MIDTERM Flashcards
A ______ helps achieve specific programming objectives with the selected group of participating patients.
good design / program design
Key design considerations involve both ___ and ____, with emphasis on patient ___ and ______.
format and content
reconditioning and education
Two types of format
open-ended and closed design,
Programs can use either an____ or a _____ , with or without _______.
open-ended or a closed design / planned follow-up sessions
With an ______ format, patients enter the program and progress through it until they achieve certain predetermined objectives.
open-ended
There is no set time frame.
Depending on his or her condition, needs, motivation, and performance, an individual patient can complete an ____ program over weeks or months.
open-ended
This format is good for self-directed patients or patients with scheduling dif- ficulties.
open-ended
It also may be the best format for patients requiring individual attention.
Open-ended
The major drawback of the ____ format is the lack of group support and involvement.
open-ended
______ may be a factor when the program is open-ended.
insurance reimbursement
The more traditional _____ uses a set time period to cover program content.
closed design
These programs usually run 6 to 16 weeks, with classes meeting one to three times a week.
closed design
_____ may dictate how many sessions make up the program.
insurance coverage
______ covers 36 initial sessions with possible cov- erage of another 36 sessions if the patient qualifies and would benefit from the additional rehabilitation sessions.
Medicare
Class sessions usually last up to _____.
2 hours
Presentations are more formal and group support involvement is encouraged.
closed design
A major draw- back to this format is that the schedule determines program completion, rather than the objectives.
closed design
most programs allow patients to____ if the anticipated improvements are not achieved.
reenroll
Regardless of the format used, long-term improvements cannot be expected without_______
planned follow-up.
_____ must be ongoing and available to all patients who complete the program
Follow-up
Frequently, this essential element of the process is difficult, especially when it is not covered by most _______, but program coordinators must ensure that it is routinely ______.
insurance plans / scheduled
_______ could be open-ended (available during regular rehabilitation sessions and offering open attendance) or could be scheduled weekly, monthly, bimonthly, or quarterly. The important thing is to have some type of _____ available.
Follow-up or reinforcement / follow-up
The _____ of the rehabilitation program usually combines physical reconditioning with education activities.
content
Programs providing ________alone are unlikely to be effective.
reconditioning or education
the ideal rehabilitation session should last about _____.
2 hours
____, ______ and _____dictate session length.
Group size, available equipment, and group interaction
Patients should arrive _______ before a scheduled session to allow for infor- mal group interaction and support.
10 to 15 minutes
Classes should begin on____ and ______ as scheduled.
time and conclude promptly
_______ should be brief and to the point.
Educational presentations
The use of ____ or _____ should enhance understanding.
audiovisuals or demonstrations
To facilitate patient comprehension, the ______ should be simple and unnecessary technical terms or concepts should be avoided.
language
_____ that enhance certain points made during a presenta- tion are both useful and desirable.
Handouts
A folder or notebook in which program activities may be recorded and handout materi- als kept should be maintained by_____
each patient.
The ______ component of the pulmonary rehabilitation program consists primarily of an exercise prescription with target heart rate based on the results of the patient’s initial exercise evaluation.
physical reconditioning
For most patients, an initial target heart rate is set using ________, or estimated as ______ greater than resting rate.
Karvonen’s formula / 20 beats/min
Because of the severity of ventilatory impairment, some patients begin exercise recon- ditioning without a _________
prescribed target heart rate.
Target heart rate = [(MHR − RHR) × (50% − 70%)] + RHR
Karvonen’s formula
the exercise prescription includes the following four related components:
- Lower extremity (leg) aerobic exercises
- Timed walking (6- or 12-minute walk)
- Upper extremity (arm) aerobic exercises
- Ventilatory muscle training
To ensure success with________, patients must actively participate both at the rehabilitation facility and at home.
physical reconditioning
While exercising at the facility, patients should be monitored by ______
pulse oximetry
______ measurements may also be made, but these are usually done at the start and end of each session unless a patient’s condition dictates other- wise.
Blood pressure
exercise sessions should be ____
upbeat
_____ helps to maintain a positive atmosphere.
Lively music
Clinicians must remember that these patients are ill and require a ______ attitude from team members, family, and the group itself.
nurturing
To ensure compliance with the program, a daily __ or ___ is completed.
log or diary sheet
These___ or ___ forms are reviewed each time the patient attends a session.
log or diary
_____ may include either walking or bicycling.
Lower extremity exercises
Patients can walk on a ______ (with set goals for distance or time and grade) or on a ______
stationary treadmill / flat, smooth surface.
With the treadmill or stationary bicycle, patients are required to cover a certain ______ every day that they are in the program.
distance or duration
Commonly, the duration is set to_______, with patients encouraged to increase both their distance and equipment ten- sion or resistance as tolerated.
30 minutes daily
Patients with significant ortho- pedic disabilities can participate in_______.
aerobic aquatic exercises
_____ also improves overall conditioning; this usually takes the form of a ______ walk performed once a day, depending on the patient’s condition and tolerance.
Walking / 6- or 12-minute
These _____ exercises are a convenient way for patients to carry out a well- defined amount of activity with increasing vigor and results over a number of weeks.
walk
During the ______ patients should walk on flat ground for as far as possible.
6 or 12 minutes,
If _____ occurs, they should stop and rest, with the rest time included as part of the time interval. After resting briefly, they should try to continue walking at a comfortable pace.
dyspnea
The objective is to____ as far as possible during the allotted time.
walk
Landmarks such as ____ can be used to quantify progress.
telephone poles, city blocks, or actual distance measures
Under adverse weather conditions, _____ can be done indoors in shopping malls, stores, or long hallways.
walking
Patients should record their progress in their ___
manuals or diaries.
Aerobic _______ improve rehabilitation outcomes for patients whose regular activities involve lifting or raising the arms.
upper extremity exercises
______ or rowing machines are available for this purpose; however, simple calisthenics using either a ___ or ____ (by prescription and with training) are a satisfactory alternative.
Arm ergometers / broomstick or free weights
Upper body endurance generally is more ___ , with many patients capable of only ______ of daily activity to start.
limited / 2 to 3 minutes
This limitation usually is related to the fact that patients may revert to using ______ for breathing while doing the upper body exercise.
accessory muscles
Patients need to breathe ______ and perform the ______ at the same time.
diaphragmatically / exercises
Arm exercises should get progressively longer, up to _______ if possible.
20 minutes
____ conditioning helps patients perform numerous useful activities at home and can increase overall physical endurance.
Upper body
Although controversy exists, _________ probably can enhance the benefits of these more traditional exercises.
ventilatory muscle training
Ventilatory muscle training is based on the concept of _______
progressive resistance.
By imposing progressively greater loads on the inspiratory muscles (mainly the diaphragm) over time, the patient’s ___ and _____ should increase.
strength and endurance
These improvements should increase the patient’s ______
exercise tolerance.
_______ The device is an adjustable flow resistor with a one-way breathing valve.
inspiratory resistance breathing device.
The_____ is created by forcing the patient to inhale through a restricted orifice.
inspiratory load
Varying the size of this orifice varies the ______ , as do changes in the patient’s inspiratory flow.
inspiratory load
During expiration, gas flows unim- peded out the one-way ______
exhalation valve
One model replaces the variable size orifice with an adjustable _______. This valve ensures a constant load regardless of how quickly or slowly the patient breathes.
spring-loaded valve
Because variations in breathing strategy during ventilatory muscle training can affect outcomes, proper _____, ____ and _____ are required.
patient evaluation, training and follow-up
The RT initially measures the patient’s maximum inspiratory pressure (PImax) using a______
calibrated pressure manometer.
Before beginning _______, the patient should assume a position that relaxes the abdominal muscles, such as the position used for cough training.
ventilatory muscle training
