Exam 2

Question 1

Normal pH

Answer 1

Acidic 7.35 - 7.45 Alkalotic

Question 2

Normal PaCO2

Answer 2

Alkalotic 35 - 45 Acidic mmHg

Question 3

Normal PaO2

Answer 3

80 - 100 mmHg

Question 4

Normal HCO3

Answer 4

Acidic 22 - 26 Alkalotic mmHg

Question 5

Hypoxemic

Answer 5

PaO2 less than 60 mmHg (SpO2 <90%)

Question 6

Hypercapnic

Answer 6

PaCO2 greater than 50 mmHg

Question 7

Duke Activity Status Index (DASI)

Answer 7

Estimates VO2 max up to 34 ml/kg/min or 9.8 METS
1-4 Light home activities.
5-9 Cilmb a flight of stairs, run a short distance.
>10 Strenuous Activity.

Question 8

Respiratory Reserve Ratio

Answer 8

pO2/FiO2
476 = normal person
>300 = sufficient respiratory reserve for mobility
<300 = ask senior PT, much caution.
<200 = Poor
<100 = Very Poor

Question 9

Abdominal Paradoxical Breathing

Answer 9

Chest out, abdominal in

Question 10

Minimal Aerobic Capacity to Remain Functionally Independent

Answer 10

Males 18 ml/kg/min or 5.14 METs

Females: 15 ml/kg/min or 4.3 METs

Question 11

Normal FEV1, FVC and FEV1/FVC

Answer 11

greater than or equal to 80%.

Question 12

Point Change on the SPPB to be minimally clinically difference.

Answer 12

1-2 point change.

Question 13

Risk of hospitalization and/or Death SPPB 0-4 score

Answer 13

Five fold increase risk

Question 14

Risk of hospitalization and/or Death SPPB 5-7 score

Answer 14

2.6 fold increased risk

Question 15

A one point increase in SPPB?

Answer 15

Gives a 14% reduction in risk.

Question 16

Global Initiative for COPD Stage 1

Answer 16

FEV1/FVC = <0.70
FEV = greater than or equal to 80% of predicted
Smokers Cough
Little or no SOB
No clinical Signs of COPD
FEV1 greater than 80%

Add reduction of risk factors, add short acting bronchodialtor

Question 17

Global Initiative for COPD Stage 2

Answer 17

FEV1 < 80% of Predicted
Shortness of Breath
Some clinical signs of COPD
Sputum producing cough

Add regular treatment with one or more long-acting bronchodialators and add pulmonary rehab

Question 18

Global Initiative for COPD Stage 3

Answer 18

SOB on mild exertion
FEV1 < 50% of predicted.

Add inhaled glucocorticosteroids if repeated exacerbations.

Question 19

Global Initiative for COPD Stage 4

Answer 19

SOB on mild exertion
Right heart failure
cyaosis
FEV1 < 30% of predicted.

These people will need long term O2 if in chronic respiratory failure. Consider Surgical Treatments

Question 20

BODE Index Definition

Answer 20

A multidimensional index developed to assess an individuals risk of death from COPD.

1. Weight
2. Airway Obstruction (FEV1)
3. Dysnpea (Medical Research Council Dyspnea Score)
4. Exercise Capacity (6 min walk test)

Question 21

BODE Index Scores

Answer 21

0-2 = 80% survival
3-4 = 67% Survival
5-6 = 57% survival
7-10 = 18% survival

Question 22

O2 reccommended for Patients with PaO2 or SpO2 of?

Answer 22

PaO2 < 60 mmHg

SpO2< 90%

Question 23

PaO2 is titrated between what?

Answer 23

PaO2 60-65 mmHg

SpO2 90-93%

Question 24

Sufficient Cardiovascular Reserve

Answer 24

Resting HR < 50% of their age predicted max heart rate
Blood pressure <20% variability recently (meaning an increase or decrease in BP of 20% or more representing hemodynamic instability.
ECG normal
Other major cardiac conditions excluded.

Question 25

Sufficient Respiratory Reserve

Answer 25

PaO2/FiO2 Ratio > 300 SpO2 > 90% and <4% recent decrease in SpO2 Respiratory Pattern Satisfactory Mechanical ventilation to be maintained during Tx

Question 26

MRC Sum Score

Answer 26

``` Assesses for critical illness weakness. Similar to MMT but no +/- UE: Wrist extension, elbow flexion, shoulder abduction LE: DF, Knee extension, Hip flexion. Total Range 0-60 ```

Question 27

MRC Score diagnosis for critical illness weakness?

Answer 27

<48/60

Question 28

Hemodynamic Stability with Body Positioning and Changes

Answer 28

Heart Rate20-30 from resting my be appropriate. BP no greater than a 10-20 mmHg drop (go with 10) Diastolic should remain the same or increase 10.

Question 29

Neoadjuvant and Adjuvant Chemo Effect on Cardiopulmonary System

Answer 29

``` Cardiotoxicity (Cardiomyopathy) Pulmonary Toxicity Fatigue Weakness Risk of Infection Decreased Aerobic Activity ```

Question 30

Lung Metastasis and Ressection of Lung Tissue

Answer 30

``` Lung Damage Decreased ventilation/perfusion Decreased FRC Increased WOB SOB Inflammation Cough Fatigue ```

Question 31

Premorbid History of Asthma

Answer 31

``` Inflammation Brochoconstriction Increased Mucous Difficulty Breathing Increased WOB SOB Coughing Wheezing. ```

Question 32

Pediatric Objective Examination

Answer 32

Communication: Affect/cognition/language and learning style. Consistent with age/ development Family Centered Culturally Sensitive