case 2 part 2

Question 1

role of physiotherapist in post operative care

Answer 1

improve lung volume back to pre operative level
mobilize the patient as soon as possible to improve avelolar recruitment

teach supportive cough and ACBT
improve exercise tolerance
advice on lifestyle changes
set funcitonal goals

Question 2

benefit of teaching supportive cough after day 1 of post operative

Answer 2

help with pain over incision
aveolar recruitment towards the base of the lungs
secretion clearance

Question 3

what is the benefit of mobilizing patient early right after surgery

Answer 3

increase aveolar recruitment at the base of the lung

Question 4

what additional equipment might be needed post operative

Answer 4

equipment for supporting respiratory funciton - the BIRD, high flow machine

equipment for home enviroment- handles, rails
moving the bedroom downstairs, ensuring rails upstairs or there is a chair in the middle of the step to rest

Question 5

what would be including in the resp assessment following day 1 of the surgery

Answer 5

A-E assessment
Airway , patient own and patent
Is she self ventilating - not self ventilating using nasal cannula 40 % FiO2
RR- 35- high , normal 12-20 bpm
sputum analysis, check for infections, look at color, ordor , consistency,
SpO2 95% on 40% FiO2

auscultation
palpation

Question 6

expected palpation for the case

Answer 6

reduce expansion in ases
excess movement in upper limb to compensation for the reduced expansion
tactile frematis in UL
visible use of the accessory muscles

Question 7

what is tactile frematis

Answer 7

vibration of the chest wall

Question 8

what would be including in the cardio assessment

Answer 8

temperature
heart rate 103 bpm normal 60-100
blood pressure

Question 9

what would the renal assessment include

Answer 9

urine output

Question 10

what observations would you be expected to see for the patient in this case

Answer 10

patient slouched in bed
slightly SOB at rest
pain limiting cough and movement
struggling to clear secretions and breathe deep due to incision site

Question 11

evidence to justify treatment plan

Answer 11

NICE guidelines —>

Question 12

effects of general anathetics

Answer 12

controlled
reversible
gross loss of awareness to stimulation

Question 13

what would you use during acute respiratory failure when the patient is hypoxic despite medical management

Answer 13

continuous positive airway pressure
non invasive ventilation