What is Pulmonary Rehabilitation? What are the 6 types that helps the patient in a Pulmonary Rehab.?1. Increase quality of life thru altering(not omitting) the daily activities of their daily living(ADL). 2. Minimizes symptoms 3. 6 types are 1. Improve Ventilation 2. Improve Airway Clearance. 3. Nutrition 4. Medication 5. Exercise 6. Patient Education.
What are the 2 types in Pulmonary Rehabilitation that improves ventilation?1. Diaphragmatic breathing technique. 2. Pursed-lip breathing technique.
In Pulmonary Rehab. How does diaphragmatic breathing technique improves ventilation?1. Most efficient way of breathing 2. Low amount of energy & O2 require to perform 3. Abdomen should expand(rise) each inspiration 4. help tone & condition the muscle related to diaphragmatic breathing.
In Pulmonary Rehab. How does Pursed-Lip breathing technique improves ventilation?1. Exhale thru pursed-lips 2. Creates a back pressure on the airway 3. Open up small airways&prevent air trapping 4.less air trapping leads to increased Vt. 5 Increased Vt leads to better coughing & airway clearance 6.Helps keep alveoli open & expanded.
What are the 4 types in Pulmonary Rehabilitation that improves Airway Clearance?1. General coughing Technique 2. Huff coughing 3. Serial Coughing 4. Multiple coughing
In Pulmonary Rehab. What are the General Coughing Technique that improves Airway Clearance?1. Deep inhalation 2. Glottic closure 3. Explosive Exhalation. 4. Relax between efforts 5. Avoid coughing too much – avoid fatigue, etc.
In Pulmonary Rehab. What are the Huff Coughing Technique that improves Airway Clearance?1.Done without closing the glottis. 2. Rapid succession of forceful exhalations.
In Pulmonary Rehab.What are the Serial Coughing Technique that improves Airway Clearance?Multiple coughs starting with small VT & gradually increasing
In Pulmonary Rehab. What are the Multiple Coughing Technique that improves Airway Clearance?Multiple coughs on a single exhalation.
What is the Nutrition that a Pulmonary Rehab. Patient need?1. Eat smaller meals 2. Low Carbohydrates intake (increase CO2 production) 3. Increase protein & fat and lipid intake. 4. Adequate fluid intake – Watch weight gain or loss & Monitor sputum thickness.
What are the medication given to Pulmonary Rehab Patient?1. Pay attention to improvement w/ regards to doses & intervals. 2. Educate on various drugs their importance & nature.
What are the exercises needed for a Pulmonary Rehab Patient?1. Instruct on limits. 2. TEACH walking, Stair Climbing, Breathing exercise, self monitoring techniques.
How do you educate a pulmonary rehab pt./family?1.Include family in education. – 2.TEACH family methods of social& emotional support 3.Accomplishing ADLs 4.Determining food nutrition from labels & other resources. 5. Importance of controlling environment-cleanliness.
What are the goals of a pulmonary rehabilitation?1. Maintain ADLs 2.Decrease frequency of infections & hospitalizations. 3. Improve breathing efficiency. 4. Produce the work of Heart. 5. Maintain appropriate weight & nutritional intake. 6. Generally increase pts. Quality of life from their point of view
What are NOT the goals of pulmonary rehabilitation?1. Cure /reverse lung disease. 2. Obtain normal ABG. 3. Accomplish normal PFT values. 4. Return pt. to normal life.
What are some of the exercise consideration a pulmonary rehab pt. must take?1. Testing-Determine patients limits & abilities during walk 2. Monitoring- HR,SaO2,RR,ECG,BP&complaint of joint discomfort 3. General Principles- maintain exercise program for 6 weeks to prove effectiveness 4. Upper &Lower-body exercise.
What is Home care all about?Home Care is mostly related to pulmonary rehab. Since it is the goal of pulmonary rehab. To return the pt. to a state where they can perform many of the ADLs on their own. Home Care is Largely about of Educating.
What are the 2 types to intialize a Home Care Program?1. Inspect & Evaluate the living environment. 2. Maintain a regimen
How do you inspect & evaluate the living environment in a Home Care planning.1. Pt. safety -Inspect electrical outlets. 2. Infection control-Adequate Hygeine &Clean resp. equipment 3. Medications- How & when to use. & teach O2 conserving options. 4.Irritants-no smoking,no pets,use whole-house humidifiers.
How do you maintained a regimen in a Home Care Planning?1. help patient create daily schedule of ADLs 2. Teach pt. how to modify schedule as needed according to daily health. 3. Ensure understanding the importance & expectations of exercise program.
What is a mode of Transport for Respiratory Patient?1. 0-80 miles use Ambulance. 2. 80-150 miles use Helicopter. 3. Greater than 150 miles-use fixed wing aircraft.
What are the equipments needed for respiratory patients transport?1. use portable light weight ventilators , pneumatically powered. 2. Ensure adequate gas pressure for entire trip. 3. If volumes & pressure fall, check tank pressure.
The practice wherein an individually tailored, multidisciplinary program is formulated which through accurate diagnosis, therapy, emotional support, and education, stabilizes or reverses both the physio-and psychopathology of pulmonary diseases is?Cardiopulmonary Rehabilitation
What is the Goal of Cardio Rehap?Achieving and maintaining the individual’s maximum level of independence and functioning in the community.
Name the four Progressive downward Spiral factors of People with COPD that decrease activity.1. Increase Level of Dyspnea 2. Bed Rest 3. Skeletal Muscle Deterioration 4. Progress Weakness – which cycles back to # 1.
Name the three results of these decrease activity factors as given to us by the diagram in class?HomeBound -> to Roombound -> to Bedbound
The History of Cardio Rehab was suggested in what year?1951
In 1962 a study was conducted that showed the results and value of reconditioning. What were those results? Lower pulse rates  Lower respiratory rates  Lower minute volumes (bpm)  Lower CO2 production  Improved efficiency of movement (muscles are more efficient, utilize less oxygen)  Improved oxygen utilization
What are the two Scientific Bases or aspects of Cardiopulmonary Rehabilitation?1. Physical reconditioning 2. Psychosocial support
Under the Physical Reconditioning Aspect of Cardiopulmonary Rehab? One of the goals is to increase these two factors to keep Homeostasis (Normal) in the cells or the body.1. Ventilation 2. Circulation
RQ (or Repiratory Quotient) is also referred to as?Ventilation Perfusion Ratio
What is normal at rest ventilation perfusion ratio or RQ0.8 or 80%. We normally produce 200 units of C02 and consume 250 units of Oxygen per minute. 200 Co2 produced divided by 250 O2 consumed is 80%
If the body is unable to get enough O2 to meet energy metabolism this condition can result?OBLA (Onset of Blood Lactate Accumulation)
If the body can’t get enough oxygen to meet it’s energy metabolism and OBLA results the body also switches to this type of metabolism?anaerobic
This term is known as how much air you can move when you are trying real hard , the most you can move) – good indicator of the ability to handle increased ↑ physical activityMVV (Maximum Voluntary Ventilation
MVV = FEV1 (Forced expiratory volume at 1 second)X 35. Normal patients can achieve & maintain what percentage of MVV during exercise?60 to 70% of MVV
FEV1 (forced expiratory volume at 1 second) x 35 = ??MVV (Maximum Voluntary Ventilation)
Under the Psychosocial support component of Cardio Rehab, these two factors are common with patients who have chronic pulmonary diseases?Depression and hostility
This can cause or aggravate physical problems associated with cardiopulmonary rehab?Stress
Psychosocial problems may be a cause of this type of asthma?intrinsic
If a patient is is admitted to a facility with the same diagnosis within a 30 day period. It WILL NOT be covered by this insurance program?Medicare
What are the common Goals of Cardiopulmonary Rehabilitation (what do we as therapists want to accomplish?)Too many to put in this field (read note) Starts with Control of Respiratory Infections, ends with Patient Education, Counseling and support
What are the common objectives of the patient at the completion of rehab?Too many for Field (read Notes) starts with development of diaphragmatic breathing skills ends with Provision for individual and family counseling
If we were to sum up all the goals into two. What would be the two major aims of Cardio Pulmonary Rehab?1)To control and alleviate disease symptoms 2) To help patient achieve optimal levels of activity.
What are the Basic Components of a cardiopulmonary rehabilitation program?Patient Selection Patient evaluation Determine individualized short and long-term goals Chest physical therapy Exercise conditioning Respiratory therapy Patient and family education General health care Assessment of patient progress Follow-