2nd semester "pulmonary rehabilitation"

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Author:
djones2007
ID:
264759
Filename:
2nd semester "pulmonary rehabilitation"
Updated:
2014-03-03 16:51:02
Tags:
study guide part two
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2nd semester
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  1. why should you "survey" a patients home?
    to make modifications, assure saftey and for infection control.
  2. What things should you check for in a patients home when surveying? (7)
    -no smoking

    -check vents, ducts, and appliances for molds

    -clean AC/ furnance filters

    -furry/feathered pets

    -cockroaches/rodent droppings/ dust mites

    -use of air filters

    -temperature shifts
  3. How do you figure out the ideal body weight for a male and female?
    female: 105 lbs + 5 lbs for every inch over 60 inches

    male: 106 lbs + 6 lbs for every inch over 60 inches

    (side note: 60 inches = 5'0

    my hieght: 5'9 = 69 inches)
  4. What should a persons predicted calories be?
    what if they are underweight?  
    predicted calories: 25-35 cal/Kg

    under weight: 35-45 cal/Kg
  5. What are 7 symptoms of impared food intake?
    • 1. Early satiety (being full very early)
    • 2. Dyspnea
    • 3. Anorexia
    • 4. Fatigue
    • 5. Bloating
    • 6. Constipation
    • 7. Dental problems
  6. Name 6 foods that are apart of the Carbohydrates food group

    what do they do?
    Fruits, grains, potatoes, cereals, pasta, & sugar

    Breaks down into CO2

    (in excess can cause S.O.B)
  7. Name 6 food that are proteins
    Milk, eggs, poultry, fish, beans, and meats

    (eat more protein if going in for surgery)
  8. Name 2 food products that are fats
    oil and butter
  9. How much salt, and water should a pateint consume in a healthy diet? should they drink alcohol? what kind of vitamins should they take?
    • salt: 2400 mg/day (1 tsp - 2300 mg)
    •       (can = retained fluid)
    • water: 6-8 glasses/day

    alcohol : NO!

    Vitamins/ minerals: multiple B with C
  10. What are antibiotics recommended for?
    not recommended except for treatment of infectious exacerbations

    *never use antibiotics for prevention
  11. what are mucolytics recommended for?
    not recommended unless patient has viscous sputum
  12. When is the use of steroids appropriate? (2)
    Only if :

    1. Pt. has improvement in symptoms or documented response to inhaled steroids on PFT

    2. FEV1 of less than 50% with history of repeated exacerbations requiring tx with antibiotics or steroids
  13. Regular use of Antitussives in contraindicated in for what disease?
    Contraindicated in stable COPD
  14. What is prescribed for all symptomatic patients with COPD?
    Bronchodilators
  15. Name the 1st - 4th line of medications for patients with COPD
    • 1st line : anticholinergics for maintenance 
    • *ipratropium bromide

    • 2nd line : beta agonists
    • *short acting is for rescue
    • *long acting is for maintenance

    • 3rd line : methylxanthine
    • (ex : Theophyllin - can increase ventilator drive, and strengthen contraction of diaphragm)
    • 4th line : steroids
  16. What are the benefits of smoking intervention? (4)
    • 1. reduced respiratory symptoms
    • 2. improved pulmonary function
    • 3. stops acceleration of age-related decline in lung function
    • 4. reduces COPD mortality rates
  17. Name 6 physiologic effects of smoking ?
    • 1. stimulates the brain
    • 2. relaxes muscle tension
    • 3. immediate gratification
    • 4. vasoconstriction
    •     *facial wrinkles
    •     *impotence
    •     *stroke
    • 5. brittle bones
    • 6. stained teeth/gum disease
  18. What are 8 things patients may experience while withdrawing from smoking ?
    • 1. irritability
    • 2. anxiety/insomnia
    • 3. difficulty concentration
    • 4. restlessness
    • 5. headache
    • 6. dizziness
    • 7. GI distress
    • 8. increased hunger
  19. What are 3 techniques to get a patient to stop smoking ?
    1. Group counseling

    2. Hypnosis

    3. Nicotine replacement
  20. What are 4 different types of nicotine replacement?
    1. Nicotine polacrilex

    2. Transdermal patch

    3. Nasal spray

    4. Inhaler
  21. What are 7 benefits to excerising?
    • 1. increased energy level
    • 2. increased muscle strength
    • 3. increased cardiopulmonary endurance
    • 4. ability to fight infection
    • 5. relaxation
    • 6. restful sleep
    • 7. increased bone density
  22. what are 6 things that exercise can decrease?
    1. shortness of breath

    2. risk factors of heart disease

    3. blood pressure

    4. side effects of medications ( steroids)

    5. depression (due to release of endorphins)

    6. blood sugar levels
  23. What are 5 activities that involve large-muscle groups that can be maintained continuously?
    1. walking

    2. treadmill

    3. stationary cycling

    4. swimming

    5. rowing
  24. For patient exercise, what should be the the frequency? intensity? duration? warm-up? and cool-down?
    Frequency: 3-5 days per week

    Intensity: 50% of peak exercise capacity based on maximum heart rate

    Duration: 20-30 minuets

    Warm-up: 10-15 minuets preceding

    Cool down: gentle stretching
  25. Patient exercise evaluation:

    1. what should you establish?
    2. how much should their PR increase by?
    3. patient should be tired but exhibit minimal ____.
    4. PR should return to baseline within _____ ____.
    5. When PR does return to baseline you should do what 2 things?
    1. base line vitals

    2. Increase by 20-30%

    3. tired but exhibit minimal discomfort

    4. PR should return to baseline in 5 minuets

    5. When it does return; increase work load and decrease supplemental O2 levels
  26. When should inspiratory muscle training be considered?
    When persistant dyspnea persists despite bronchodilator therapy
  27. inspiratory muscle training:

    what is a Nonlinear device?
    what is a Threshold device?
    what should you start at?
    what is the frequency?
    nonlinear device: unreliable training loads if the expiratory flow is not controlled.

    Threshold device: provides reliable loads

    Start at 1/3 of patients MIP to a max of 60% of MIP

    Frequency: 2-5 times per day, 15-30 min, approx 12 breaths per minuet

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