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Fundamentals Unit 8
SPC Fundamentals Unit 8 Exam 3
| Question | Answer |
|---|---|
| Hyperinflation Pressures | IS=Negative pleural & alveolar pressure IPPB=Positive alveolar & pleural pressure PEP=Positive alveolar & pleural pressure |
| IS | Incentive Spirometer |
| IPPB | Intermitted Positive Pressure Breathing |
| PEP | Positive Expiratory Pressure |
| Cardiovascular Effects of Positive Pressure Therapy | 1. Decrease venous return 2. Decrease C.O. 3. Increase PVR (Pulmonary Vascular Resistance) 4. Increase ICP (Intracranial Pressure) |
| Clinical Application for Positive Pressure Therapies | "Use all hyperinflation Txs" Patients with Neuromuscular Disease Patients with post-op abdominal/thoracic surgery |
| Incentive Spirometer is... | A sustained maximal inspiration device that gives visual/auditory feedback to encourage breath hold for >3sec 5-10 breath every 1-2hrs |
| Indications of IS | Atelectasis VC (Vital Capacity) >10-15ml/kg |
| Contraindications of IS | Uncooperative Patients VC (Vital Capacity) <10-15ml/kg |
| Hazards of IS | 1. Hyperventilation (may cause dizziness) 2. Fatigue 3. Hypoxemia |
| Equipment of IS | Volume-bellows/piston Flow-ping-pong balls |
| Monitoring of IS | Improved 1. Breath Sounds 2. Chest X-Ray 3. Volume/Flow Setting 4. Breath Hold |
| Intermitted Positive Pressure Breathing is... | Application of positive pressure upon inspiration to a spontaneously breathing patient for 10-20min Typically QID |
| Indications of IPPB is | Atelectasis Patients who cannot or will not take a deep breath VC (Vital Capacity) <10-15 ml/kg |
| Contraindications of IPPB is | Absolute: Untreated tension Pneumothorax Relative: ICP>15mmHg (Normal is <10mmHg) & Active Hemoptysis |
| Hazards of IPPB is | 1. Pulmonary Barotrauma 2. Gastric Distension 3. Decreased venous return |
| Equipment of IPPB is | 1. Pressure-cycled IPPB machine 2. Disposable breathing circuit w/ medication nebulizer |
| Monitoring of IPPB Machine is | Sensitivity/ Peak Pressure/ Flow |
| Monitoring of IPPB Patient is | Tidal Volume/ Respiratory Rate Should improve: Breath Sounds/X-Ray |
| Calculate Tidal Volume VT for IPPB | 1/3 predicted IC (50ml/kg) Weight of Patient x 50=(?) (?)/3=(?)ml |
| CPAP (Continuous Positive Airway Pressure) | For ventilator pressure |
| EPAP (Expiratory Positive Airway Pressure) | For hyperinflation & bronchial hygiene Tx Same as PEP |
| PEP (Positive Expiratory Pressure) | For hyperinflation & bronchial hygiene Tx Same as EPAP |
| Indications for PEP is | Atelectasis Excessive Airway Secretions VC (Vital Capacity) >10-15ml/kg |
| Contraindications for PEP is | Absolute: 1. Untreated Tension Pneumothorax Relative: 1. ICP (Intracranial Pressure) >15mmHg 2. Epistaxis 3. Active hemoptyis |
| Hazards of PEP is | 1. Increased ICP 2. Decrease Venous Return 3. Gastric Distention 4. Epistaxis |
| Equipment of PEP is | 1. Disposable 2. Variable Resistance 3. Flow Resistor |
| Monitoring of PEP is | Sputum--Volume/Qualities Improved Breath Sounds & X-Ray |
| ACD | Airway Clearance Devices |
| Indication of ACDs | Mobilized Secretions |
| Oscillation in terms of Airway Clearance Devices | Rapid air vibration transmitted to the thorax-lungs in order to enhance the mobilization of secretions |
| HFCWC Devices (ACD) | High Frequency Chest Wall Compressions |
| Features of HFCWC Devices | Oscillatory Generator 5-25 hertz Vest or Shell Fitted to patients chest 1 hertz=60 cycles per min |
| HFO Devices (ACD) | High-Frequency Oscillatory Ventilator |
| Features of HFO Devices | Flutter Valve Steel Ball creates PEP Angle held effects hertz (15) |
| Acapella HFO Device | Uses a counterweighted plug and magnet to generate oscillation through pivoting cone up to 30hz |
| (IPV) Intrapulmonary Percussive Ventilator HFO Device | Pneumatic device that delivers oscillations @ 6-14hz via a circuit/nebulizer/mouthpiece set up |
| M-I-E Device (ACD) | Mechanical Insufflation/Exsufflation |
| Features of M-I-E Device | Used on patients with neuromuscular disorders that cannot clear disorders Peak cough flow <270 L/m Artificial Cough Machines +Pressure 30-50cmH2O via mask for 1-3sec then -Pressure of -30 to -50 for 2-3sec Repeat 5x |
| Monitoring of M-I-E Device | Sputum--Volume/Qualities Improved Breath Sounds & Chest X-Rays |
| ACBT | Airway Clearance Breathing Technique |
| Indications of ACBT | Mobilized Secretions |
| FET (ACBT) | Forced Expiratory Techniques |
| FET (Huff Cough) | A cough maneuver where forced exhalation from low to middle lung volume With Glottis open-patient should phonate or huff Helps prevent airway collapse |
| ACB (ACBT) | Active Cycle of Breathing |
| AD (ACBT) | Autogenic Drainage |
| AD is | "Unstick" peripheral mucus by breathing at low lung volumes "Collect" mucus from middle airways by breathing at tidal volumes "Evacuate" central airways by using high lung volumes |
| Monitoring of ACBT is | Sputum--Volume/Qualities Improved Breath Sounds & Chest X-Ray |
Created by:
Langhout1418
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