Week 3

Question 1

Pulmonary rehab often deals with

Answer 1

chronic diseases

Question 2

Pulmonary rehab can be delivered in a…

Answer 2

hospital,

clinic,

follow up at home,

physical care medicine,

ICU

Question 3

Ultimate goal with pulmonary rehab is to

Answer 3

help pt manage condition at home/community to prevent further complications/readmissions

Question 4

Main lifestyle modification for lung disease

Answer 4

smoking

Question 5

Very common symptom of lung disease is

Answer 5

SOB/dyspnea

–> depends on the severity how many activities SOB impacts

Question 6

Why is cognitive impairments a symptom of lung disease?

Answer 6

having low oxygen for prolonged period of time this has an impact on the brain possibly causing these cognitive impairments

Question 7

Is SOB common in patients with lung conditions or heart conditions?

Answer 7

Both

Question 8

T/F those without lung diseas can still have SOB, why?

Answer 8

True

lung function changes with age – lung muscle strength decreases (such as seniors with SOB who don’t have lung condition)

Question 9

Lung Disease - cycle of inactivity

Answer 9

1) SOB, accomplishing activities difficulty

2) Poor confidence, less P.E

3) Muscle lose strength, heart function decreases

4) Fitness declines, social isolation

5) Worsening SOB, anxiety/depression

6) loss of independence, symptoms worsen

Question 10

What should pts with lung conditions be doing instead of resting?

Answer 10

low or high functioning activities

Low functioning: mobilization, safety w/transfers, basic ADLs, activity tolerance

High functioning: building on activity tolerance (ADLs, IADLs), life balance, IADLs

Question 11

Supplemental oxygen

Answer 11

prolongs life, improves quality of life, can be temporary or permanent

Question 12

Endotreacheal intubation

Answer 12

goes through the mouth/nose and down the throat and to the lungs

 pt with this will not be awake, will be unconcious and wont be able to speak/interact

 will be doing positioning, but won’t do transfers or mobility

Question 13

Tracheostomy

Answer 13

 goes directly into throat

 can be awake and talk

Question 14

Endotreacheal intubation VS Tracheostomy

Answer 14

Endotreacheal intubation:
goes through the mouth/nose and down the throat and to the lungs

 pt with this will not be awake, will be unconcious and wont be able to speak/interact

 will be doing positioning, but won’t do transfers or mobility

Tracheostomy:
 goes directly into throat

 can be awake and talk

Question 15

Scope of practice for assistants with supplemental oxygen

Answer 15

 assistants are allowed to change mode of oxygen delivery (wall, portable, tank)

 assistant NOT allowed to “titrate”

Question 16

Target Pulse Oximeter in COPD pts

Answer 16

target pulse oximetry in pts = 88% to 92%

Question 17

Diaphragmatic breathing

Answer 17

 improves breathing pattern
 helps with building activity tolerance
 improves SOB & fatigue

Question 18

Pursed Lip Breathing

Answer 18

 Controls SOB by quickly slowing down pace of breathing
 prolongs exhalation time by moving old air out of lungs

Question 19

Energy Conservation Techniques for Pulmonary Conditions

Answer 19

 Position: sitting when possible, limit bending/reaching, upright posture
 avoiding carrying heavy objects
 resting at least 60 mins after a meal
 using warm not hot water (in shower)

Question 20

Posture slump vs upright for pulmonary condition pts?

Answer 20

Upright

Question 21

Speed of breathing to regain control of your breathing, shallow/fast VS deep/slow breathing

Answer 21

deep/slow breathing

Question 22

Where should breathing occur

Answer 22

Abdomen

Question 23

Which should be longer? Breathing in or breathing out?

Answer 23

Breathing out

Question 24

Can you feel breathless even with normal oxygen levels in the blood?

Answer 24

 Yes

Question 25

Does everyone with a chronic lung condition require oxygen at home?

Answer 25

No

Question 26

Tests are needed so your doctor can tell if you need home oxygen. True or False?

Answer 26

True

Question 27

Prescribed oxygen is used only when the person feels they need it. True or False?

Answer 27

False

Question 28

It is important to keep active even though someone has oxygen. True or False?

Answer 28

True

Question 29

Apneic (Apnea)

Answer 29

a long pause after every inspiration and expiration; usually occurs during sleep

Question 30

Orthopnea

Answer 30

only being able to breathe comfortably when in an upright position – often measured in number of pillows required to breathe (or Lazyboy) while sleeping

Question 31

Dyspnea

Answer 31

subjective feeling of not being able to breathe comfortably

Question 32

Average respiratory rates depending on age:

Answer 32

Under 6 years = 25-60bpm 10 years = 15-20bpm Adults = 12-20 bpm

Question 33

Barrel Chest

Answer 33

large shaped/rounded chest  trapped air  Usually seen with COPD, emphysema

Question 34

Kyphotic Chest

Answer 34

increased curvature of spine (sunken in/bent over old lady)  Postural/age  Reduced air flow/ineffective inspiration

Question 35

Scoliotic chest

Answer 35

curvature of the spine  Reduced air, dysfunctional respiratory muscles

Question 36

Why do people lean/bend forward when in respiratory distress?

Answer 36

 stabilizes ribs and supports chest wall

Question 37

Some signs of respiratory distress

Answer 37

 cyanosis (blue-ish) around lips, nails  Positioning/leaning forward  Accessory muscle use (increase use of neck muscles and absence of diaphragm use, common in those with COPD)

Question 38

Auscultation

Answer 38

Listening to lungs

Question 39

Covid-19

Answer 39

 ACUTE

Question 40

Atelectasis

Answer 40

Segmental/full lung has collapsed  ACUTE  manual therapy  breathing/mobility

Question 41

Pneumonia

Answer 41

Infection of the air sacs in the lungs  ACUTE  can be very mild with few symptoms to life threatening  anti-biotics  manual therapy  breathing/mobility

Question 42

Chronic obstructive pulmonary disease (COPD) Signs?

Answer 42

Group of lung diseases that block airflow due to narrowing of the bronchial tree.  CHRONIC  Caused mainly by smoking or exposure to second-hand smoke or severe pollution  Medications to manage wheezing  Lifestyle modifications Signs:  Clubbing – thumbnails are humps  Increased SOB  Barrel chested  Auscultation (listening to breathing) decreased breathing sounds

Question 43

Cystic Fibrosis:

Answer 43

 CHRONIC  Genetic disorder that shortens lifespan and results in copious secretions  lots of manual therapy

Question 44

Contradictions to manual cardiorespiratory therapy:

Answer 44

 Active hemoptysis (coughing up blood)  Pulmonary emboli (blood clot that can get caught either in heart and cause heart attack or brain and cause stroke)  Spinal injury  Pleural effusion  Agitated patient  Rib fracture

Question 45

Treatment options for cardiorespiratory patient:

Answer 45

 secretion clearance  cough assist  breathing exercises  incentive spirometry  relaxation strategies  exercises

Question 46

Percussion

Answer 46

Uses cupping or clapping of the hands to loosen mucous  Goals - move the mucous from smaller to larger airways to be coughed or suctioned out  Use a cupped hand

Question 47

Vibrations

Answer 47

technique that gently shakes the mucus so it can move into the larger airways  Use a flattened hand

Question 48

For a strong cough you need two things:

Answer 48

1) To be able to completely fill your lungs 2) To be able to breathe out forcefully