RESP 130 Week 7 – Lung Expansion Therapy

This set of flashcards covers essential concepts and facts regarding lung expansion therapy, including factors associated with atelectasis, clinical signs, procedures like IS and IPPB, contraindications, indications, and outcomes of therapies.

What are the 8 factors associated with atelectasis?

1. Obesity 2. Neuromuscular disorders 3. Heavy sedation 4. Surgery near diaphragm 5. Bed rest 6. Poor cough 7. History of lung disease 8. Restrictive chest-wall abnormalities

What are the 6 clinical signs of atelectasis?

1. History of recent major surgery 2. Tachypnea 3. Fine, late-inspiratory crackles 4. Bronchial or diminished breath sounds 5. Tachycardia 6. Increased density and signs of volume loss on chest radiograph.

What does lung expansion therapy do?

Increases lung volume by increasing the transalveolar pressure

What are the two ways that PAL gradient can be increased?

Decreasing surrounding pleural pressure 2. Increasing alveolar pressure

What is the best way to keep lungs expanded?

Early mobilization of the patient

What are the 3 most common complications of incentive spirometry?

1. Hyperventilation and respiratory alkalosis 2. Discomfort secondary to inadequate pain control 3. Fatigue

Between flow oriented and volume oriented which type of IS device is more popular?

Flow oriented

What is the typical frequency for IS use?

5-10 times an hour

What are the three things necessary for successful IS implementation?

1. Cooperation from the patient 2. Effective teaching 3. Return demonstration to ensure understanding

What does IPPB stand for?

Intermittent positive pressure breathing

What does IPPB do?

Uses positive airway pressure to expand the lungs

What are 5 indications for IPPB?

1. To improve lung expansion in patients with atelectasis 2. To clear secretions in patients who can’t cough effectively 3. As an alternative to intubation or continuous ventilatory support 4. To deliver aerosol medication to patients with respiratory muscle fatigue 5. To reduce the sensation of dyspnea

What are 4 contraindications for IPPB?

1. ICP greater than 15 mmHg 2. Hemodynamic instability 3. Active hemoptysis 4. Nausea

What are the 4 steps to implement IPPB?

1. Preliminary planning 2. Evaluating alternatives 3. Baseline assessment 4. Discontinuation and follow-up

What does CPAP do?

Elevates and maintains high alveolar and airway pressures throughout the full breathing cycle

What are two indications for CPAP?

1. Treatment of atelectasis 2. Treatment of cardiogenic pulmonary edema

What are two contraindications for CPAP?

1. Hemodynamic instability 2. Patient with hypoventilation

What are 4 complications associated with CPAP?

1. Barotrauma 2. Hypoventilation 3. Gastric distention 4. Vomiting and aspiration

True or False: CPAP helps with hypercapnia?

False

What is the most common problem with PAP therapies?

Leaks

What are the 4 types of threshold resistors?

1. Underwater seal resistors 2. Weighted-ball resistors 3. Spring-loaded valve resistors 4. Magnetic valve resistors

How is EPAP different from CPAP?

EPAP only creates PAP during expiration, CPAP creates it continuously

What are 4 indications for PEP therapy?

1. Reduce air trapping with asthma or COPD 2. Mobilize secretions in patients with cystic fibrosis and chronic bronchitis 3. Prevent or reverse atelectasis 4. Optimize bronchodilator therapy

What is one major contraindication for PEP therapy?

Untreated tension pneumothorax

What are 2 major expected outcomes of PEP therapy?

1. Increase sputum production (<30 mL/day) 2. Improved breath sounds