Procedural interventions: Exercise Rx, Airway Clearance, Breathing Exercises, Cardiac Rehab Flashcards Preview

NPTE Cardio, Pulm & Lymph > Procedural interventions: Exercise Rx, Airway Clearance, Breathing Exercises, Cardiac Rehab > Flashcards

Flashcards in Procedural interventions: Exercise Rx, Airway Clearance, Breathing Exercises, Cardiac Rehab Deck (33)
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1

Using the Karvonen Formula, how do you determine the lower Target Heart Rate (THR) zone?

Lower THR = [(HRmax - HRrest) x 40%] + HRrest

2

Using the Karvonen Formula, how do you determine the upper Target Heart Rate (THR) zone?

Upper THR = [(HRmax - HRrest) x 85%] + HRrest

3

How do you determine duration for aerobic exercise prescription?

Low intensity: > or = 30 mins
High intensity: 20 mins

4

What is the frequency for aerobic exercise prescription?

3 - 5 days per week

5

What is the Active Cycle of Breathing Technique

3 phases
1. Breathing Control: 5-10 seconds relaxed breathing
2. Thoracic Expansion Exercise: 3-4 deep slow breaths
3. Forced Expiratory Technique: 1-2 huffs at mid to low lung volumes

6

What is Autogenic Breathing?

3 phases
1. Unsticking phase: slow breathe in, 3 sec hold, exhale into expiratory reserve vol
2. Collecting Phase: breathe at tidal vol with intermittent holds
3. Evacuating phase: deep inspirations, breath holding, huff cough

7

What is directed cough?

max inhale
2-3 sec breath hold
sharp cough 2-3x

8

What is huff coughing?

Inhale deeply
cough saying "Ha, Ha, Ha"

9

What is high frequency airway oscillation, Acapella or Flutter?

Combine positive expiratory pressure and high frequency airway vibrations to mobilize mucus secretions in airways

10

What is Postural Drainage?

positioning patient so gravity helps remove secretions

11

What is Percussion?

Rhythmic clapping or cupping over thorax

12

What is Vibration for airway clearance?

Flat hand, quick vibrations during exhale

13

What is Shaking for airway clearance?

Flat hand, large oscillations during exhale

14

What is a PFELX?

Inspiratory Muscle Trainer
- turn dial to regulate resistance

15

What population would benefit from Pursed Lip Breathing (PLB)?

Emphysema - prevent airway collapse

16

What positions are best to relieve Dyspnea?

Reverse Trendelenburg Position
- Supine, head above trunk and LEs

Semi-Fowler's Position
- Supine, HOB elevated 45 deg, pillow under the knees
**Also good for CHF and other cardiac issues**

17

Where does Phase I of Cardiac Rehab take place?

Inpatient

18

What parameters determine exercise prescription in Phase I Cardiac Rehab?

Heart Rate and RPE scale

19

What are the criteria to discontinue exercise in Phase I of Cardiac Rehab?

- HR >130 bpm or > 30 bpm or resting
- DBP > or = 110 mm Hg
- Dec in SBP > 10 mm Hg
- Significant ventricular or atrial dysrhythmias
- 2nd or 3rd degree heart block
- Signs or symptoms including angina, marked dyspnea, and ECG changes suggestive of ischemia

20

What are the typical METs in Phase I of Cardiac Rehab?

2-3 METs: supervised level walking
3-4 METs: up and down hill steps or treadmil walking

21

What is the RPE for Phase I of Cardiac Rehab?

RPE < 13 (6-20 scale)
- Post surgery: < 30 bpm over resting HR
- Post MI: < 120 bpm or 20 bpm over resting

22

What is the exercise frequency for Phase I of Cardiac Rehab?

First 3 days: 3-4x/day
After 3 days: 2x/day (longer sessions)

23

What are the expected outcomes of Phase I of Cardiac Rehab?

- Walk 5 to 10 mins continuously (or 1000 feet) 4x daily
- Walk up and down 1 flight of stairs independently
- Know safe HR and RPE limits
- Know abnormal signs and symptoms

24

What the session duration during Phase I of Cardiac Rehab?

10 - 15 mins of continuous activity

25

How long does Phase I of Cardiac Rehab last?

3-5 days

26

Where does Phase II of Cardiac Rehab take place?

Immediate Outpatient (after release from inpatient)

27

How long does Phase II of Cardiac Rehab last?

Immediately after discharge up to 12 weeks

28

How many session is ECG and BP monitored on patients in Phase II of Cardiac Rehab?

6 to 12 sessions (> 12 for high risk)

29

What are the criteria to discontinue exercise in Phase II of Cardiac Rehab?

- Plateau or dec in HR with inc work
- SBP plateaus or falls with inc in work or > 250 mm Hg
- DBP > 115 mm Hg
- ST segment depression > 1 mm
- 2nd or 3rd degree heart block
- Ventricular Dysrhythmias
- Angina or other symptoms of cardiovascular insufficiency

30

How do you determine intensity in Phase II of Cardiac Rehab?

HR, METs and RPE
- HR: rest + 20 bpm
- METs: calculated as a %
- RPE: specific to mode of exercise