A patient has been using continuous positive airway pressure ...

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A patient has been using continuous positive airway pressure (CPAP), and now the health care provider is recommending bi-level positive airway pressure (BiPAP). The patient is asking the nurse to explain the difference again.
 
  Which response is appropriate?
  a. CPAP maintains a set positive airway pressure during inspiration only.
  b. CPAP opens the airways during inspiration and allows them to close during expiration.
  c. BiPAP maintains a set pressure that is the same for inspiration and expiration.
  d. BiPAP delivers sufficient expiratory pressure to keep the airways open.

Question 2

A patient with a continuous IV infusion has an order for ciprofloxacin to be given IV piggyback. Which action by the nurse is appropriate for administering the medication?
 
  a. Hang the bag with ciprofloxacin higher than the continuous infusion bag.
  b. Stop the continuous infusion while running the ciprofloxacin.
  c. Connect the piggyback tubing into the Y-port on the tubing of the continuous infusion that is closest to the patient.
  d. Occlude the tubing of the continuous infusion just above the injection port while injecting the medication.

[Pamela.irrgang@yahoo.com]

Answer to Question 1

D
BiPAP uses two modes of pressure: one for inspiration and one for expiration. During expiration, BiPAP delivers sufficient pressure to keep the airways open. CPAP maintains a set positive airway pressure during inspiration and expiration. It keeps the airways open and prevents upper airway collapse.

Answer to Question 2

A
The set is called a piggyback because the small bag or bottle is set higher than the primary infusion bag or bottle. In the piggyback setup, the main line does not infuse when a compatible piggybacked medication is infusing. The port of the primary IV line contains a back-check valve that automatically stops the flow of the primary infusion once the piggyback infusion flows. After the piggyback solution infuses and the solution within the tubing falls below the level of the primary infusion drip chamber, the back-check valve opens, and the primary infusion starts to flow again. The piggyback is connected to a short tubing line that connects to the upper Y-port of a primary infusion line or to an intermittent venous access. The tubing is occluded to check for blood return or to give an IV bolus, but not for a piggyback medication.