Week 11 Restrictive Disease Flashcards
what happens when a patient is already deconditioned from a chronic condition and develops another issue superimposed on the chronic condition?
their baseline of function is already low when adding additional issues then the level of function becomes even lower (usually below the level needed for independence in ADLs)
what are some causes of restrictive disease?
chest wall stiffness
acute or chronic interstitial or infiltrative disease
N-M disease, severe obesity, pleura disease, kyphoscoliosis
what is restrictive lung dysfunction?
difficulty in bringing O2 in due to decreased lung compliance or impaired ability of the thorax to expand
increased stiffness of lungs or chest wall
respiratory muscle weakness
pulmonary edema
what are the 3 main characteristics of RLD?
decreased pulmonary compliance, resistance to lung expansion is increased
increased work of breathing
on PFT all lung volumes and capacities are decreased
what is pulmonary fibrosis?
inflammatory process of alveolar wall
decreased lung compliance, lung volume, surface area for gas exchange, diffusion area
increased V/Q mismatch, work of right ventricle, WOB
what are the signs and symptoms of pulmonary fibrosis?
Chest x-ray, ABGS: pO2 decreased/pCO2 normal, breath sounds are decreased, Cor pulmonale, clubbing, cyanosis, DOE then SOB at rest, nonproductive cough, weight loss
what treatment is used for pulmonary fibrosis?
corticosteroids only for acute inflammatory stage, O2, nutrition, pulmonary rehab
what are the signs and symptoms of pneumonia?
crackles over consolidation
infiltrate on chest x-ray
hypo-resonance on percussion
DOE/SOB
tachypnea
what medical treatment is used for pneumonia?
antibiotics
bronchodilators/steroids
what PT intervention is used for pneumonia?
breathing Ex
mobilization
strengthening
PD/Chest PT
what are the effects of restrictive disease?
reduced chest wall mobility created a vicious cycle: disease –> dyspnea –> poor posture & chest wall mobility –> disuse –> disease
use of corticosteroids to tx dz may lead to osteoporosis, steroid myopathy, reduced immunity, etc.
what are the risk factors for pneumonia?
interstitial fibrosis with little respiratory reserve, bad breathing mechanics, poor airway clearance
what is bronchopneumonia?
widespread inflammation of distal airways
what is epiglottitis?
life-threatening infection of young children
obstruction, cyanosis, and stridor
what is croup?
upper airway infection that blocks the breathing and has a distinctive barking cough
inspiratory stridor, cough, and hoarseness
occurs secondary to epiglottitis or laryngotracheobronchitis
what are the classic signs and symptoms of restrictive lung dysfunction?
tachypnea, cyanosis, dry cough, dyspnea, alveolar hyperventilation/decreased CO2, V?Q mismatch, hypoxemia, clubbing, decreased lung volumes and capacities, decreased diffusion capacity, pulmonary HTN
what may treatment include for RLD?
supplemental O2, antibiotics, chest tube, Rx for some conditions, supportive until condition resolved, breathing exercises, chest expansion, postural correction, conditioning: mobility and strengthening
what are the typical walking speed times for common activities
> ___ m/s to safely manage city crosswalk
> ___ m/s typically able to complete household chores
> ___ m/s able to carry groceries and complete light yard work
> ___ m/s able to climb several flights of stairs
> 0.49
0.89
1.11
1.33
walking speed of <0.59 m/s is predictive of:
increased risk for adverse outcomes, such as falls
walking speed of <0.4 is predictive of:
less likely to be d/c to home from acute care
limited to household ambulation
requires assistance to enter and exit
difficulty negotiating stairs in the home
