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Flashcards in Practice Patterns for Cardiopulm Rehab Deck (36):
1

What is diagnoses and impairments are in Pattern 6A?

Primary prevention/risk reduction for cardiovascular/pulmonary disorders- diabetes, family hx, HTN, obesity, sedentary lifestyle, smoking
Impairments: functional work capacity, aerobic capacity, dyspnea

2

What are treatments and outcomes for people in pattern 6A?

Visits: 1-6
POC: ther ex, risk management, disability mgmt., WOB mgmt.
Outcomes: aerobic capacity, mm strength and endurance, wellness, impact on functional limitations (job, school, leisure, ADL)
Past and current PT involvement in health and wellness, risk management/prevention

3

What populations/diagnoses are in pattern 6B?

Impaired aerobic capacity/endurance with deconditioning: diabetes, HIB, cancer, Parkinson's, MS, ALS, ischemic heart disease, cardiomyopathy, CHF, PVD, pneumonia, emphysema, bronchitis, dyspnea and respiratory abnormalities, diseases of the mitral and aortic valve

4

What are evaluation/tests/measures done with pattern 6B?

History, aerobic, strength, endurance, body comp, gait, locomotion, balance, pain, self care/ADL, respiration/gas exchange (O2 sats), circulation (ABI, BP)

5

What is POC and outcomes for 6B?

Visits: 6-30
POC: ther ex, risk management, disability mgt, WOB mgt/breathing strategies, balance, postural control, ADL training, devices/adapted equipment, work
Outcomes: aerobic capacity, mm strength and endurance, pain management, balance and gait/AD, impact on functional limitations physiologic response to increased O2 demand improved

6

What are diagnoses covered in pattern 6C?

Impaired ventilation, respiration/gas exchange and aerobic capacity associated with airway clearance dysfunction
ICD 9 codes: CF, pneumonia, COPD, pneumoconiosis, pulmonary congestion, pulmonary fibrosis, injury to heart and lung

7

What are evaluation/tests/measures for pattern 6C?

Aerobic, strength, endurance: pulmonary distress, cardiovascular response
Circulation
Edema
Integumentary integrity
Pain
Posture: bent over, tripod position
Self care
Respiration/gas exchange

8

What is POC and outcomes for pattern 6C?

Visits: 5-30
POC: ther ex, disability mgt, WOB mgmt./breathing strategies, relaxation techniques, flexibility ex, balance, postural control, ADL training, functional training programs, manual/mechanical techniques and positioning
Outcomes: aerobic capacity, mm strength, endurance, AD, impact on functional limitations, supervision of activities/tasks/ADLs, independence of pt with postural drainage techniques, edema measures, gait w/o negative physiological response, lung sounds, O2 sats, O2 use, QOL

9

What populations are in pattern 6D?

Impaired aerobic capacity/endurance associated with cardiovascular pump dysfunction or failure
ICD 9 codes: diseases of valves, HTN, heart disease, MI, pericarditis, cardiomyopathy, conduction disorders, cardiac dysrhythmias, heart failure, aortic aneurysm

10

What are evaluation/tests/measures for Pattern 6D?

Aerobic, strength, endurance: pulmonary distress, cardiovascular response
Circulation: EKG, auscultation, RR, HR, autonomic response
Body comp and edema
Integumentary integrity/wounds
Gait and balance/posture
Pain

11

What is POC and outcomes for pattern 6D?

Visits 5-30
POC: ther ex, disability mgmt., balance/neuro re-ed, task specific performance training, relaxation flexibility ex, balance, postural control, ADL training, functional training programs and return to work, movement efficiency and energy conservation
Outcomes: aerobic capacity, mm strength and endurance, assistive device, impact on functional limitations, supervision of activities/tasks/ADL, edema measures, gait w/o negative physiologic response, QOL

12

A patient comes to your clinic and may have: diabetes, family hx of heart problems, HTN, obesity, sedentary lifestyle, and smokes? What practice pattern might these people be in?

Pattern 6A

13

What is the practice pattern for people with valve disease, HTN heart disease, MI, pericarditis, cardiomyopathy, conduction disorders, cardiac dysrhythmias, heart failure, or an aortic aneurysm?

Pattern 6D

14

What is practice pattern for impaired circulation and anthropometric dimensions associated with lymphatic system disorders? Impaired ventilation and respiration gas exchange

6H
6E-6G

15

What are the three things for functional mobility?

Bed mobility
Transfers: sit to stand, sternal precautions
Ambulation: weight bearing status using UEs for RW

16

If a patient comes into the clinic with either CF, pneumonia, COPD, pneumoconiosis, pulmonary congestion, pulmonary fibrosis, or an injury to heart and lung what would their practice pattern be?

Pattern 6C

17

What are components of exercise prescription (7)?

Risk screening: minimize risk, maximize benefit
Specificity of training: mode, intensity, duration, frequency, rate of progression
Cardiorespiratory fitness: most beneficial for secondary prevention of CHD
Body composition
Muscular strength and endurance
Flexibility
Functional tests

18

How is exercise intensity determined for cardiorespiratory fitness?

Most challenging task in designing the exercise program: requires individualization, monitoring/supervision
Expressed as percent of functional capacity: VO2 max, age adjusted HR max
Monitor intensity during exercise: RPE, HR, VO2 via METs,

19

How is HR and METs used in determining exercise intensity?

HRR (karvonen formula): exercise prescription start at 40-50% total HRR
THR (% of HR max or AAMHR)
Keep in mind diagnosis with exercise prescription: low % EF, severe pulmonary disease, co morbidities

Can use % METS from GXT for exercise prescription
Monitor HR or RPP: environment (heat, humidity)

20

How do we look at exercise response?

RPE: educate on RPE so pts become familiar with the feeling of exertion during exercise at appropriate THRR
Dyspnea scale
Angina scale

21

Why is there a need for respiratory muscle exercises?

Respiratory muscle fatigue is chronic may be related to symptoms of SOB

22

What are examples of ways to get respiratory muscle exercise?

High intensity aerobic exercise promotes respiratory muscle strength: older adults with lung disease are unlikely to sustain these intensities
Resistive breathing devices: sustain greater vent work, less respiratory fatigue, ability to affect work capacity not yet determine in literature

23

What is role of flexibility in rehab?

Perform in a slow, controlled manner
Gradual progression to greater ranges
Yoga: open up chest

24

You have a patient in the clinic that either has diabetes, HIV, cancer, Parkinson's, MS, ALS, ischemic heart disease, cardiomyopathy, CHF, PVD, pneumonia, emphysema, bronchitis, dyspnea and respiratory abnormalities, diseases of mitral valve so what would be the practice pattern?

Pattern 6B

25

What practice pattern(s) does diabetes belong too?

Pattern 6A
Pattern 6B

26

What practice pattern does COPD belong too

Pattern 6C

27

What pattern does MI belong too

D

28

What pattern does bronchitis belong too?

B

29

What pattern is CF

C

30

What pattern is HIV

B

31

What pattern is smoking

A

32

What pattern is pneumonia?

B or C

33

What pattern is heart failure

D
CHF= B

34

What category is emphysema

B

35

What pattern is valve disease

D
maybe B

36

What is pattern for pulmonary fibrosis

C