Pulmonary Rehabilitation

Question 1

It is a program of education and exercise that focuses on restoring chronic respiratory patients to the highest functional capacity possible.

Answer 1

Pulmonary Rehabilitation

Question 2

is a comprehensive education and exercise program designed to
improve the cardiovascular fitness of patients with known cardiac dysfunction.

Answer 2

Cardiac rehabilitation

Question 3

Pulmonary rehabilitation differs from cardiac

rehabilitation with _________________.

Answer 3

Respect to the organ affected and hence to the type of program implemented

Question 4

Cardiac patients, on the other hand, are able to perform greater amounts of work and are __________________.

Answer 4

not limited solely by dyspnea

Question 5

Other differences center on patient focus and monitoring during exercise.
• Cardiac programs are more concerned with ___________

Answer 5

Patient’s pulse, blood pressure, and electrocardiogram via telemetry

Question 6

• Pulmonary patients are monitored for __________

Answer 6

pulse rate, respiratory rate, oxygen saturation, and peak flow rates

Question 7

The restoration of the individual to the fullest medical, mental, emotional, social, and vocational potential of which he/she is capable. (Year)

Answer 7

1942

Question 8

Became more specific and formed the Committee on Pulmonary Rehabilitation, which specified a medical practice that was intended to help pulmonary patients attain their optimum state of heath (Year)

Answer 8

1974

Question 9

ACCP stands for?

Answer 9

American College of Chest Physicians

Question 10

continue the advancement of pulmonary rehabilitation in terms of programs, services, professional practice, networking, and continuing education (Year)

Answer 10

1983

Question 11

AACVPR released new evidence-based guidelines recommending pulmonary rehabilitation for patients with COPD indicating that pulmonary rehabilitation can:
• Improve a patient’s exercise tolerance.
• Reduce levels of perceived dyspnea.
• Improve health-related quality of life.
• Reduce hospital admissions.
• Reduce the costs of health care utilization

(Year)

Answer 11

2007

Question 12

The major goal of pulmonary rehabilitation :

Answer 12

Restore the patient to the highest possible functional capacity, given the patient’s degree of pulmonary impairment and overall life situation.

Question 13

Two principal objectives of pulmonary rehabilitation

Answer 13

• To control and alleviate as much as possible the
symptoms and pathophysiologic complications
of respiratory impairment.
• To teach patients how to achieve optimal
capability for carrying out their activities of
daily living (ADLs).

Question 14

Before any testing is performed, a complete patient

workup should be completed. This includes:

Answer 14

• A complete patient history
• Physical examination.
• Laboratory testing
• Electrocardiogram and chest X-ray.

Question 15

Factors in doing PFT to patient:

Answer 15

• Allow for the differentiation between obstructive
and restrictive disease.
• Establish a baseline for the patient.
• Determine the extent of pulmonary impairment
present.
• Identify the degree of reversal produced by
bronchodilator therapy.

Question 16

The most important aspect of patient evaluation and testing before any pulmonary rehabilitation effort

• This is the most complex test but the most important in terms of the patient data and information it provides.

Answer 16

Cardiopulmonary Exercise Testing (CPX testing or stress test)

Question 17

Major indications for CPX testing include:

Answer 17

• Patient assessment and evaluation.
• Differentiating between pulmonary or cardiac
dysfunction and overall poor physical
conditioning.

Question 18

Main contraindications of CPX testing:

Answer 18

Acute electrocardiographic changes associated with serious cardiac dysrhythmias and angina.

Question 19

The two basic components of the CPX test or evaluation are ______

Answer 19

• regimens determining lung function

- those measuring cardiovascular function

Question 20

A CPX test should last about ______ or _______

if the patient is elderly

Answer 20

10–12 minutes , 6 minutes

Question 21

CPX test may be terminated for a number of other reasons, including:

Answer 21

• Equipment or monitoring-system failure.
• Patient fatigue.
• Clinical signs and symptoms of physiological distress
(vertigo, pallor, or headache).
• Significant hypoxemia.
• Major cardiac arrhythmias.
• Or substantial changes in blood pressure.

Question 22

• This type of format is more traditional than the open
  format.
• It uses a set period of time with a designated
  number of class sessions and a specific end date.
• Sessions may be conducted once, twice, or three times a
  week for anywhere from 6 to 16 weeks.

Answer 22

CLOSED-FORMAT PROGRAMS

Question 23

• This type of format have no designated number of class sessions or specific end dates.
• Patients continue in the program and progress at their own pace until they achieve specific objectives and attain prescribed performance levels
• patient who don’t achieve their goal in closed format

Answer 23

OPEN-FORMAT PROGRAMS

Question 24

Session in which may be conducted in the hospital, at the patient’s home, or at the rehab facility, require less equipment and personnel than do group sessions

Answer 24

INDIVIDUAL SESSIONS

Question 25

Individual programs are especially effective for _______ who are being weaned from ventilatory support or for those with neurological disorders

Answer 25

ventilator-dependent patients

Question 26

This session involve classes of 4–12 patients, depending on space, equipment, personnel, and the number of patients who qualify. - more cost-effective than individual sessions. - attend rehabilitation programs more for psychosocial than for physical reasons

Answer 26

GROUP SESSIONS

Question 27

Facilities that offer outpatient pulmonary rehabilitation must address patient needs in terms of ____________

Answer 27

Accessibility, parking, and mass transit.

Question 28

``` For an average class of 8–12 patients, a classroom that is ____________ is adequate, ```

Answer 28

12 feet by 16 feet (192 square feet)

Question 29

and an exercise area approximately twice that size up to ______________ should suffice.

Answer 29

(up to 400 square feet)

Question 30

A typical group session should be approximately ______, whereas individual sessions can range from a ________.

Answer 30

2 hours long , half hour to an hour

Question 31

Normally, ____________ of each session can be | devoted to patient education.

Answer 31

30–60 minutes

Question 32

Each session should begin with a _______ followed by the patients’ comments on their progress

Answer 32

welcoming remark

Question 33

These techniques can produce profound benefits by helping patients control their breathing, improve ventilatory muscle endurance and strength, and reduce the work of breathing and dyspnea.

Answer 33

Breathing Retraining

Question 34

Considered to be the cornerstone of breathing retraining for COPD patients in pulmonary rehabilitation

Answer 34

Diaphragmatic breathing with pursed lips

Question 35

Retarding expiration:

Answer 35

• Slows their respiratory rate. • Reduces the work of breathing. • Creates a back pressure that prevents collapse of the smaller airways. • Lessens the probability of air trapping. • Promotes more effective ventilation.

Question 36

It may take ________ before some patients | breathe diaphragmatically

Answer 36

6–8 weeks

Question 37

Incentive spirometer, should be performed for up to _______ , ________ on a regular basis to be effective.

Answer 37

15 minutes, | three or four times a day

Question 38

This apparatus uses a spring-loaded valve mechanism to provide a consistent inspiratory pressure training load, independent of inspiratory flow rate.

Answer 38

Threshold loading

Question 39

movement without resistance or tension - To increase stamina and endurance, improve cardiovascular status, and increase maximum oxygen consumption

Answer 39

Aerobic or isotonic conditioning

Question 40

movement with resistance or tension - To increase muscle strength and tone for both upper and lower body

Answer 40

Isokinetic techniques

Question 41

resistance or tension without movement - To increase muscle strength and tone

Answer 41

Isometric exercises

Question 42

stretching and bending - To increase flexibility, agility, and strength

Answer 42

Calisthenics

Question 43

used to document a | patient’s perceived degree of dyspnea

Answer 43

The Borg or modified Borg | Dyspnea scale

Question 44

Patients may be included in pulmonary rehabilitation when they terminate an exercise evaluation at a level less than what percentage of their maximum oxygen consumption?

Answer 44

75%

Question 45

The most effective breathing technique a patient with chronic obstructive pulmonary disease can acquire is which of the following?

Answer 45

diaphragmatic breathing with pursed lips

Question 46

Reconditioning involves the following :

Answer 46

- strengthening essential muscle groups, - improving overall O2 utilization and - enhancing the body’s cardiovascular response to physical activity

Question 47

To determine the patient’s cardiopulmonary status and | exercise capacity, both __________ and a ____________ may be performed.

Answer 47

pulmonary function testing , cardiopulmonary exercise evaluation

Question 48

With regard to test preparation, patients should fast ________ before the procedure.

Answer 48

8 hours

Question 49

The ideal class size of Rehabilitation Program should range from _____ to _____ participants

Answer 49

3 to 10

Question 50

The quantity of equipment needed depends on ________ , _______, and ______

Answer 50

class size, scheduling, and available space.

Question 51

Pulmonary rehabilitation programs must include five components which must be documented in the patient’s medical record. The five components include the following:

Answer 51

1. Physician-prescribed exercise, including aerobic exercise performed during each session 2. Education and training that relate to an individual patient’s needs 3. Psychosocial assessment 4. Outcomes assessment 5. Treatment plan that details how these components are used for each individual patient

Question 52

If no improvements in physical or psychosocial measures occur within a class or group, _________ are the most likely cause

Answer 52

program deficiencies