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Fundamentals Unit 8

SPC Fundamentals Unit 8 Exam 3

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