Rehab For COPD

Question 1

Breathing technique where physician resists patient’s inhalation, then lets go

Answer 1

Segmental breathing

Question 2

Maximum blood flow is greatest at the _____________ portion of the lung

Answer 2

Most gravity dependent

Question 3

Examples of long acting beta agonists

Answer 3

Salmeterol, formoterol

Question 4

Method of diaphragmatic breathing

Answer 4

Use diaphragm to breathe and relax abdominal muscle during inspiration.

Question 5

Therapeutic exercise parameters:
How long of a daily walk?
How high of a pulse goal?
For how many weeks?

Answer 5

12-minute daily walk
20-30% increase of your pulse, but <120
10-12 weeks

Question 6

Changes in TV, FRC, maximum oxygen uptake with diaphragmatic breathing

Answer 6

Increased TV, decreased FRC, increased oxygen uptake

Question 7

Method of pursed lip breathing

Answer 7

Inhale through the nose and exhale through the mouth longer

Question 8

2 types of IPPV

Answer 8

Daytime mouthpiece IPPV

Nocturnal nasal IPPV or mouthpiece with seal

Question 9

What is diaphragmatic breathing used for

Answer 9

Reverse altered pattern of respiratory muscle recruitment in COPD patients

Question 10

When going from sitting to trendelenburg, effect on work of breathing

Answer 10

Work of breathing increases when going from sitting to trendelenburg because diaphragm has to contract against abdominal contents

Question 11

V/Q mismatch between upper and lower lobes when sitting upright

Answer 11

Lower lobes is perfused more and upper lobes is ventilated more

Question 12

Positioning technique for postural drainage

Answer 12

Affected lung segment placed at highest position

Question 13

What can be used for prophylactic treatment for COPD

Answer 13

Cromolyn

Question 14

Breathing technique that prevents air trapping and promotes greater gas exchange

Answer 14

Pursed lip breathing

Question 15

Guideline for O2 use during exercise

Answer 15

If SO2 falls below 90% with exercise

Question 16

When do you take SABA for exercise induced bronchospasm

Answer 16

15-20 minutes before starting exercise

Question 17

What inhaled anticholinergics can be used in COPD

Answer 17

• ipratropium (Atrovent)

- tiotropium (Spiriva)

Question 18

It indicates visceral protein depletion and is a good predictor of rehab potential

Answer 18

Albumin

Question 19

Nutrition recommendations for COPD patients

Answer 19

• protein 1.7g/kg/day

- increase fluid intake

Question 20

Effect of inh steroids on fev1

Answer 20

Increases fev1 by 10%

Question 21

Combivent

Answer 21

Albuterol/ipratropium

Question 22

Supplemental O2 is recommended for patients with a continuous pO2 of

Answer 22

55-60mmHg

Question 23

1st, 2nd and 3rd line treatment for exercise induced bronchospams

Answer 23

1st - SABA and cromolyn
2nd - inh corticosteroid
3rd - anticholinergic

Question 24

Effect of pursed lip breathing on TV

Answer 24

Increases TV

Question 25

What lab value can be used that correlates with severity and chronicity of disease

Answer 25

Albumin

Question 26

Symbicort

Answer 26

Budesonide/formoterol

Question 27

Most common method of noninvasive positive pressure airway support

Answer 27

Intermittent positive pressure ventilation (IPPV)

Question 28

MOA of inhaled anticholinergics

Answer 28

Antimuscarinic - inhibits muscarinic receptors --> inhibits parasympathetic --> bronchodilation

Question 29

When supine, apical blood flow ______

Answer 29

Increases

Question 30

Three types of positive pressure ventilators

Answer 30

Intermittent (IPPV), Continuous (CPAP), Bilevel (BiPAP)

Question 31

Mucomyst

Answer 31

N-acetylcysteine - mucolytic for secretion control

Question 32

Is upper or lower extremity exercise better for COPD?

Answer 32

Upper extremity

Question 33

Patients who produce >_______mL/day of sputum need secretion mobilization

Answer 33

30

Question 34

Incentive spirometry is contraindicated in lung problem in what kind of diseases

Answer 34

Neuromuscular disease

Question 35

What must you avoid when taking methylxanthines?

Answer 35

Methylxanthines, such as theophylline, should not be taken with caffeine

Question 36

When changing from sitting to supine position, relation between venous and arterial pressure??

Answer 36

Venous pressure increases in relation to arterial pressure in gravity dependent areas

Question 37

What does BiPAP allow?

Answer 37

Adjusts inspiratory (IPAP) and expiratory (EPAP) components individually

Question 38

Examples of inhaled steroids

Answer 38

Budesonide (Pulmicort), beclomethasone (Qvar), fluticasone (flovent)

Question 39

Normal V/Q ratio

Answer 39

0.8

Question 40

Benefits of pre-op and post-op chest therapy program

Answer 40

Decreases pneumonia incidence and reduces probability of post-op atelectasis

Question 41

Examples of Short acting beta agonists

Answer 41

Albuterol, levalbuterol

Question 42

Technique to reduce dyspnea and work of breathing in COPD patients

Answer 42

Pursed lip breathing

Question 43

MOA of cromolyn

Answer 43

Inhibits release of histamine