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Cardiopulm Final > Exercise Perscription > Flashcards

Exercise Perscription Flashcards

1
Q

Asthma, Emphysema, and Chronic Bronchitis are…..

A

Obstructive diseases

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2
Q

For mild Obstructive lung disease, FEV1 is going to be less than ____ of predicted values

FEV1/FVC is going to be less than __________

A

80%

70%

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3
Q

The vital capacity of obstructive lung patients is _______

A

Typically within normal range

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4
Q

What is the only lung volume not included in vital capacity?

A

Residual volume

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5
Q

Your lungs capacities are considered normal if you’re within _____________ of predicted

A

80% and 120% of what’s predicted

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6
Q

Any patient under __________ of FVC has a restrictive lung disease

A

80%

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7
Q

Patients with MILD lung diease will present how?

A

They will tolerate normal exercise perscription that healthy people can do

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8
Q

Patient’s with moderate lung disease have _______ ventilatory responses

A

abnormal

Patient becomes short of breath with mild activity

ventilation cant increase w/ exercise that well (little ventilatory reserve)

May experience mild to moderate hypoxemia at rest

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9
Q

T or F: Using heart rate is a good tool to measure exertion for moderate lung disease patients

A

False

Their HR will be very high w/ activity

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10
Q

In severe lung disease, FEV1 is under ________ of predictive value

A

50%

Pt may need continuous or intermittent oxygen

Pt may have elevated CO2 levels

Pt may have right ventricular dysfunction during exercise

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11
Q

What is typically the problem for patient’s with poor oxygenation and how can PTs help?

A

Ineffective clearance of secretions

Teach patient’s how to remove secretions

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12
Q

What are techniques that PTs can use to assist ventilatory pump dysfunction (precursor to pump failure, increased reliance on accessory muscles, weakness of diaphram)?

A

Sniffing

Diaphramatic breathing

Positioning (sidelying)

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13
Q

For patients with pump dysfunction, if O2sat goes below __ we stop exercise

A

88

The goal of supplemental oxygen is to maintain atleast 88-92% without giving TOO much oxygen which can supress the drive to breath from the CNS

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14
Q

Phrenic nerve damage can lead to…

A

Ventilatory pump dysfunction

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15
Q

How can PTs help ventilatory pump failure patients?

A

Make sure they can expand properly for breathes

try to reduce accessory muscle use (diaphramatic breathing)

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16
Q

What signifies the end stage of respiratory failure

A

paradoxical brathing (hoovers sign)

Abdomen and ribcage no longer expand together, and now theyre moving in opposite directions (one goes in while the other goes out)

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17
Q

For patient’s with end stage pump failure or patients experiencing dyspnia how should we position them?

A

Position of recovery: leaning foward

Helps move diaphram upward so diaphram can descend and draw in breath

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18
Q

What is the problem w/ giving patient’s too much oxygen

A

The lack of CO2 decreases CNS drive to breath

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19
Q

How else can we move the diaphgram upward for a patient experiencing pump failure?

A

Scooping technique

20
Q

Why would a spinal cord patient use an abdominal binder

A

It replaces the pressure that the abdominal muscles would be providing to keep the diaphram up

w/o the abdominal binder their diaphram might rest too low

21
Q

If someone has a flail segment of ribs (3 or more ribs) what is the danger?

A

ribs might puncture lungs

22
Q

Pulmonary Artery hypertension critera

A

greater than 20 at rest

greater than 30 with exercise

23
Q

How is pulmonary arterial pressue monitored

A

Swan Gantz cathered

24
Q

5 groups of pulmonary hypertension

A

-idiopathic

-caused by R heart failure

-Caused by lung disorders

-pulmonary embolus

-other diseases

25
Q

At what pulmonary hypertension level do you stop exercise

A

40-50 watch and pay attention to symptoms and stop the intensity of the exercise

26
Q

What happens if a patient gets a spike of pulmonary artery pressure

A

Dizzy/light headed/ loss of conciousness
(happens very quick)

Sharp drop of SpO2

27
Q

Treatment for poor oxygenaiton

A

Supplemental O2

Bronchodilators

Teaching airway clearance techniques

28
Q

Treatment for Ventilatory pump dysfunction

A

Supplemental O2,

Facilitated breathing techniques (teach diaphramagtic breathing)

Exercise training

29
Q

Ventilatory Pump Failure treatment

A

Foward lean

Facilitatory/inhibitory breathing techniques

Pursed Lip

Breathing Techniques

Ventilatory muscle training

Abdominal Binder

30
Q

T or F, patients w/ pulmonary artery hypertension cannot take bronchodilators

A

True, because it will further raise the blood pressure

31
Q

What muscles is it the hardest to get oxygen to?

A

Lower limbs

32
Q

Acceptable Parameters for PT intervention:

A

Under RR over 40 at rest (dont work with patients 40+ RR)

HR 60-120 at rest, able to speak comfortably (120+ no go)

Pulse oximetry over 90

Need for supplemental O2 to keep SPO2 over 0

33
Q

Reasons to stop or modify PT intervention

A

Unable to speak comfortably

SPO2 under 85

HR drops more than 10BPM

SBP drops over 10mmHG

Guy’s i promise you this is going to be the majority of the questions lmao (no promises!)

34
Q

Giving a patient too much O2 can do what?

A

Reduce drive to breathe by CNS

35
Q

What is the preferable method of training respiratory patients

A

Short bursts of activity with many rest breaks, activity becomes longer overtime

(interval walking)

36
Q

What preformance tests are good for establishing someone’s muscular endurance?

A

6MWT

2MWT

30Second STS for LE muscular endurance

37
Q

Overall Exercise Perscription for non-acute COPD patient

A

Strength training 2 times a week

60-70% 10-15 reps

Aerobic 3-5x a week

Emphasis on interval training using BORG scale

38
Q

Why is it important to work on muscular strength with lung patients

A

Muscles become more efficient at using oxygen

39
Q

What kind of exercises should we use to help a patient correct posture after a lot of sitting and hunching over

A

Upper back

40
Q

an RPE of __________ is good for patients with COPD/lung problems

A

3-6

15-20 reps

41
Q

Why cant you use heartrate as a gauge of exertion for COPD patients?

A

HR is already very high at rest

42
Q

It is important to have a patient on _____________ for initial exercise training sessions

A

Pulse Ox

43
Q

What is MVV

A

Maximum ventilatory volume

Amount of air in and out in 1 minute

44
Q

MMV should never be more then __% of predicted MMV for a patient

A

70%

If you see an exercise test with more than 70% that means that respiratory system was the limiting factor

45
Q

If a patient is less than __% of predicted inspiration muscle strength, this indicates clinical weakness of respiratory muscles

A

50%

Cardiopulm Final (8 decks)

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