20 markers

Question 1

Outline how a physiotherapist may help a patient to relieve breathlessness

Answer 1

• Treating the underlying cause
• Encourage and educate on the important of exercise, to strengthen muscles and reduce anxiety around breathlessness
• Educate on how to reduce energy expenditure e.g. using towel robe
• Walkinf aids/ fan therapy
• Teaching breathing control and positions of ease

Question 2

Outline the role of the physiotherapist in the management of sputum retention

Answer 2

• Educate on importance of proper hydration
• Manual techniques e.g percussion/ vibrations
• Oscilliary vests/ water chambers/ Positive expiratory pressure machines

Question 3

Outline the significance of sounds heard over the lungs during auscultation

Answer 3

Auscultation is a technique aiding understanding/ diagnosing of respiratory issues
Normal = vestibular (lung fields, low picthed, soft, rustling), bronchial (trachea, high pitched)
Abnormal = wheezes (expiration, high pitched whisling, obstructed airways), Crackles (inspiration, coarse sound resembling hair being rubbed together, pneumonia, congestive heart failure, interstitial lung disease), Stridor (harsh high pitched, inspiration, upper airway obstruction

Question 4

Suggest how physio may help in the prevention and management of DVTs

Answer 4

Virchow’s triangle - stasis, vessel wall injury, hypercoagubility

Prevention: education on risk factors (leukaemia, polyctgaemia, recent surgery, trauma, age and pregnancy), anticoagulants, compressions stockings to aid venous return, recommend regular exercise to aid venous return

Management: bed rest, investigate cause, anticoagulation, thrombolytic therapy to bust clots, thrombectomy

Question 5

Outline the role of physios in preventing/ managing post-op respiratory problems

Answer 5

• educate on likely condition post op
• Pre-hab: strengthen muscles and teach breathing techniques
• education of rehydration/ effects of anaesthesia
• positions of ease
• sputum clearance tenchniques to counter hyperactivity of goblet cells caused by anaesthetic
• strengthen muscles to enable mobilisation to improve discharge date

Question 6

Outline how physio might help mange asthma symptoms

Answer 6

• educate on how and when to use inhaled corticosteroids
• positions of ease/ breathing control
• Active cycle of breathing/ sputum management
• exercise recommendations

Question 7

Outline 5 problems COPD, suggest 1 treatment/management for each one

Answer 7

Breathlessness is caused by COPD due to the inability to get air out at a normal rate - physios can teach positions of ease

Productive cough - Active cycle of breathing to clear sputum

Anxiety - educate the patient on why certain things happen so they know what to expect

Reduced social interaction - physios can teach some suitable exercises to increase cardiovascular potential to increase confidence when going out

Wheeze/ inability to take deep breath - physios can suggest inhaled therapy e.g. preventer/ reliever inhalers