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pt 571 cardiopulmonary > 2.2 Body Positioning and Mobilization of the Deconditioned Patient > Flashcards

2.2 Body Positioning and Mobilization of the Deconditioned Patient Flashcards

1
Q

Why is body positioning important?

A 
heart function
lung function
bone density
GI mobility
ect...
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2
Q

Aerobic deconditioning is the function of what 2 principle mechanism?

A

1) removal of gravitational stress
2) removal of exercise stress

Results from

  • threats to O2 transport
  • dysfunction of one or more steps of O2 transport
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3
Q

If a patient hasn’t been seen for PT in days and in the hospital what should we be thinking?

A

Any complications?

Very decreased aerobic capacity!

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4
Q

If PaO2 drops on curve can be detrimental. T/F.

A

True. Think O2 dissociation curve!!

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5
Q

How can BiPAP help with someone that is getting worsened respiratory acidosis?

A

bi-level positive airway pressure

forces airways to stay open to Ventilate better!

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6
Q

Thoracentesis and ascites procedures

A

US to find space of fluids and drains it…

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7
Q

What position is better for pleurel effusion patients?

A

Sitting up for diaphragm to be better position.

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8
Q

Types of Atelectasis

A

1) Resorption
2) Compression
3) Contraction

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9
Q

Resorption Atelectasis

A

Completes OBSTRUCTION of an airway –> reabsorption of the O2 trapped in the dependent alveoli, w/o impairment of blood flow through the affected alveolar walls

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10
Q

Compression Atelectasis

A

Results when the pleural cavity is partially or completely filled by fluid exudate, tumor, blood, or air

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11
Q

Contraction Atelectasis

A

Local or generalized fibrotic changes in the lung or pleura prevent full expansion

Decreased lung compliance, collapse, disease state…

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12
Q

Key exam Q’s?

A 
Cough?
SOB?
Chest discomfort?
PLOF?
Activities since admin?
Life-space assessment?
DASI?
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13
Q

What should we think about before entering?

A 
Red flags?
Clinical presentation of referring dx?
Most recent CXR
Most recent lab values
Review of vital signs over the past 12-24 hours
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14
Q

What should you look for with a patient laying in bed?

A

Venturi mask - Increase lung expansion

Breathing pattern, distressed, tachypnic, skin color, edema

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15
Q

Hypothesis of Key Impairments

A

Hospitalization reconditioning
Decreased aerobic capacity (O2 transportation)
Increased work of breathing and O2 demand
Generalized weakness/strength/power deficits
ROM
Pain

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16
Q

What does the MRC Sum Scale look at?

A

Objective way to demonstrate how weak the patient is in the ICU

17
Q

Would O2 improve after exercise?

A

It should after resting!

18
Q

What are 3 principles of exercise rx?

A

1) Specificity of training
2) Overload
3) Adaptation window

19
Q

Examples of specificity of training?

A

Change height of bed and challenge it…

20
Q

Examples of overload?

A

Walk 45’ today and tomorrow work further…

21
Q

Examples of adaptation?

A

Larger improves quickly, room of improvement

22
Q

Deep slow breathes effects/improves… IS

A

Atelectasis!

23
Q

With sitting at the bed METS?

A

1-2

*Understand METS

24
Q

What are some ways we can measure intensity?

A 
% park HR
Max HR (calculation)
RPP, rate pressure product (angina threshold)
RPE
METS
25
Q

Stairs is considered what MET?

A

4/5

26
Q

Duration?

A

Minutes to get training effect? Increase this as tolerated!!

Always warm up and cool down - prevent hypotension and prepares heart!

27
Q

What do we have to promote if a patient is bedridden??

A

WB!!!

28
Q

Goals should include:

A 
OOB
Aerobic conditioning
Functional strength/power training
Functional mobility
Pt/Family education
29
Q

Its w/ ventilatory pump dysfunction difficult thoracic expansion treatment or pathological?

A 
Pursed-lip breathing
Diaphragmatic
Sniffing
Segmental and lateral costal breathing/expansion or manual technique
Air stacking
Biomechanics
Breathing inhibition techniques
Airway clearance techniques
Supplemental O2
Exercise, retraining!
30
Q

Treatments

A

Sitting EOB

Posture - support under feet

31
Q

Deep breathing/ventilation: facilitate inspiration

A

Trunk extension
Shoulder flexion, abduction, ER
Looking up

32
Q

Deep breathing/ventilation: facilitate expiration

A

Trunk flexion
Shoulder extension, adduction, IR
Looking down

33
Q

If a patient can’t breath what should we work on first?!

A

BREATHE

pt 571 cardiopulmonary (7 decks)

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