Respiratory Therapy Techniques
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Respiratory Therapy Techniques

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Questions and Answers

What is the target inspiratory effort for incentive spirometry, based on the patient's inspiratory capacity?

  • 30% of inspiratory capacity (correct)
  • 20% of inspiratory capacity
  • 40% of inspiratory capacity
  • 50% of inspiratory capacity

    • Which statement about EzPAP is true?

  • It must be used exclusively with a nebulizer.
  • It utilizes the 'Coanda' effect to enhance flowmeter output. (correct)
  • It is the only therapy available for conscious patients.
  • It cannot be used with unconscious patients.

    • What is the primary purpose of vibratory therapy?

  • Increase lung capacity significantly
  • Rehabilitate pulmonary function in athletes
  • Constrict airways to prevent mucus buildup
  • Loosen and remove secretions from airways (correct)

    • Which device is known for having variable resistance and is suitable for cooperative patients?

    <p>Acapella</p> Signup and view all the answers

    Which of the following is NOT an objective of PAP therapy?

    <p>Directly increase inspiratory capacity</p> Signup and view all the answers

    Which statement about CPAP is correct?

    <p>CPAP can assist with conditions like OSA and cardiogenic pulmonary edema.</p> Signup and view all the answers

    What is a primary indication for BiPAP therapy?

    <p>Ventilation support for COPD patients.</p> Signup and view all the answers

    Which of the following statements about CPAP therapy is false?

    <p>CPAP is primarily used for ventilation issues.</p> Signup and view all the answers

    Which condition could potentially contraindicate the use of CPAP?

    <p>Barotrauma.</p> Signup and view all the answers

    How does BiPAP differ from CPAP?

    <p>BiPAP is primarily used for ventilation rather than oxygenation.</p> Signup and view all the answers

    What is the primary characteristic of passive atelectasis?

    <p>Loss of negative pressure in the pleural space</p> Signup and view all the answers

    Which of the following is NOT a sign of atelectasis?

    <p>Increased respiratory rate</p> Signup and view all the answers

    Which condition is characterized by low lung compliance?

    <p>Pneumonia</p> Signup and view all the answers

    What factor increases the risk of respiratory complications after upper abdominal surgery?

    <p>Obesity</p> Signup and view all the answers

    Which type of atelectasis occurs due to airway obstruction that prevents air intake into the alveoli?

    <p>Absorption atelectasis</p> Signup and view all the answers

    What does IPAP stand for in the context of Positive Airway Pressure instruments?

    <p>Inspiratory Positive Airway Pressure</p> Signup and view all the answers

    When EPAP is set equal to IPAP, what type of therapy does it provide?

    <p>Continuous Positive Airway Pressure</p> Signup and view all the answers

    What is typically required to estimate FiO2 when using home models of oxygen therapy with PAP?

    <p>Calculated oxygen flow</p> Signup and view all the answers

    What is the purpose of Flex settings in Positive Airway Pressure instruments?

    <p>Reducing pressure during exhalation</p> Signup and view all the answers

    What is the recommended starting pressure range for CPAP therapy?

    <p>8 to 12 cmH2O</p> Signup and view all the answers

    When should the FiO2 be increased to 100% in oxygen therapy with PAP?

    <p>If lower FiO2 is ineffective</p> Signup and view all the answers

    What is the role of Auto-Titration in PAP devices?

    <p>Adjusts pressures based on breathing patterns</p> Signup and view all the answers

    What additional oxygen might be necessary if a patient is already on a 2L Nasal Cannula while using a PAP device?

    <p>4 liters of extra oxygen</p> Signup and view all the answers

    What is the typical starting pressure setting for BiPAP?

    <p>12/6</p> Signup and view all the answers

    Which adjustment should be made to maintain the Delta if IPAP is increased?

    <p>Increase EPAP by the same amount</p> Signup and view all the answers

    What is a primary benefit of pursed lip breathing?

    <p>Prevents airway collapse</p> Signup and view all the answers

    How should oxygen titration be adjusted if SpO2 levels improve during BiPAP therapy?

    <p>Decrease FiO2 to 50-60% first</p> Signup and view all the answers

    Which condition is NOT an indication for pursed lip breathing?

    <p>Lung cancer</p> Signup and view all the answers

    Study Notes

    BiPAP

    • BiPAP uses two pressures: IPAP (inspiratory) and EPAP (expiratory)
    • Starting pressure: Typically set at 12/6 (IPAP/EPAP), adjust based on individual needs
    • Increasing ventilation: If necessary, increase IPAP and EPAP by the same amount to maintain the difference between the two
    • Decreasing oxygen titration: Reduce oxygen if blood oxygen levels improve
    • EPAP is similar to PEEP (Positive End-Expiratory Pressure) and CPAP
    • Increasing EPAP helps improve oxygenation

    Pursed Lip Breathing

    • Creates back-pressure within the airways and alveoli
    • Prevents collapse: Helps prevent atelectasis (lung collapse)
    • Achieved by: Exhaling against partially closed lips
    • Indicated for: Asthmatics, exacerbations of COPD, and other obstructive diseases
    • Benefits:
      • Improves ventilation
      • Helps remove trapped air (CO2)
      • Decreases work of breathing (WOB)
      • Prevents rapid-shallow breathing

    Incentive Spirometry

    • Basic process:
      • Involves sustained, maximal inspiration for 5 to 10 seconds
      • Measures the patient's inspiratory capacity
    • Target: Usually 30% of the patient's inspiratory capacity (IC)
    • Calculation Example: IC = IBW (kg) x 45
    • Requires patient cooperation

    EzPAP

    • Alternative to Incentive Spirometry for patients unable to cooperate
    • Can be used for unconscious patients
    • Therapeutic range: 8 to 12 cmH2O
    • Can be coupled to a nebulizer
    • Replaces older IPPB therapy

    Vibratory Therapy

    • Loosen and remove secretions
    • Devices: Acapella, Flutter Valve, AerobiKA, Metaneb
    • Acapella: Uses mouthpiece or mask, features variable resistance

    PAP - Positive Airway Pressure

    • Objectives:
      • Prevent or improve atelectasis
      • Increase Functional Residual Capacity (FRC)
      • Open Airways

    CPAP

    • Primarily used for:
      • Treatment of atelectasis
      • Oxygenation
      • OSA
      • Cardiogenic pulmonary edema
    • Maintains positive pressure throughout inspiration and expiration
    • Typical pressures: 8 to 12 cmH2O for adults
    • Does not benefit: Refractory oxygenation (FiO2 alone does not improve SpO2)
    • May be administered by: Nasal pillows, nasal mask, total face mask

    BiPAP

    • Primarily used for:
      • Ventilation
      • OSA
      • COPD patients
    • Best choice for ventilation issues
    • May be administered by: Nasal pillows, nasal mask, total face mask

    Lung Expansion Therapy

    • To prevent or resolve atelectasis
    • Collapsed alveoli: Due to decreased FRC
    • Types of atelectasis:
      • Passive (relaxation atelectasis): Loss of negative intrapleural pressure
      • Absorption: Complete obstruction of airway preventing air intake

    Patient profiles at risk for respiratory complications

    • Obesity
    • OSA
    • Smoking
    • COPD
    • Diabetes
    • Hypertension

    Lung Compliance

    • Ability of the lungs to stretch and expand
    • Types:
      • Static (air not moving)
      • Dynamic (air is moving)
    • Low compliance (stiff lungs):
      • Hard for patient to inspire
      • Lungs recoil well (easier exhalation)
    • High compliance (floppy lungs):
      • Air enters normally
      • Exhalation is more difficult

    Pressures

    • IPAP: Inspiratory Positive Airway Pressure
    • EPAP: Expiratory Positive Airway Pressure
    • Delta (P/S): Difference between IPAP and EPAP

    Oxygen Therapy with PAP

    • Direct Supply: Some units directly supply oxygen
    • Indirect Supply: Requires adding oxygen through a tubing and adapter

    Features of the Instrument

    • Auto-Titration: Automatically adjusts pressures based on breathing pattern
    • Flex Settings: Reduces pressure during exhalation
    • Titration/Management Considerations (CPAP):
      • Starting Pressures: 8 to 12 cmH2O
      • Rule of thumb:
        • Low SpO2/PaO2: Increase FiO2
        • FiO2 50-60% and low SpO2/PaO2: Increase CPAP pressure
        • High FiO2 (50-60%) ineffective: Increase FiO2 even if above 60%
        • FiO2 100% ineffective: Shunt present, increase pressure

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    Description

    This quiz covers essential respiratory therapy techniques, focusing on BiPAP, pursed lip breathing, and incentive spirometry. Learn how these methods improve ventilation, prevent lung complications, and optimize oxygenation for patients with respiratory issues. Test your knowledge and understanding of these critical respiratory interventions.

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