increased flow results in

A

decreased Vt

23
Q

Decreased flow results in

A

increased Vt

24
Q

Increased flow results in __________ inspiratory time

A

Decreased

25
Q

Decreased flow results

A

Increased inspiratory time

26
Q

Increased lung compliance results in

A

Increased inspiratory time

27
Q

Decreased lung compliance resulting

A

Decreased inspiratory time

28
Q

Increased Raw results in

A

Decreased inspiratory time

29
Q

Decreased Raw results in

A

Increased inspiratory time

30
Q

The patient is having difficulty cycling the IPPB machine into the inspiratory phase. How should this be corrected?

A

Adjust the sensitivity so that the patient has to generate a pressure of -0.5 to - 2 cm H2O to start inspiration

31
Q

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?

A

Instruct the patient to breathe slower and to pause longer between breaths

32
Q

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?

A

Increase the machine flow rate

33
Q

IPPB machine repeatedly cycles on shortly after the patient has begun the expiratory phase. What should be done to correct this?

A
  1. Decrease the machine sensitivity
  2. Make sure rate control is off
34
Q

When is EzPAP indicated?

A

Prevention or treatment of atelectasis for patients who do not meet the guidelines of IS, a vital capacity (VC) of > 10 mL/kg IBW

35
Q

Indications for IS (3)

A
  • 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
36
Q

What are some complications of IS (5)

A
  1. hyperventilation: have a patient pause longer between deep breaths
  2. Fatigue
  3. Ineffective if not performed properly
  4. IS is inappropriate if used as the only treatment for atelectasis or consolidation
  5. Discomfort secondary to inadequate pain control
37
Q

Requirements for effective IS (4)

A
  • 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
38
Q

What is a good starting point for IS for the pt?

A

Twice the pt’s Vt

39
Q

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

A

KNOW how to perform IS

Respiratory Care Seminar (19 decks)

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