Week 4 - Pulmonary rehab Flashcards

(48 cards)

1
Q

What is pulmonary rehab

A

Program designed to improve QoL for certain lung conditions

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2
Q

Lung conditions

A

COPD
asthma
pulmonary hypertension
cystic fibrosis

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3
Q

pulmonary rehab aims to

A

Increase awareness about chronic disease and its management/monitoring
provides education on how to achieve exercise/activities with less SOB
Reduce symptoms, leading to more active life
enable people to achieve and maintain their maximum level of independence and functioning

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4
Q

Pulmonary rehab team

A

doctors
nurses
dieticians
PTs
OTs
OTA PTA
respiratory therapists

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5
Q

Doctors in pulmonary rehab

A

diagnosis

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6
Q

Respiratory therapists

A

experts in respiratory function
O2 devices - a lot more training
decide which device is most appropriate for pt.

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7
Q

Settings where services are delivered

A

hospital
clinic
follow up at home
physical care medicine
ICU

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8
Q

Areas of interventions

A

smoking cessation
exercise
breathing training
learning to eat well
psychological counselling
ultimate goas
education

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9
Q

Breathing training

A

Pursed lip breathing
diaphragmatic breathing
distress control techniques

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10
Q

Psychological counselling

A

depression
anxiety

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11
Q

Ultimate goal

A

manage condition at home and in community

services to maximize functional independence within the context of their own homes

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12
Q

OT performance issues - general physical deconditioning

A

few days of inactivity in bed reduces skeletal muscle mass and strength
long term consequences

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13
Q

OT performance issues - pain and fatigue is from…

A

from prolonged bed rest
mild, moderate or severe fatigue

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14
Q

OT performance issues - impaired activity tolerance

A

at different levels

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15
Q

OT performance issues - cognitive impairments

A

chronic or acute

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16
Q

OT & OTA role in pulmonary rehab (16)

A

early mobilization
positioning
ADL re-training
IADL re-training
activity tolerance and energy conservation techniques
Ventilation strategies
stress management
relaxation strategies
therapeutic exercise programs
UE function
safety
home O2 management
wellness at home and in community
cognitive strategies
equipment provision, seating and mobility

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17
Q

Early mobilization - settings

A

ICU
Acute setting
subacute setting

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18
Q

Examples of OTA intervention - Low functioning

A

transfer safety
mobility indoor
basic ADLs
activity tolerance, daily and weekly schedule

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19
Q

Examples of OTA intervention - High functioning

A

Building on activity tolerance
Life balance
IADLs
could come in later in rehab plan

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20
Q

Supplemental Oxygen

A

low levels of oxygen for long periods of time can cause problems to vital organs
prolongs life
improves QoL
can be temporary or permanent

21
Q

Endotracheal intubation

A

aren’t able to breathe
inserted into mouth down to throat
cannot talk
often not conscious
will never leave to go home intubated

22
Q

Standards of practice - allowed and not allowed

A

Never change O2
can change if you have a serious, precise conversation

23
Q

Diaphragmatic breathing

A

improves breathing pattern
improves SOB & fatigue
most efficient muscle for breathing

24
Q

pursed lip breathing

A

helps control SOB
quickly slows down pace of breathing
moves old air out of lungs

25
reporting to therapist
use appropriate terminology and medical abbreviations use outcome measures Document how long Doc difficulty
26
Posture
Slump vs. upright
27
speed of breathing
shallow/fast vs. deep/slow regaining control of your breathing
28
where should breathing occur
Diaphragm
29
which should be longer, breathing in or out?
out
30
What to do if pt. shows signs of respiratory distress
stop activity take a break check vital signs seek medical help if symptoms don't improve after rest inform OT and team modify for future interventions to decrease intensity
31
Outcome measures
Borg RPE scale VAS scale
32
Documenting how long...
pt. is able to tolerate each activity to show progress overtime
33
doc difficulty
activity and progression each session that you're addressing activity tolerance
34
RR and pattern - Normal
Symmetry between movement of chest wall and abdomen
35
RR and pattern - apneic (apnea)
long pause after every inspiration and expiration
36
Apneic cause
neurodegenerative disease, obesity, narcotic use, hypoventilation syndrome
37
RR and pattern - Orthopnea
only able to breathe comfortably when in upright position often measured in number of pillows required to breathe while sleeping
38
Respiratory rates - under 6 years
25-60 bpm
39
Respiratory rates - 10 years
15-20 bpm
40
Respiratory rates - adults
12-29 bpm
41
Barrel chest
large shaped chest trapped air usually seen with COPD
42
Kyphotic chest
increased curvature of spine postural (hunched over) reduced air flow/ineffective inspiration seen more in frail pt. posture education
43
Scoliotic chest
curvature of spine reduced air dysfunctional respiratory muscles
44
Signs of respiratory distress
increased RR cyanosis around lips, nails nostrils flaring indrawing sweating wheezing/whistling positioning
45
Cyanosis
blue lips loss of heat from lips or nails
46
Indrawing
chest and neck "sing: in with each breath
47
Things we may feel (palpate)
vibrations respiratory expansion subcutaneous emphysema skin temp pulse
48
Auscultation
listening to lungs abnormal sounds: crackles wheezes decreased flow