mobilisation and management of breathlessness

Question 1

mob

Answer 1

therapeutic application of low intensity exercise to manage CV / pulmonary dysfunction

Question 2

consequences of bed rest

Answer 2

loss of muscle 
loss of aerobic capacity 
general function decline 
risk of clots 
Reduced ROM

Question 3

response to mobilisation

Answer 3

increased oxygen requirements
BP HR
Increased minute vent - airway clearance
V/Q matching

Question 4

prescription of mob

Answer 4

sufficient to elicit progressive physiological adaptation within limits of dyspnoea, perceived exertion, angina and general fatigue

Question 5

CI / considerations

Answer 5

safety - balance/ power
Portsmouth sign - HR> BP
Tachycardia - >100 / Brady <40 
BP - hypertension - 140/90 = clinical hypertension 
sever= 200/100
SpO2 maintain >88%

Question 6

prescription of mob

Answer 6

set intensity within safety limits - no temp/ tightness/ pain
warm up steady state cool don / recovery
rhythmic mvmt of large muscle groups
duration based on patient response
avoid isometrics
acute Cardioresp dysfunction - interval training may be required
Patient should be rested
time with medication

Question 7

Borg breathlessness scale

Answer 7

3 - moderate

Question 8

document

Answer 8

date time aids used
medication
oxygen
progression plan

Question 9

Pursed lip breathing
technique
Benefits

Answer 9

breathe through nose
lips together except at centre
out x2 breathing in
exhaling - blow air out with firm steady effort

Benefits - PLB
- decrease freq of rest 
increase TV
increased oxygenation 
Provides patient with sense of control

Question 10

PLB - mechanism of Action

Answer 10

creates a back pressure which produces a small PEEP - positive end expiratory pressure
PLB helps support breathing by opening airways during exhalation and increasing the excretion of CO2

Question 11

PLB - caution

Answer 11

• correct technique
  can cause fatigue of resp muscles
  Low levels of CO2

Question 12

breathing controls suggestions to patient
when walking
when climbing stairs

Answer 12

walking: walk only a fast and as far as you can while respecting your own limits
do not hold your breath

stairs: climb slowly
do not force breath out

Question 13

STALL technique

Answer 13

stop what you’re doing
try and remain calm and turn up your oxygen
assume a position of comfortt - sitting / lean forwards
l - let yourself daydream - imagine safe place
L let breathing return to normal

Question 14

Medication

Answer 14

supplemental O2
short acting bronchodilators
- positions of ease