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Ch39 pg 909-918
Res 130 Lung Expansion Therapy/Bronchial Hygiene Exam 2
| Question | Answer |
|---|---|
| Which of the following is not a potential hazard of intermittent positive-pressure breathing? | A) Increased cardiac output |
| Which of the following statements is not true about intermittent positive-pressure breathing (IPPB)? | D) IPPB should be the single treatment modality for resorption atelectasis. |
| All of the following parameters should be evaluated after intermittent positive-pressure breathing therapy except: | D) temperature. |
| All of the following machine performance characteristics should be monitored during intermittent positive-pressure breathing therapy except: | C) humidity output. |
| Which of the following initial flow settings would you select when setting up a continuous positive airway pressure flow-mask system for a patient with atelectasis? | A) 2 to 3 times the patient’s minute ventilation |
| In order to eliminate leaks in an alert patient receiving intermittent positive-pressure breathing therapy, which of the following adjuncts would you first try? | D) Nose clips |
| Which of the following patient groups should be considered for lung expansion therapy using intermittent positive-pressure breathing (IPPB)? | A) I and II I. Patients with clinically diagnosed atelectasis who are not responsive to other therapies. II. Patients at high risk for atelectasis who cannot cooperate with other methods. |
| Which of the following positions is ideal for intermittent positive-pressure breathing therapy? | A) Semi-Fowler's |
| Which of the following are appropriate initial settings for intermittent positive-pressure breathing given to a new patient? | C) Sensitivity 1 to 2 cm H2O below ambient pressure (i.e. -1 to -2 cmHO); pressure 10 to 15 cm H2O; moderate flow |
| When checking a patient’s intermittent positive-pressure breathing (IPPB) breathing circuit before use, you notice that the device will not cycle off, even when you occlude the mouthpiece. What would be the most appropriate action in this case? | B) Check the circuit for leaks. |
| What is the minimum airway pressure at which the esophagus opens, allowing gas to pass directly into the stomach? | B) 20 cm H2O |
| Which of the following will make an intermittent positive-pressure breathing (IPPB) device cycle off prematurely? I. Airflow obstructed II. Kinked tubing III. Occluded mouthpiece IV. Active resistance to inhalation | D) I, II, III, and IV I. Airflow obstructed II. Kinked tubing III. Occluded mouthpiece IV. Active resistance to inhalation |
| Which of the following is an absolute contraindication for using intermittent positive-pressure breathing? | C) Tension pneumothorax |
| During administration of a continuous positive airway pressure flow mask to a patient with atelectasis, you find it difficult to maintain the prescribed airway pressure. Which of the following is the most common explanation? | A) System or mask leaks |
| Which of the following is NOT a potential contraindication for intermittent positive-pressure breathing? | D) Neuromuscular disorders |
| Which of the following are potential desirable outcomes of intermittent positive-pressure breathing (IPPB) therapy? I. Improved oxygenation II. Increased cough and secretion clearance III. Improved breath sounds IV. Reduced dyspnea | D) I, II, III, and IV I. Improved oxygenation II. Increased cough and secretion clearance III. Improved breath sounds IV. Reduced dyspnea |
| The general assessment, common to all patients for whom intermittent positive-pressure breathing (IPPB) is ordered, should include which of the following? | D) I, II, and III I. Measurement of vital signs II. Appearance and sensorium III. Chest auscultation |
| What is the most common complication associated with intermittent positive-pressure breathing (IPPB)? | C) Respiratory alkalosis |
| Which of the following should be charted in the patient’s medical record after completion of an intermittent positive-pressure breathing treatment? | D) I, II, and III I. Results of pre- and posttreatment assessment II. Any side effects III. Succint but complete account of the treatment session. |
| Which of the following are contraindications for continuous positive airway pressure (CPAP) therapy? | C) I, II, and III I. Hemodynamic instability II. Hypoventilation III. Facial trauma |
| Which of the following are appropriate volume goals for intermittent positive-pressure breathing (IPPB) therapy? | B) I and II I. 10 to 15 ml/kg ideal body weight II. At least 30% of the inspiratory capacity (IC) |
| Prior to starting intermittent positive-pressure breathing (IPPB) on a new patient, what should the practitioner explain? | A) I, II, III, and IV I. Why the physician ordered the treatment. II. What the IPPB treatment will do. III. How the IPPB treatment will feel. IV. What the expected results are. |
| Which of the following are potential complications of continuous positive airway pressure (CPAP) therapy? | C) I, III, and IV I. Barotrauma III. Gastric distention IV. Hypercapnia |
| Which of the following is false about gastric distention with intermittent positive-pressure breathing (IPPB)? | D) Gastric distention is a relatively harmless effect of IPPB. |
| Which of the following mechanisms probably contribute to the beneficial effects of continuous positive airway pressure (CPAP) in treating atelectasis? | D) I, II, III, and IV I. Recruitment of collapsed alveoli. II. Decreased work of breathing. III. Improved distribution of ventilation. IV. Increased efficiency of secretion removal. |
| What is the optimal breathing pattern for intermittent positive-pressure breathing (IPPB) treatment of atelectasis? | A) Slow, deep breaths held at end-inspiration. |
| A patient receiving +12 cm H2O flow-mask continuous positive airway pressure, you note that the pressure drops to +6 cm H2O during inspiration, but returns to +12 cm H2O during exhalation. Which of the following would likely correct this problem? | C) Increase the system flow. |
| Which of the following are essential components of a continuous positive airway pressure (CPAP) flow system? | D) I, II, III, and IV I. Blended source of pressurized gas II. Breathing circuit with reservoir bag III. Low-pressure or disconnect alarm IV. Expiratory threshold resistor |
| Intermittent positive-pressure breathing is associated with a passive exhalation. | A) True |
| In administering intermittent positive-pressure breathing therapy, which of the following breathing patterns would be most desirable? | A) 6 to 8 breaths/min, inspiration/expiration ratio (I:E) of 1:3 |
| The "Administration" of intermittent positive-pressure breathing (IPPB) should include which of the following? | C) I, II, and III I. Evaluating alternative approaches to the patient's problem. II. Setting specific, individual clinical goals or objectives. III. Conducting a baseline assessment of the patient. |
| In terms of machine performance, what large negative pressure swings early in inspiration indicate? | B) Incorrect sensitivity |
| When adjusting the sensitivity control on an intermittent positive-pressure breathing device, which of the following parameters are you changing? | C) Effort required to cycle the device “on” (begin inspiration). |
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Cam1228
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