Rehab For COPD Flashcards
Breathing technique where physician resists patient’s inhalation, then lets go
Segmental breathing
Maximum blood flow is greatest at the _____________ portion of the lung
Most gravity dependent
Examples of long acting beta agonists
Salmeterol, formoterol
Method of diaphragmatic breathing
Use diaphragm to breathe and relax abdominal muscle during inspiration.
Therapeutic exercise parameters:
How long of a daily walk?
How high of a pulse goal?
For how many weeks?
12-minute daily walk
20-30% increase of your pulse, but <120
10-12 weeks
Changes in TV, FRC, maximum oxygen uptake with diaphragmatic breathing
Increased TV, decreased FRC, increased oxygen uptake
Method of pursed lip breathing
Inhale through the nose and exhale through the mouth longer
2 types of IPPV
Daytime mouthpiece IPPV
Nocturnal nasal IPPV or mouthpiece with seal
What is diaphragmatic breathing used for
Reverse altered pattern of respiratory muscle recruitment in COPD patients
When going from sitting to trendelenburg, effect on work of breathing
Work of breathing increases when going from sitting to trendelenburg because diaphragm has to contract against abdominal contents
V/Q mismatch between upper and lower lobes when sitting upright
Lower lobes is perfused more and upper lobes is ventilated more
Positioning technique for postural drainage
Affected lung segment placed at highest position
What can be used for prophylactic treatment for COPD
Cromolyn
Breathing technique that prevents air trapping and promotes greater gas exchange
Pursed lip breathing
Guideline for O2 use during exercise
If SO2 falls below 90% with exercise
When do you take SABA for exercise induced bronchospasm
15-20 minutes before starting exercise
What inhaled anticholinergics can be used in COPD
- ipratropium (Atrovent)
- tiotropium (Spiriva)
It indicates visceral protein depletion and is a good predictor of rehab potential
Albumin
Nutrition recommendations for COPD patients
- protein 1.7g/kg/day
- increase fluid intake
Effect of inh steroids on fev1
Increases fev1 by 10%
Combivent
Albuterol/ipratropium
Supplemental O2 is recommended for patients with a continuous pO2 of
55-60mmHg
1st, 2nd and 3rd line treatment for exercise induced bronchospams
1st - SABA and cromolyn
2nd - inh corticosteroid
3rd - anticholinergic
Effect of pursed lip breathing on TV
Increases TV
What lab value can be used that correlates with severity and chronicity of disease
Albumin
Symbicort
Budesonide/formoterol
Most common method of noninvasive positive pressure airway support
Intermittent positive pressure ventilation (IPPV)
MOA of inhaled anticholinergics
Antimuscarinic - inhibits muscarinic receptors –> inhibits parasympathetic –> bronchodilation
When supine, apical blood flow ______
Increases
Three types of positive pressure ventilators
Intermittent (IPPV), Continuous (CPAP), Bilevel (BiPAP)
Mucomyst
N-acetylcysteine - mucolytic for secretion control
Is upper or lower extremity exercise better for COPD?
Upper extremity
Patients who produce >_______mL/day of sputum need secretion mobilization
30
Incentive spirometry is contraindicated in lung problem in what kind of diseases
Neuromuscular disease
What must you avoid when taking methylxanthines?
Methylxanthines, such as theophylline, should not be taken with caffeine
When changing from sitting to supine position, relation between venous and arterial pressure??
Venous pressure increases in relation to arterial pressure in gravity dependent areas
What does BiPAP allow?
Adjusts inspiratory (IPAP) and expiratory (EPAP) components individually
Examples of inhaled steroids
Budesonide (Pulmicort), beclomethasone (Qvar), fluticasone (flovent)
Normal V/Q ratio
0.8
Benefits of pre-op and post-op chest therapy program
Decreases pneumonia incidence and reduces probability of post-op atelectasis
Examples of Short acting beta agonists
Albuterol, levalbuterol
Technique to reduce dyspnea and work of breathing in COPD patients
Pursed lip breathing
MOA of cromolyn
Inhibits release of histamine
