Pulmonary Rehab

Question 1

Length of pulmonary rehab?

Answer 1

6-12 weeks in formal, supervised programs

• benefits wane over time due to progression of disease

Question 2

Goals of Pulmonary Rehabilitation

Answer 2

• Control and alleviate symptoms
• Improve activity tolerance
• Promote self-reliance and independence
• Decrease need for acute resources
• Improve quality of life
• Improve treatment adherence and acute exacerbation prevention

Question 3

Contraindications to pulmonary rehab?

Answer 3

• Unstable cardiac disease
• Severe orthopedic problems (RA)
• Any acute illness limiting participation
• Lack of motivation
• Severe psychiatric illness
• Severe cognitive problems

Question 4

What is the purpose of a 6 minute walk test (6mwt)

Answer 4

It is used to evaluate exercise tolerance and functional capacity in individuals with various cardiopulmonary diseases and other conditions.

Question 5

When should a 6 minute walk test (6mwt) be stopped?

Answer 5

• Chest pain suspicious for angina.
• Decreasing LOC and coordination
• Intolerable dyspnoea.
• Leg cramps or extreme leg muscle fatigue.
• Persistent SpO2 < 80%. (In a community setting the test may be stopped if SpO2 < 85%)
• Any other clinically warranted reason.

Question 6

What should be measured from a 6 minute walk test (6mwt)

Answer 6

SpO2 and HR before and after test

• BP and dyspnea score as well
• Record the stopping time and monitor other s and s
• Once SpO2% >= 85% give the following encouragement (repeat this encouragement every 15 seconds if necessary).6 “Begin walking as soon as you feel able.”

Question 7

What goals should you discuss with the patient?

Answer 7

1. What do they want out of PR (expectations)
2. Past med history
3. Current and past Meds
4. Oxygen therapy needs
5. How are they coping

Question 8

MRC Dyspnea scale; what is each grade (1-4)

Answer 8

Question 9

What could be some Breathing management techniques for COPDers?

Answer 9

• Purse lip breathing
• Diaphragmatic breathing
• Mindfulness meditation
• During activity
• Body positon

Question 10

What is the purpose of airway clearance?

Answer 10

1. Prevention of infection
2. Reduces SOB caused by sputum blocking the airways

Question 11

Airway clearance technique’s

Answer 11

1. Controlled cough
2. Huff cough
3. OPEP device

Question 12

What should be avoided when performing airway clearance techniques

Question 13

How does a OPEP device work?

Answer 13

A drug free device that resists the exhaled breath causing vibrations that should loosen up secretions.

• exhale time should be 3-4 times longer than inhalation time

Question 14

OPEP technique?

Answer 14

Question 15

6 Principles of energy conservation

Answer 15

1. Prioritize activities
2. Pace Yourself
3. Plan your schedule
4. Awareness of posture and movement
5. Pursed Lip Breathing
6. Positive Attitude and Self Compassion

Question 16

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