Mohammad Ibrahim

BSRT-2

FRT lab: Activity 9

I. Procedure
1. Identify the parts of the following IPPB machine. (Drawing will be on handwritten)
2. Draw and label the IPPB circuit. (Drawing will be on handwritten)
II. Question for Research
1. Write the procedure on how to assemble IPPB circuit.
- Explain procedure to patient.
- Attach circuit corrugated tubing, expiratory valve line, and nebulizer tubing to IPPB machine.
Pressure test the circuit and machine to insure proper function; open up nebulizer control,
set inspiratory pressure level, and cycle the machine manually.
- Block the mouthpiece with sterile gauze or the sterile circuit package. The machine should
cycle off when the preset inspiratory pressure is reached.
- Aseptically prepare medication as prescribed and insert in the IPPB nebulizer.
- Instruct patient to:
a. Purse lips around mouthpiece so air do not leak, keeping the tongue back.
b. Breathe through the mouth only. Mask may be used if patient is unable to cooperate
with mouthpiece.
c. Inspire slowly and deeply not letting air “puff” cheeks out. Pause briefly at end of
inspiration then exhale.
- After patient is comfortable with this technique, treatment can begin.
- Set sensitivity to cycle on with patient’s inspiratory effort.
- Adjust inspiratory pressure to 10 – 15 cmH2O, assessing adequate volume by chest
expansion and auscultation.
- Adjust nebulizer controls to have medication nebulized adequately.
- Monitor patient throughout duration of treatment.
- When treatment is complete, detach circuit from IPPB machine, discard any excess solution
from nebulizer, and place circuit in plastic bag at bedside for use with next treatment.
- Age-appropriate considerations include assessing the patient’s ability to cooperate with a
mouthpiece. An appropriate fitting mask may be used if necessary in geriatrics.
2. During IPPB therapy, a patient suddenly complains of a sharp, left-sided chest pain. She
becomes cyanotic and dyspneic. How would you assess this patient’s condition and what
actions should be taken?
- Immediately stop the therapy, administer oxygen and notify the nurse and physician. Listen
to breath sounds and use diagnostic chest percussion and palpation to determine the
presence of a tension pneumothorax.
3. You note that a BIRD IPPB device is stuck in the inspiratory position. Identify 3 causes of this
problem and what you would need to do to correct each situation.
a. Leak in the circut or disconnect. check all connections to make sure they are tight.
b. Leak around the lips. make sure the lips are sealed or use are sealed or usea sealed
mouthpiece or mask.
c. Leak from nose. use noseclips
d. Malfunction of exhalation valve. replace circut