Pulmonary Rehab - CH 21 PPT

Question 1

define pulmonary rehab

Answer 1

comprehensive intervention for patients with chronic respiratory disease

Question 2

what is pulmonary rehab composed of

Answer 2

patient assessment/goal setting
exercise prescription / training
self-management education
nutritional intervention
psychosocial support

Question 3

explain goals specific to pulmonary rehabilitation

Answer 3

goals that pertain to
exercise capacity
symptoms
health-related quality of life
psychosocial status

Question 4

what symptoms are to be aided with during pulmonary rehab

Answer 4

dyspnea and fatigue

Question 5

explain the members of pulmonary rehabilitation team

Answer 5

patient/family
medical director
program director
other team members:
– respiratory therapist, PT, counseling, pharmacology and nutrition

Question 6

where to PTs help the most with pulmonary rehab

Answer 6

evaluation
outcome measurement
exercise/functional training
airway clearance
education

Question 7

what is the foundation of pulmonary rehab

Answer 7

patient assessment and goal setting
– designs program

Question 8

components of initial patient assessment for pulmonary rehab

Answer 8

medical history
review/interpretation of diagnostic test
patient interview
physical/symptom assessment

Question 9

specific exercise program components of pulmonary rehab

Answer 9

posture
balance
gait
strengthening
flexibility
energy conservation / adaptive equipment

Question 10

goal of exercise in pulmonary rehab

Answer 10

improve cardiopulmonary endurance and breathing mechanics
– optimize patient ability to complete ADLs

Question 11

explain educational topics in pulmonary rehab

Answer 11

patient understanding/management of disease
use/misuse of oxygen
practical solutions to implement activity into daily life

Question 12

why is misuse of oxygen a problem

Answer 12

over saturation when not needing O2 will cause hypoxic drive to fail

Question 13

what should be assessed in the nutritional assessment

Answer 13

height/weight measurement
calculation of BMI
documentation of recent/significant weight change

Question 14

what is a significant weight change in those during pulmonary rehab

Answer 14

> 3 lbs

Question 15

what does a PFT tell one in pulmonary rehab

Answer 15

GOLD rating
– indirectly ADL ability

Question 16

explain why a PFT is not as helpful in pulmonary rehab

Answer 16

pt’s lungs are physiologically compromised already, we are more managing their care for the rest of their life

Question 17

chart review components

Answer 17

current pulmonary diagnosis
diagnostic/lab values
all treatments for disease
any other medical diagnoses

Question 18

what makes up the patient examination for pulmonary rehab

Answer 18

nutrition eval
chest eval

Question 19

explain chest eval components in patient exam

Answer 19

auscultation of lung / heart sounds
cough assessment
inspection of breathing pattern
– accessory muscle use

Question 20

components of functional evaluation within patient examination

Answer 20

ADL/IADL
balance/gait
prior level of function
need for adaptive equipment
fall risk
social / leisure activity

Question 21

explain energy conservation techniques

Answer 21

focus on ADLs that are most problematic
– evaluate the environment and how to modify ADLs via:

breathing techniques
slow paced with breaks
set priorities/organize movements

Question 22

some key treatment principles for dyspnea relief

Answer 22

controlling breathing pattern with paced breathing/movement

altering postures to improve respiratory muscle function

relaxation techniques

Question 23

what can be taught to facilitate paced breathing

Answer 23

pursed-lip breathing
COPD - tripod positioning

Question 24

indication for supplemental oxygen use

Answer 24

PO2 <55 mmHg
SpO2 <88%

– or <59 mmHg / <89%
if evidence of cor pulmonale / RHF / erythrocytosis

Question 25

goals of physical conditioning exercises

Answer 25

increase cardiorespiratory endurance maximize work capacity improve strength, flexibility, respiratory muscle function

Question 26

during endurance training, what is needed to be considered

Answer 26

time, workload, and physiological responses -- monitor oxyhemoglobin saturation -- optimize bronchodilator use

Question 27

what improves respiratory muscle endurance/strength

Answer 27

moderate to high intensity aerobic exercise of upper and/or lower extremities

Question 28

for those with mild lung disease, what are exercise considerations

Answer 28

shortness of breath w/ relative heavy exercise -- pulmonary rehab not recommended

Question 29

for those with moderate lung disease, what are exercise considerations

Answer 29

typically due to an exacerbation of disease or worsening condition -ECG, vitals and 6 MWT