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2011-10-21 13:15:38
Crafton Hills College resp 131 IPV

Crafton Hills College resp 131 IPV
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  1. Is a form of chest physical therapy administered to the airways by a pneumatic deviced called the Percussinator.
    Intrapulmonary percussive ventilation (IPV)
  2. The breathing circuit of the IPV
  3. mini bursts of gas are delivered into the lungs at rates ___________
    between 100-300 bpm
  4. The three ways IPV can be delivered.
    Mask, mouth piece, or inline during mechanical ventilation
  5. Is depressed creating a continuous percussion with the patient breathing through the percussion as desired.
    Thumb button
  6. Allows dense aerosols to be delivered to promote:
    bronchial hygiene, reduce edema and decrease brinchoconstriction
  7. What is the traditional medication that is used for IPV
    Racemic Epinephrine
  8. What is the dilution of racemic epi. used?
    1/2cc of 2.25% and 20ccH2O
  9. What effect does sputum have on FRC?
  10. What effect does spasm have on FRC?
  11. What effect does collapse have on FRC?
  12. What effect does swelling have on FRC?
  13. What effect does Hyperinflation have on FRC?
  14. What type of bias flow pattern is used by IPV?
    Asymetric Bias Flow Pattern
  15. When gas flows over a thickly lined mucus layer, a shear force directly proportional to the velocity of the gas is produced.
    Asymetric Bias Flow Pattern
  16. If the Asymetric flow is maintained and exceeeds the cohesive and/or the adhesive forces of the mucus, the mucus will move?
    in the direction of gas flow.
  17. This is the mechanical device that delivers the pulsed gas to the Phasitron in the patient circuit.
  18. How is the percussionator operated?
    by a pneumatically powered pressure controller that is time cycled
  19. The percussinator is triggered by?
    the thumb control.
  20. Volume of pulsatile gas is controlled by adjusting the?
    System presssure
  21. What is the pressure that the IPV can deliver?
    Between 25-40 psi
  22. As the pressure is increased, the volume delivery is?
  23. How is frequency levels controled on the IPV-1C?
    Tthe iimpact control
  24. How is the frequency level controlled on the IPV-2C?
    The frequency control
  25. the frequency is adjustable between _________
    100-300 pulses per minute
  26. I:E ratios of the IPV?
  27. High frequencies cause what kind of I:E ratios?
  28. Low frequencies cause what kind of I:E ratios?
  29. The pulses of gas are delivered fro here.
  30. Each pulse of gas from the phasitron has an I:E ratio of?
  31. Phasitron: Gas is entrained during the inspiratory phase from the nebulizer through _____?
    Entrainment Port
  32. Phasitron: Open to ambient during expiratory phase.
    Exhalation port
  33. Aerosolized medication is admitted through tthe entrainment port and delivered to the patient's airway through the ?
  34. The patient is free to breathe aerosol passively from the nebulizer without any percussive effect whem this is open.
    The exhalation port
  35. Prevention and/or reversal of atelectasis, retained recretions in patients who are unable to deep breathe and cough effectively, Expected increase in pulmonary secretions secondary to injury or pathophysiology.
    Indications for IPV
  36. What is the abosolute contraindication for IPV
    untreated pneumothorax
  37. This IPV machine is suitable for the management of patients with cardiopulmonary disease in which secretion mobilization is desirable. is an acute care IPV.
  38. Is the most complex of the IPV vents. is an advanced post-surgical model intended for acute care use. Has the most control fetures giving the practioner great flexibility in the clinical application of the device.
  39. This is the on/off valve that controls the operation of the IPV-2. On i allows the practioner to operate the ventilator delivering IPV therapy, or IPV therapy with continuous positive airway pressure. This is termed oscillatory demand CPAP.
    Master Switch
  40. Regulates the percussive ventilation, flow of gas going out of the oscillator cartidge, and has the effect of reducing the percussive amplitude by modulatinf the output of the oscillator cartridge.
    Inspratory flow.
  41. This contril gives the practioner the ability to control the rate of inspiratory pressure rise during pulsed gas delivery, The control consists of a needle valve downstream from the oscillator.
    Inspiratory Time
  42. Allows the practioner to control the frequency of pulsed gas delivery to the Phasitron.
    Frequency Control
  43. Is a pressure reducing valve that determines the impact velocity of the percussive pulses.
    Source pressure
  44. It is recommended to begin therapy at?
  45. An adjustable regulator used to provide CPAP during oscillatory or demand ventilation.
    Demand CPAP control
  46. Located in the front panel to manually trigger the ventilator into the oscillatory mode. Is provided in the event the ventilator is used for cardiopulmonary resuscitaion efforts.
    Manual Inspiration
  47. Controls the frequency of the pulsed gas delivery to the Phasitron.
    Source Pressure Impact Control
  48. High density Aerosol Therapy, Extarthoracic percussion, IPPB, Mechanical Chest Thumpers, Squeezers and vibrators, upper airway secretion mobilizers, Bi level (I-E PAP) breathing devices CPAP devices, and Postural drainage are what?
    Features IPV combines
  49. These are What kind of patients that will benefit from IPV; Caridio pulmonary shock, acute COPD, Smoke inhalation and'or pulmonary burns, aspiration of irritants CHF, asthma, atelectasis or surgery leading to atelectasis, acute pneumonia, and infants with BPD meconium.
    Acute patients
  50. These are what kind of patients will benefit from IPV: Cyctic fibrosis, chronic bronchitis w/ emphysematous changes, bronchiectasis, neuomuscular disease or immobility, fibrotic disease, refractory hypoxemia.
    Chronic patients
  51. These are what kind of patients: Continue to smoke or visit smoking areas, abuses alcohol/drugs, malnurished, negative view on life, not follow exercises, not able to keep a daily record, Stressfull family life or lassitude, not follow the directions precisely, and non-compliant.
    Ones who would not benefit from IPV
  52. Prevention and/or reversal of atelectasis, retained secretions in patients who are unable to deep breathe and cough effectively, expected increase in pulmonary secretions secondary to injury or pathophysiology are what for IPV?
  53. Known bullous emphysema, S/P acute intracranial event, s/p intra-occular surgery, s/p head trauma, s/p repair of tracheosophageal tear, hemoptysis, hemodynamic instability, nausea, and active TB are what to IPV?
    relative contraindications
  54. Hyperventilation, pneumothorax, impedence of venous return leading to decreased cardiac output, increased intracranial and/or intra-occular pressure, gastric insufflation, hemoptysis, hypoxemia secondary to changing V/Q and/or decreased cardiac output, air trapping, auto peep, and/or overdistension of alveoli are what to IPV?
  55. How much medication or diluent is needed for every minute of treament desired?
    1cc per min.
  56. part of the start up: where should the percussiong control knob be set?
    at 12:00 (to possition)
  57. Part of the start up: What IPV operating pressure should it be started at?
    20-40psig (usually 25psig to start)
  58. Start the IPV TX by instructing the patient to breath mist for?
  59. When do you stop the treatment?
    when the neb. is empty
  60. Gen Guid. for IPV on vents: Place the vent on SIMV or CPAP mode. Assit contro/CMV mode is _________
    NOT recomended.
  61. Gen Guid. for IPV on vents: Pressure support should be ______?
    turned off
  62. Gen Guid. for IPV on vents: should volume or pressure modes be used?
    both can be used.
  63. Gen Guid. for IPV on vents: A rise of _______ in peak airway pressure is often required to administer effective airway percussions.
    15 cm H2O
  64. Gen Guid. for IPV on vents: Increase the _____&______ to avoid alarm violations
    high minute & tidal volume alarm
  65. Gen Guid. for IPV on vents: the IPV treatment should not be used w/o ________
    normal saline or other meds.
  66. aerosol is delivered at approx.
    15Lpm (1cc/min)
  67. If using a mask delivery, tight seal is not necessary but may need to?
    increase delivery pressure
  68. If giving O2, percentage is between?
  69. Be prepared to suction how long after TX?
    30-60 mins
  70. Is the device gravity dependent?
  71. When should you lube the connections?
  72. disassemble phasitron for cleaning espcially if using?
    saline in neb.
  73. How often should it be calibrated?
  74. When should it be overhauled?
    every three years
  75. Increased sputum production, improved breath sounds, improved lung and chest wall mechanics, resolution of lung infiltrates and atelectasis as shown on CXR are what to IPV?
    clinical outcomes
  76. compare and contrast IPPB and IPV: This has positive pressure insp. max, min. rates, patient and seal dependent, min. airway support, pressure barotrauma risk, min. aerosol deposition.
  77. compare and contrast IPPB and IPV: This has step inflation pressure splint, percussive rate max 200, patient and seal semidependent, max. airway support, min barotrauma risk, max aerosol deposition, time saving, two treatments in one, frequency of TX can be decreased as desired.
  78. IPV appears to be the most effective means of reducing?
    airway obstruction
  79. IPV has been shown to increase pulmonary function and improve Oxygenation by?
    splinting the airway open
  80. IPV can significantly improve oxygenation and has little harmful effect on?
  81. IPV delivers mini burst of air on?
    both inhalation and expiration
  82. IPV is as effective as CPT, flutterm or chest vest therapy in?
    improving pulmonary fuction and sputum experctoration
  83. IPV has shown more clinically important improvement in atelectasis than?