Tx of Acute Conditions

Question 1

Acute CardioPulmonary Conditions (5)

Answer 1

Increased secretions
Hypoxia
Altered mental state
Changes in cardiac function
Pneumonia

Question 2

Effects of Bed Rest on CV System (7)

Answer 2

Increase basal HR
Decreased max HR & O2 consumption
Orthostatic hypotension
Increased DVT risk
Decreased blood volume
Decreased hemoglobin concentration
Decreased blood flow

Question 3

T/F: Blood clots that kill people are found in the calf.

Answer 3

False: The thigh.

*Still exercise them, but check w/nursing

Question 4

Effects of Bed Rest on Respiratory System (4)

Answer 4

Decreased VC & RV
Decreased PaO2
Inability to clear secretions
Increase ventilation-perfusion mismatch

Question 5

Effects of Bed Rest on Musculoskeletal System (4)

Answer 5

Decreased muscle strength/girth
Decreased efficiency of contraction
Joint contracture
Decubitus ulcers

Question 6

Effects of Bed Rest on Nervous System (5)

Answer 6

Emotional problems
Behavior disturbance
Cognitive function
Altered sensation
Joint position sense

Question 7

4 Stages of an Effective Cough

Answer 7

Inspiration greater the tidal volume
Closure of the glottis
Abdominals/intercostals contract (increase intrathoracic pressure)
Sudden opening of glottis & air forced out

Question 8

Cough Techniques for Emphysema (2)

Answer 8

• Active Cycle Breathing Technique (ACBT)

- Small/Med sized breaths > 2-3 huffs > small coughs

Question 9

Cough Techniques for Post-Op Patients

Answer 9

Series of coughs to reduce fatigue

• Small breath, Small cough
• Med breath, med cough
• Large breath, large cough

Question 10

Steps: Active Cycle Breathing Technique

Answer 10

1. Diaphragmatic breathing at normal tidal volume, 5-10s
2. Deep inhalation w/relaxed exhalation at vital capacity range. Coupled w/percussion on exhalation.
3. Repeated diaphragmatic breathing.
4. 1-2 huffs focusing on abdominal contraction
5. Repeated diaphragmatic breathing.

Question 11

PT Assisted Coughing Techniques (2)

Answer 11

Costophrenic Assist

Counter-rotation Assist

Question 12

Self Assisted Coughing Techniques (3)

Answer 12

Prone on elbows, head flexion
Long sitting
Short sitting (SCI)

Question 13

Breathing Control for Obstructive (3)

Answer 13

Energy conservation
Relaxation
Pacing activity

Question 14

Clinical Decision Making (8)

Answer 14

1. Identify ALL factors causing oxygen deficit
2. Determine whether mobilization and exercise are indicated & which specifically address O2 deficits
3. Match appropriate mob/exercise to O2 transport capability
4. Set intensity w/in therapeutic limits
5. S/P: combine upright position w/thoracic mobility, AROM, breathing control
6. Set duration to pt responses, not time
7. Increase intensity, duration or both to pt tolerance
8. Continue to progress fxn’l status improves or threat of O2 transport minimized

Question 15

Dyspnea Scale

Answer 15

0: No dyspnea
1: Mild, noticeable
2: Mild, some difficulty
3: Mod, can continue
4: Severe, cannot continue

Question 16

Angina Scale

Answer 16

1+: Light, barely noticeable
2+: Mod, bothersome
3+: Severe, very uncomfortable
4+: Most severe, unbearable