IPPB

diaphragmatic breathing diaphragmatic respiration.

frog breathing (glossopharyngeal breathing) respiration unaided by the primary or ordinary accessory muscles of respiration, the air being “swallowed” rapidly into the lungs by use of the tongue and the muscles of the pharynx; used by patients with chronic muscle paralysis to augment their vital capacity.

intermittent positive pressure breathing (IPPB) see intermittent positive pressure breathing.

mouth breathing breathing through the mouth instead of the nose, usually because of some obstruction in the nasal passages.

breathing pattern, ineffective a nursing diagnosis approved by the North American Nursing Diagnosis Association, defined as inspiration and/or expiration that does not provide adequate ventilation. Etiologic and contributing factors include disorders of the nervous system in which there is abnormal response to neural stimulation, as in spinal cord injury; impairment of musculoskeletal function, as in trauma to the chest; pain and discomfort associated with deep breathing, as after abdominal or thoracic surgery; fatigue and diminished energy level; inadequate lung expansion, as in poor body posture and positioning; inappropriate response to stress, as in hyperventilation; inflammation of respiratory structures; and tracheobronchial obstruction.

Subjective symptoms include reports of dyspnea, shortness of breath, pain associated with breathing, complaints of dizziness, and previous episodes of emotional or physical stress or fear and anxiety. Objective symptoms include increased respiratory rate and changes in depth of respirations, fremitus, abnormal arterial blood gases, nasal flaring, orthopnea or assumption of the three-point position, in which the patient sits down and elevates the shoulders by stiffening each arm and pushing downward with the hands on the chair or bed, use of accessory muscles of respiration, increased anteroposterior diameter of chest (barrel chest), and altered chest excursion.

The goal of nursing intervention is to help the patient experience improved gas exchange by using a more effective breathing pattern. This might include teaching appropriate breathing exercises and proper use of accessory muscles of respiration, and encouraging body posture that maximizes expansion of the lungs. If postoperative pain is a contributing factor, providing support of the operative site to reduce strain during coughing or moving about could encourage deeper respirations and a more normal breathing pattern. If a causative factor is stress with resultant hyperventilation or some other ineffective breathing pattern, the patient may need help in developing more beneficial coping mechanisms such as relaxation techniques.

pursed-lip breathing a breathing technique in which air is inhaled slowly through the nose and then exhaled slowly through pursed lips. This type of breathing is often used by patients with chronic obstructive pulmonary disease to prevent small airway collapse.

breathing-related sleep disorder any of several disorders characterized by sleep disruption due to some sleep-related breathing problem, resulting in excessive sleepiness or insomnia. Included are central and obstructive sleep apnea syndromes (see adult sleep apnea).

intermittent claudication a group of symptoms characterized by pain, cramping, and weakness in the calf muscles of one or both lower limbs, brought on by walking and relieved by resting for a few minutes. It is a form of arterial occlusive disease and is caused by atherosclerotic lesions of the limbs, which diminish blood supply to the muscles of the lower leg. Called also angina cruris.

Treatment has traditionally involved vascular reconstructive surgery to bypass the diseased portion of the vessel. Modification of risk factors has also proved beneficial, such as smoking cessation, weight loss, and introduction of a graduated program of walking and exercise.

intermittent explosive disorder a rare impulse control disorder in which a periodic loss of control of aggressive impulses results in serious assault or destruction of property; the outbursts are totally out of proportion to any apparent stress.

intermittent positive pressure breathing (IPPB) a form of respiratory therapy using a ventilator for the treatment of selected patients with atelectasis, those needing occasional assistance breathing, or those requiring some types of aerosol medications. As the name implies, this involves application of pressure only during the inspiratory phase, in order to help the patient breathe more deeply. It is used when other less expensive, less invasive forms of respiratory care have not been effective. Called also intermittent positive pressure ventilation.

Because of their compact size and capability of operating independently of an electrical current, IPPB machines are used widely. Similar treatment can also be delivered with a volume-, pressure-, or time-limited ventilator or manual resuscitation device. The American Association for Respiratory Care has published detailed and comprehensive clinical practice guidelines for the use of intermittent positive pressure breathing, which are available online at http://www.rcjournal.com/online_resources/cpgs/ippbcpg.hotmail.