Pulmonary Pulm onary Physical Physical Therapy Th erapy Review Study online at quizlet.com/_b8kzc
43.
7.26-7.41
Wha t's the normal normal pH value for infants?
21.
7.35-7.45
Wha t normal normal rang e for pH?
44.
7.35-7.45
Wha t's the normal normal pH value for adults?
118. 10-15
179. Abdominal
binder
The usual suctionin g time is between?
seconds 38.
1220br/min
Wha t's the normal normal value of Respiratory Respiratory rate rate for adults?
45.
20mL
Wha t's the tidal tidal volume normal value for infants?
27.
22-28 mEq/mL.
Wha t is the normal normal value of Bicarbonate (HCO ₃) within a rterial rterial blood?
41.
34-54
Wha t's the PaCO₂normal value for infants (mmHg)?
42.
35-45
Wha t's the PaCO₂normal value for adults (mmHg)?
22.
3545mmHg
137. 40%-85%
37.
34.
40br/min 60100bpm
175. 60%-80%
At what percentage percentage range sh ould a pulmonary pulmonary patient exercise intensity be calculated if using the Karvonen's formula? Wha t's the normal normal value of Respiratory Respiratory Rate for infant?
At what percentage percentage range sh ould a cardiac patient exercise intensity be calculated if using the Karvonen's formula? Wha t's the PaO₂normal value for infant (mmHg)?
35.
75/50
Wha t's the normal normal value of BP for infants (mmHg)?
40.
80-100
Wha t's the PaO₂normal value for a dults dults (mmHg)?
33.
120bpm
117. 120mmHg
46.
500mL
135. Abdominal
strengthening
Wha t's the normal normal value of BP for adults adults (mmHg)?
What Wha t type type of physical therapy intervention intervention can be used for high cervical or high thoracic spinal cord injury patients whose abdominal muscles are too weak to provide the necessary support for the abdominal contents needed for passive exha lation? (be sure that binder does not restrict inspiration) This exercise is used when abominal muscles muscles are too weak to provide provide an effective cough
54.
Alveolar hyperventilation
It is a cause for respiratory alkalosis
55.
Alveolar hypoventilation
It is a c ause for respiratory respiratory acidosis
18.
Alveolar ventilation
Defined as: the abili ty to remove remove carbon dioxide from the pulmonary circulation and maintain pH
Wha t's the normal normal value of HR for adults?
75-80
120/80 or less
splinting
Wha t's the normal normal value of PaCO₂ within a rterial rterial blood in healthy individuals?
39.
36.
136. Abdominal
Normal abdominal tone holds the abdominal contents directly under under the diaphragm, assisting the return of the diaphragm to the normal high domed position. When a patient lacks functional abdomina musculatur musculaturee such a s SCI patient, the diaphragm is lower in thorax dcreasi dcreasing ng inspiratory i nspiratory reserve reserve (IRV). The more upright body posiiton the lower the diaphragm an d the lower the inspiratory capacity. What can be used to assist such a patient to maintain or support support the abdominal vicera to assist in ventilation?
164. Anterior
basal segments
What Wha t lung segment is being being drained here? - Patient in trendelenburg, trendelenburg, and s ideline position, pillow under knees. - therapist claps with slightly cupped hand han d over lower ribs
161. Anterior
What Wha t lung segment is being being drained here? - Patient is lying flat on back with pillows under the knees, hips are approximately approximately at 45° angl e - Therapist claps between clavicle and nipple on each side
segments
Wha t's the normal normal value of HR for infan ts? Suction Suction system should be set a pproximately pproximately at how may mmHg? Wha t's the tidal tidal volume normal value for adults? 57.
Anxiety, restlessness, dyspnea, headache
Early sign s & s ymptoms ymptoms of respiratory acidosis include?
159. Apical
segments
180. Apnea
What Wha t lung segment is being being drained here? - Patient is in upright position in bed or chair leaned back at 30° angle - Therapist c lasps las ps markedly cupped cupped hand over area between clavicale and top of scapula on each side
102. Atelectasis
Defined as no respirations
190. Apply
If an Arterial line gets dislodge during pressure treatment treatment,, what w hat is the next thing to do? immediately to or above the arterial insertion site to stop bleeding bleeding
77.
Aspiration pneumonia
If a chest x-ray initially shows pneumonitis, and in the chronic stage of disease disease show s necrotizing pneumonia with cavitation. What conditions conditions is this finding ass ociated ociated with?
74.
Aspiration pneumonia
Aspirated material material causes an acute inflammatory reaction within the lungs. Usually found in patients w ith impaired swallowi ng (dysphagia (dysphagia ), fixed neck extension, intoxication, impaired consciousness, neuromuscular disease, recent anesthesia
111. Assisted
cough
110. Assisted
cough
79.
Asthma
What Wha t air clearance technique is being used here? - Patient is positioned against a solid surface in s upine with h ead of bed in trendelenbur trendelenburg g position position or sitting with w heelchair against the wall wal l or agai ns the therapist - The therapist's hand is placed below the patient's subcostal angle (similar to heimlich maneurver) - The patient inhales deeply, and as the patient attempt attemptss to cough, the therapist pushes inward and upwardly assisting the rapid exhalation of air This technique is used when the patient's abdominal muscles cannot generate an effective effective cough. (i .e. spinal s pinal co rd injury) injury) Condition that shows increased reactivity of the trach trachea ea and bronchi to various stimuli such as a llergens, llergens, exercise, cold , and manifests by widespread narrowing of the airways due to inflammation, smooth muscle constriction, and increased secretions that is reversible reversible in n ature. ature. The Th e patient with this condition condition may show wheezing, possible crackles a nd decreased decreased breath breath sounds. s ounds.
Description: Collapse or airless alveolar unit, caused by hypoventilation hypoventilation secondary to pain during the ventilatory cycle (pleuritis, (pleuritis, post operative operative pain, or rib fracture), fracture), inter in ternal nal bronchial obstruction obstruction (aspiration,mucus plugging). external bronchial compression compression ( tumor tumor or enlarged lymph nodes), low tidal volume volume (narcotic o verdose, verdose, in appropriately appropriately low ventilator settings) or neurlogic insult
85.
Atelectasis
It is caused by a blockage of the air passages (bronchus or bronchioles) Lung Collapse o r by pressure on the outside of the lung. Sig ns & s ymptoms ymptoms include: - Difficulty breathing, Chest pain, Cough
48.
Atelectasis, fibrosis, pulmonary edema
Crackles or rales, repitations is an adventitious adventitious s ound heard during inspiration. what pathology would these sounds indicate?
betal blockers, bronchodilators
Medications within pulmonary pupulation pupulation that usually a lter vital vital signs s igns are:
60.
Bicarbonate ingestion, vomiting, duirectis, steroids, adrenal disease
Wha t are the causes of Metabolic Metabolic alkalosis?
82.
Bronchiectasis
A chronic con genital or acquired disease characterized by abnormal dilatation of the bronchi a nd excessi ve sputum sputum production
52.
Bronchophony
A sound characterized by an intense, in tense, clear sound during auscultation, even at the lung bases.
173. Bronchophony
Which Whi ch technique is being demonstrated demonstrated here? - Patient is asked to say "99", and the words are auscultated clearly over the entire chest
32.
146. Chest
Tubes
156. Chronic
Bronchitis
Medical equipment that is used to evacuate air or fluid trapped in the intrapleura space. (Usually found in post operative patients) The infl amed bronchi bronchi produce produce a lot of mucus. This leads to cough and difficulty getting air in and out of the lungs. This is called
155. Chronic
Bronchitis
88.
Chronic Obstructive Disease
A type type of COPD defined defined as hypersecretion hypersecretion of mucus sufficient to produce a productive cough on most days for 3 months during 2 consecutive years. Hypersecretion of mucus usually usually begins in the large airways and is not associated with airway obstruction. Later hypersecretion hypersecretion progresses to the smal ler airways, where airway obstruction begins initially. This is called: This condition is characterized by airflow limitation that is not fully reversible. reversible. The airflow limitation is usually both progressiveand associated with an abnormal inflammatory response response of the lung s to nox ious particles particles or ga sses. A typical typical ch aracteristic found is increas ed A-P diameter diameter of chest wal l.
78.
Chronic Obstructive Diseases
Pulmonary function tests showing decreased FEV ₁, decreased FVC, increased FRC and RV, and decreased FEV ₁/FVC ration are most likely associated with
87.
Chronic Restrictive Disease
This condition is typified typified by difficulty difficulty expanding the lungs causing a reduction in lung volumes volumes
89.
Chronic Restrictive Disease
Pulmonary function tests usually reveal reveal a: - reduction in Vital capacity (VC), Functional residual capacity (FRC), and Total lung capacity (TLC)
58.
Confusion, somnolence, coma
Late sign s & symptoms symptoms of respiratory acidosis include:?
187. Continue
GET
186. Continue
GET
97.
47.
Cough with hemoptysis Crackles
Keeping Keeping in mind normal a dult dult levels of BP a therapist is getting ready to assist in performing performing a G.E.T. Baseline of BP 1 22/84 mmHg. During the test, the BP = 244/82 244/82 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T? Keeping Keeping in mind normal a dult dult levels of BP a therapist is getting ready to assist in performing performing a G.E.T. Baseline of BP 1 22/84 mmHg. During the test, test, the BP = 144/88 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T? A pertinent pertinent finding with lung con tusion tusion during a physical examination is An adventious sound: a cracklin g sound heard usually during inspiration that indicates pathology (atelectasis, fibrosis, pulmonary edema). this is aka rales, crepitations
80.
Cystic Fibrosis
A genetically inh erited erited diseas disease e characterized by by thickening of secretions of ALL exocrine glands (glands that secrete their producs to ducts to a specific location), leading to obstruction of, for example, pacreatic, pulmonic, gastrointestinal.
81.
Cystic Fibrosis
This condition may present as an obstructive obstructive,, restrictive restrictive or mixed mixed disease. Clinica l s/s include: - meconium ileus, frequent respiratory infections (especially staphylococcus aureus and pseudomonas aeruginosa) - Inabili ty to to gain ga in w eight despite adequate adequate caloric intake. - Diagnosis made post natally by a blood test show ing the presence presence of trypsinog trypsinog en or later by a positive sweat electrolyte test
192. d
Chronic Restrictive Diseases h ave different different etiologies w hich is typified by by difficulty difficulty expanding the lungs causing a reduction in lung volumes Which statement statement is true true about Chronic Restrictive Restrictive Diseas e a) Restrictive disease can be due due to alterations in lung parechyma and pleura pleura b) Restrictive Restrictive diseas diseas e can be due due to to alteration in the chest wall c) Restrictive lung lung disease ca n be due to alterations i n the neuromuscular neuromuscular apparatus d) All of the above statements are true
28.
Dead space
Defined as: anatomical conducting airways or physiological (disease such as pulmonary emboli). emboli). it is a space that is well ventilated but but no respiration (gas exchange) occurs
30.
decreased ability to perform ADLs or shortness of breath
Common Common complain ts expressed amoung pulmonary pulmonary diagn osed patients during during a physical therapy examination usually include:
101. Decreased
breath sounds over over effusion, bronchial breath sounds may be present around the perimeter perimeter of the effusion. Pleural Pleural friction fri ction rub may be possible possi ble with inflammatory process
A pertinent pertinent finding of pleural pleural effusion effusion during during a physical examination examination is
26.
Decreases
If there is retention (increased) of CO₂in the blood, wha t happens to the pH value?
1.
Diaphragm
Which Whic h muscle is called the primary muscle of inspiration?
122. Diaphragmatic
breathing
This breathing exercise can be used with: - Post operative patients, post trauma patients, - Patients with obstructive or restrictive pulmonary pulmonary lung diseases
121. Diap hragmatic hragmatic
breathing
120. Diap hragmatic hragmatic
breathing
56.
Dizzness, syncope, tingling, numbness, early tetany
172. Egophony
51.
Egophony
Wha t breathing breathing exercise is being used here? - Position Pos ition the patient semireclined (semifowler's position) - Plac e the therapist's therapist's hand han d gently over over the subcostal angle of the patient's thorax - Apply gentle pressure throughout the exhalation phase of breathing - Ask patient patient to to inha le again st resistance resistance of the therapist's hand - Release pressure allowing a full inhalation - Progress to independence independence of therapist's hand, in upright upright sitting, sitting, s tanding, tanding, w alking and stair climbing Wha t type type of breathing breathing exercise is used best to to increase ventilation, improve improve gas exchange, decrease work of breathing, facilitate relaxation, maintain or improve MOBILITY of chest wall? Sign & s ymptoms ymptoms of respiratory respiratory alkal osis include:
Which Whic h technique is being demonstrated demonstrated here? - Patient is a sked to say "E" aloud, but the sound that is auscultated over over the chest is "A" It is a nasal or bleating sound heard during during auscultation. "E" sound are transmitted to sound like "A".
157. Emphysema
A form of COPD, a con dition that limits the flow of a ir when you breathe breathe out. It occurs when the air sacs at the ends of your smallest air pass ages (bronchi oles) are gradually destroyed. destroyed. Smoking is the leading cause.
158. Emphysema
Wha t Pulmonary Pulmonary condition presents presents clinically with Shortness of breath, scant sputum production and barrel-shaped configuration of the chest wall, with increased subcostal angle?
115. Endotracheal
suctioning
6.
Expiratory reserve volume
This airway clearance technique is used ONLY when regular cough technique, huffing, assisted cough and tracheal stimulation has failed to adequately adequately remove secretions Defined as: volume of gas that can be exhaled beyond a normal resting TIDAL VOLUME
13.
Force Expiratory volumen volumen in 1 second (FEV ₁)
20.
Free floating floating hydrogen ions in the body
11.
Functional Residual Capacity
144. fungal
infection of the mouth and throat 14.
Healthy population
The amount of air exha led during during the first second of Forced Expiratory Vital capaci ty (Vital capacity) What Wha t does does pH indicates?
Defined as: The a mount of air that resides in the lungs after normal resting Tidal Exhalation ( ERV + RV) Inhale steriods steriods such as Vanceril and Azmacort main side effect effect is called thrust. thrust. wha t is it? Which population population is FEV ₁at least 70% of FVC? (FEV ₁/FVC x 100 > 70%)
Hemoptysis, and Cough and expectoration of LARGE amounts of mucopurulent secretions
In add a ddition ition to pertinent pertinent found in most respiratory diseases such as cyanosis, clubbing, hypoxemia, dyspnea, tachypnea, a distinguishing finding in Bronchiect Bronchiectasis asis is/are
95.
Hemothorax
Description: Blood in the pleural pleural space s pace usually from a laceration of the parietal parietal pleura
91.
Hold Treatment until palliative therapy reduces the tumor size and relieves relieves the bronchial obstruction
One physical therapy consideration with regards to pneumonias of carcinogenic origin is that tha t if they develop develop behind behind a COMPLETELY obstructed brochus, they CANNOT be cleared with physical therapy techniques. If a PT finds this condition to be true in a patient, What is the next thing to do if the PT needs to perform Chest PT?
84.
108. Huffing
109. Huffing
107. Huffing
The technique that will be a more effective effective airway clearance technique in patients with COPD such as asthma, cystic fibrosis, fibrosis, bronchiectasis , bronchopulmonary dysplagia, respiratory respiratory distress distress syndrome is: What Wha t air clearance technique is being used here? - Ask patient to inhale deeply, and immediately the patient forcibly expels the air saying "ha..ha..ha.."
Technique that is more effective in patients with collapsible airways, such as patients with chronic obstructive obstructive diseas diseas es (Asthma, (As thma, cystic fibrosis,Bronchiectasis, Respiratory distress distress syndrome, syndrome, Bronchopulmonary dysplagia). It prevents the high intrathoracic pressure pressure wh ich causes prematur prematuree airway closure
23.
hypercapnea
When PaCO ₂> 45mmHg, 45mmHg, this condition is called:
16.
Hyperoxemia
Defined Defined as: When PaO ₂> 100mmHg
24.
Hypocapnea
When PaCO ₂< 35mmHg, this condition is called:
130. Incentive
Spirometer
blood blood pressure, sodium retention, muscle wasting, osteoporosis, GI irritation, and hypercholesteremia
What Wha t medical medical device device can as sist sis t a patient with an a cute condition such as post trauma trauma pain, or post operative operative pain, or acute lobar collapse to measure and encourage deep inspiration thereby assisting with achieve maximal inspiration during sustained maximal inspiration exercise?
142. Increased I ncreased
Anti-infla mmatory mmatory agaents such a s steroids, are used to decrease muscosal edema, edema, decrease inflammation, reduce airway reactivity. reactivity. Steriods can be administered either either system s ystemicall icall y or topically. what are the common side effects effects of systemic administration of steriods?
103. Increased
What Wha t are the the indications for postural drainage?
pulmonary secretions, Aspi ration, Atelectasis Atelectasis or collapse 171. Increased I ncreased
volume in the venous system and may be an early sign of R side Heart Failure (cor pulmonale) pulmonale)
During examination, a patient presents presents with w ith jugular venous distention (veins are distended above the level of the clavicles), what is this condition indica tive of? of?
25.
Increases
If there is removal of CO ₂in the blood, wha t happens happens to the pH pH value?
9.
Inspiratory capacity
Defined as: The amount of air that can be inhaled from Resting End Expiratory Pressure (REEP) TV + IRV
5.
Inspiratory Insp iratory reserve volume volume
Defined as: volume of gas that can be inhaled beyond a normal resting TIDAL VOLUME
126. Intractable
hypoventilation 181. Kussmaul
breathing
147. lack
of sweating,dry mouth, delusions
166. Lateral
basal segments
149. Leaning
forward forward in sitting position 163. Lingular
segments
Wha t condition condition renders renders the use of segmental breathing inappropriate? inappropriate? Defined as a deep deep and labored breathing breathing secondary to metabolic acidosis e.g., Diabetic ketoacidosis but also renal failure. It is a form of h yperve yperventilation, ntilation, which whi ch is a ny breathing breathing pattern pattern that reduces carbon dioxide in the blood due to increased respiratory rate and depth of respiration. Atrovent Atrovent is an a nticholin ergic drug drug that inhibit inhi bit the paras ympathetic ympathetic nervous system system which causes an i ncrease ncrease in the HR, BP and bronchodilation. What the known side effects effects of this type type of drugs? drugs?
Drains the Posterior R or L apical segments (upper lobes) Wha t lung segment is being drained here? - Patient in trendelenbu trendelenburg rg postion w ith head down on Right side and rotates 1/4 turn turn backw ard. Pill ow may be placed from behind from shoulder to to hip. Knees should be flexed - Therapist cla ps over Left nipple nipple area.
Lung capacities capac ities
Defined as: two or more lung volume added together (i.e. TV + IRV, etc...)
96.
Lung contusion
Description: Blood and edema edema withi n the alveoli a nd interstitial space due to blunt chest trauma wi th or w ithout rib fractures fractures
flat flat on back (pillow under knees)
169. lying
in bed with the head flat on abdomen (pill (pi llow ow under abdomen)
59.
Metabolic alkalosis
The following may be cause of: - Bicarbonate ingestion, vomiting, diuretics, sterioids, adrenal disease
15.
Mild hypoxemia
A young individual individual PaO ₂is measured to be < 90mmHg, what is this condition called?
140. Paced
breathing or activity pacing
138. Paced
breathing or activity pacing 139. Paced
breathing or activity pacing
Which Whic h postion patient with cardiopulmonary cardiopulmonary dysfunction can n ot tolerate? Drains Posterior R or L segments (upper (upper lobes aka superior segments)
154. Lying
Drains Posterior Basal Segment (R or L)
152. Lying
In trendelenburg position tilted R or L, Drains Middle lobes (R or L)
on back (trendelenburg)
The following may be described as a cause for a condition that increases the pH in blood. What is this condition called? - Diabetic, lactic or uremic acidosis,prolonged diarrhea
Drains Anterior R or L segments (upper (upper lobes)
151. Lying
on abdomen in trendelenburg
Metabolic acidosis
Wha t lung segment is being drained here? - Patient in trendelenburg, trendelenburg, a nd lying on abdomen, then rotates 1/4 turn upward. Upper Upper leg is flexed over over a pillow for support - Therapist claps over uppermost portion of lower ribs
8.
150. Lying Lyi ng
62.
168. The
A PT at a local h ospital is w orking w ith a pulmonary pulmonary patient who li ves on the 2nd. floor in a two story appartment appartment building building w ith no elevator. elevator. Th e patient presents with difficulty difficulty ascending a fligh t of stairs (12 steps). steps). The PT instructs the following: - Before ascending the first step, step, inhal in halee deeply deeply and exhale slowly with pursed lips. Upon exhalation, ascend two steps and stop. Inhale again, and exhale with pursed lips. Upon exhalation, advance another two steps, etc. until you have reach the end. Wha t techniques techniques is being used here? here? This breathing technique is used to spread out out the metabolic demands of any activity over time by slowing its performance. performance. It is used when patients who becomes becomes dyspneic during the performance performance of an activity or exercise What Wha t technique technique is being used here? here? - Break down any activity into manageable components components that tha t can be performe performed d within the patient's pulmonary pulmonary sys tem's tem's a bilites. - Inhale at rest, and upon exhalation with pursed lips, complete the first component of the desired activity. - Stop the the activity, and inh ale at a t rest - Upon exhalation with pursed lips, complete the next component of a ctivity ctivity - Repeat the above steps involving inhalation/ exhalation exhal ation until a ctivity ctivity is completed without shortness of breath. (This technique provides provides performance performance of activity on exhalation phase and rest on inhalation phase)
A patient visits visits for the first time time The patient has Cardiopulmonary Rehabilitation Unit at a local Chronic hospital for h is first a ppoiment. ppoiment. Before Before the obstructive examination examination as the PT walks towards waiting disease area, the patient is observed assuming the professorial position (leaning forward on knees or some object) and is demonstrating increas ed effort with breathing and increas ed used of accessory muscles. What can be concluded in this situation?
72.
Patient has developed respiratory acidosis, and GET should be terminated
105. Perform
treatment treatment in in the horizontal plane to accomodate for present condition
100. Pleural
effusion
A patient is being being a dminis dminis tered tered a Graded Graded Exercise Test in order to to find his functional exercise capacity. if a PT confirms that the patient's PaCO ₂has risen to > 10mmHg or is in fact > 65mm 65mmHg, Hg, w hat can be concluded in this situation? A PT who w orks in acute care at a local loca l hospital is given a patient with increased pulmonary secretions/Aspiration/Atelectasis or collapse. According the patient's chart the Right middle lobe is the site of treatment. The PT is thinking of using the trendelenburg position to perform his treatment treatment.. If the patient is know to have any of the conditions below, what will be the next thing to do? - Circulatory system : Pulmonary edema, CHF, Hypertension Hypertension - Abdominal problems: problems: Obesity, ascites,pregnancy, ascites,pregnancy, hia tal h ernia,nausea ernia,nausea and vomiting, recent food consumption consumption - Neur N eurologicl ologicl system: Recent neurosurgery, neurosurgery, increased intracranial pressure, aneurysm precautions - Pulmonary s ystem: ystem: Shortness of breath Description: Excessi ve fluid between between the visceral and parietal pleura. pleura. The main cuases of this condition are increased pleura permeability to proteins from inflammatory diseases such as : pneumonia, pneumonia, rheumatoid rheumatoid arthritis, systemic lupus, neoplastic disease, increased hydrostatic pressure pressure within pleural pleural s pace (CHF), decreased decreased in osmotic pressure (hypoproteinemia), (hypoproteinemia), pertoneal fluid withi n the pleural space (ascites, cirrhosis) or interference of pleural re-absorption from tumor tumor invading pleural pleural lymphatics lymphatics
94.
Pneumothorax
Description: A condition where air is in the pleural space, usually through a lacerated visceral pleura pleura from a rib fracture fracture or rupt rupture ure bullae
93.
Possible Ecchymosis (bruising)
One reason for which a PT may not perform chest compressive manuevers and coughing in a patient with low platelet count is:
92.
Possible fractures from thoracic bone metastasis
One reason for which a PT may not perform chest compressive manuevers and coughing in a patient with pneumonia of carcinogenic origin origin is :
165.
Posterior basal segments
160. Posterior
104. Postural
segments
What Wha t lung segment is being drained here? here? - Patient in trendelenburg and lying on abdomen, with pillow under hips. - Therapist claps over lower ribs close to spine on each side What Wha t lung segment is being drained here? here? - Patient is sitting leaning forward with forearm resting resting again st a pillow at 30° angle - Therapist stands behind and claps over upper back on both si des
drainage
A PT who w orks in acute care at a local hospital is given a patient with increased pulmonary secretions and/or aspiration or atelectasis or collapse. What physical therapy intervention intervention wil l be appropriate appropriate for any of these indications?
a shower seat, hand held shower, and use of terry cloth robe after showering, so the patient does not have to stand, hold his/her breath as often, often, or dry off in the humid environment, environment, thus reduci ng the energy energy cost of a ctivity
What Wha t will be an appropriate appropriate as sistive sis tive device(s) device(s) for energy conservation for a pulmonary pulmonary patient wh o finds showering very difficulty due to the activity itself and the humid environment environment that tha t accompanies this task?
98.
Pulmonary edema edema
Description: Excessive seepage of fluid from the pulmonary pulmonary vascula r system into the interstitial interstitial space. May be of cardiogenic or non ca rdiogenic rdiogenic origin
99.
Pulmonary emboli emboli
Description: A thrombus thrombus from the peripheral venous circulation becomes becomes embolic and lodges in the pulmonary pulmonary circulation. A small emboli does not necessarily cause infarction
141. Provide Pr ovide
133. Pursed
lip breathing
132. Pursed
lip breathing
134. Pursed
lip breathing
7.
Residual Resid ual volume
It is primarily for patients wi th OBSTRUCTIVE OBSTRUCTIVE disease w ho experience dyspnea at rest or with minimal activity/exercise activity/exercise or wh o use an ineffective breathing pattern during activity/exercise This breathing breathing exercise is used to red reduce uce the respiratory rate, rate, i ncrease tidal volume, volume, reduce reduce dyspnea, dyspnea, decrease decrease mechanical disadvantage of an impaired ventilatory pump, pump, improve improve gas mixing a t rest for patient with COPD, and facilitate relaxation Wha t breathing breathing exercise is being used here? - Slowly inhale through nose or mouth - Passively exhale (position the mouth as if you were blowing out candles) - Additional hand han d pressure pressure from the therapist applied to abdomen abdomen ca n be used to gently prolong expiration - Abdominal muscle contraction can be used judiciously to increase exhale volume. volume. Care must must be be taken NOT to increase intra thoracic pressure which might produce produce airwa y collapse. Defined as: volume of gas that remains in the lungs after ERV (maximal exhalation) has been exhale
19.
Respiration
Defined as: The diffusion of gas across the alveolar capill ary membrane membrane
83.
Respiratory Distress Syndrome
Formerly known as hyaline membrane disease. Alveolar colla pse in premature premature infan t resulting resulting from lung inmaturity, inmaturity, inadequate level level of o f pulmonary surfactant
86.
Respiratory Distress Syndrome
If a Chest X-ray does confirm the presence presence of the cla ssic ssi c granular gran ular pattern pattern ("ground glas s") caused ca used by distended distended terminal airways and alveolar collapse. Wha t condition condition is thi s finding a ssociated ssoci ated with?
3.
Resting position positi on of the diaphragm is lower in the thorax decreasing the inspiratory reserve volume
Special population such as patients with spinal cord injury lack functional abdominal musculature. What characteristic this population exhibit in terms terms of resting position of the diaphragm a nd ins piratory reserv reservee volume? volume?
162. Right
middle
lobe
63.
Secondary hyperventilation (Kussmaul breathing), nausea, lethargy, and coma
123. Segmental
breathing
124. Segmental
breathing
127. Segmental
breathing
125. Segmental
breathing
119. Semi-Fowler's
position 170. Semi-fowler's
position in bed or sitting si tting over over the side of the bed or or chair
What Wha t lung segment is being being drained here? - Patient in trendelenbu trendelenburg rg postion w ith head down on left side and rotates rotates 1/4 1 /4 turn backward. Pillow may be placed from behind from shoulder to hip. Knees should be flexed - Therapist claps over righ rightt nipple area. Signs & Symptom Symptomss of metabolic aci dosis are?
This breating exercise is used to: - Improve ventilation of hypoventilated lung segments - Alter regional distribution of gas - Maintain Main tain or restore residual residual ca pacity - Maintain Main tain or improve mobility of chest wall wal l and prevent prevent pulmonary pulmonary compromise compromise This breathing exercise is used with patients who have pleuritic, incisional or posttrauma pain that is causing a decreased movement in a portion of the thorax or a re at risk for developing atelectasis What Wha t breathing breathing exercis e is being used here? - Position patient to facilitate inhalation to a certain segment, such as postural drainage postions, Upright sitting - Apply gentle pressure to the thorax over the area of h ypoventilation ypoventilation during EXHALATION - Increase to firm pressure just prior to inspiration - Ask patient to breathe in against resistance of the therapist's hand - Release resistance resistance allowing a full inhalation A pulmonary pulmonary patient at a local h ospital is at risk for developing developing a telectasi telectasiss or collapse. What breathing exercise is most appropriate to address this condition? What Wha t position position sh ould be be used used when performing performing diaphrag matic breathing breathing ? Which positions are most commonly commonly found in patients with cardiopulmonary cardiopulmonary dysfunction?
50.
29.
Severe Severe airway ai rway Wheezes is no rmally heard during during obstruction expiration, but which condition is wheezes may also be heard heard during inspiration? Shunt
in trendelenburg
Defined as: no respiration occurs because of a ventilation abnormality. Complete atelectasis of a respiratory unit allows the blood to to travel travel through the pulmonary pulmonary capillary without gas diffusion occuring.
153. Sidely Sid elying ing
Drains Anterior Basal Segments (R or L)
148. Sitting
Drains the Anterior R or L apical segments (upper lobes
upright in bed or chair 116. Sterile
gloves/clean gloves 31.
steroids
112. Suction
Catheter
167. Superior
segments
178. Supine
position
191. Supplemental
Oxygen 145. Supplemental
Oxygen is indicated 17.
Supplemental oxygen is needed
131. Sustained
maximal inspiration 128. Sustained
maximal inspiration
Medications wi thin pulmonary population population that usually mask vital signs are: After performing performing ass isted cough cough on a spinal cord injury patient, patient, the PT n otices that expectoration expectoration for this patient is problematic (has difficulty clearing secretions), what equipment should be used to help this patient? What Wha t lung position is being drained here? - Patient lying on abdomen with pillows under hips (which position hips approximately approximately 45° ang le) - Therapist cla ps over middle middle of back a t tip of scapula on either side of spine Normal abdominal tone holds the abdominal contents directly under under the diaphragm, assisting the return of the diaphragm to the normal high domed position. When a patient lacks functional abdomina musculature such as SCI patient, patient, the diaphragm is lower in thorax dcreasing inspiratory reserve reserve (IRV). The more uprigh uprightt body posiiton the lower the diaphrag diaphrag m and the lower the inspiratory capacity. what position is most advantageous for the diaphragm?
What Wha t breathing breathing exercis e is being used here? here? maximal - Inspire slow ly through nos e or pursed pursed lips to inspiration maximal inspiration - Hold maximal inspiration for 3 seconds - Passively exhale the volume
fremitus
176. Tactile
fremitus 184. Terminate
GET
189. Terminate
GET
188. Terminate
GET
185. Terminate
GET
If a patient either O2sat < 88% or Pa O2 < 55 mmHg, what is the next thing to do? Regardless of activity, if Oxygen saturation levels decrease to less than 88% or PaO ₂is less than 55mmHg, then: A recently recently diagnos ed pulmonary pulmonary patient patient has a documented PaO ₂< 55 mmHg. mmHg. W hat can be concluded concluded about about this this patient before before therapy session is initiated?
This breathing exercises is used to increased inha led volume, volume, sustain or i mprove mprove alveolar inflation, maintain or restore functional residual capacity
129. Sustained
177. Tactile
What Wha t kind of medical medical asepsis s hould be used when performing performing endotracheal suctioning?
It is used in acute situations for patients with post trauma trauma pain, pai n, post operative operative pain, acute lobar collapse
183. Terminate
GET
wha t is being performe performed d on the the followi ng procedure? - place the palms of your hands lightly on the chest wall ande ask the patient to speak a few words or say 99 several several times times Defined as the vibration felt while palpating over the chest wall as a patient speaks Keeping Keeping in mind normal a dult dult levels of PaCO2, a therapist is getting ready to assist in performing a G.E.T. Baseline of PaCO2 = 40mmHg. 40mmHg. During the test, the PaCO2 = 52mmHg. What is the next thing to do based on guide g uidelines lines of termination termination criteria criteria for G.E.T? Keeping Keeping in mind normal a dult dult levels of BP a therapist is getting ready to assist in performing performing a G.E.T. Baseline of BP 1 22/84 mmHg. During the test, test, the BP = 108/8 4 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T? Keeping Keeping in mind normal a dult dult levels of BP a therapist is getting ready to assist in performing performing a G.E.T. Baseline of BP 1 22/84 mmHg. During the test, the BP = 254/82 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T? Keeping Keeping in mind normal a dult dult levels of BP a therapist is getting ready to assist in performing performing a G.E.T. Baseline of BP 1 22/84 mmHg. During the test, test, the BP = 140/106mmHg. What is the next thing to do based on guidelines of termination termination criteria criteria for G.E.T? A therapists is getting ready to assis t in performing a Graded Exercise Test (GET). Keeping Keeping in mind normal a dult dult levels of PaO2. Baseline Pa O2 = 90mmHg for this patient. During the test, the Pa O2 is measured to be 54 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?
182. Terminate
GET
A therapists is getting ready to to assist ass ist in performing a Graded Exercise Test (GET). Keeping Keeping in mind normal a dult levels of PaO2. Baseline Pa O2 = 90mmHg 90mmHg for this patient. During the test, the Pa O2 is measured measured to be 68 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?
66.
Terminate A patient is in the cardiopulmonary cardiopulmonary lab at a local GET hospital. A Graded Exercise Exercise Test (GET) is being administered in order order to find his functional exercise capacity. During the test, test, the PT notices that PaO ₂has decreased decreased to < 55mmHg. The most appropriate appropriate course of action to take is:
67.
Terminate A patient is in the cardiopulmonary cardiopulmonary lab at a local GET hospital. A Graded Exercise Exercise Test (GET) is being administered in order order to find his functional exercise capacity. During the test, test, the patient is showing signs of exercise discomfort. The Pt suspects that the patient's PaCO ₂has either either increased to > 10mmHg or is in fac t > 65mmHg. 65mmHg. If the PT does con firm that either of the two condtions is true, what is the next thing to do?
69.
70.
71.
65.
Terminate A patient is in the cardiopulmonary cardiopulmonary lab at a local GET hospital. A Graded Exercise Exercise Test (GET) is being administered in order order to find his functional exercise capacity. During the test, test, the PT notices that the patient developed symptoms of fatigue. The most appropriate appropriate course of action to take is: Terminate A patient is in the cardiopulmonary cardiopulmonary lab at a local GET hospital. A Graded Exercise Exercise Test (GET) is being administered in order order to find his functional exercise capacity. During the test, test, the PT ch ecks for Blood pressure. If the patient SBP is either > 250mmHg, or DBP increas es to > 20mmHg 20mmHg from baseline or BP decreases with increasing workloa d. What sh ould the the PT do if any of these these conditions is confirmed to be true? true? Terminate GET
If a patient wh ile performing performing a Graded Graded Exercise Test shows a ny of these conditions, conditions, wha t should the PT do? - Leg pain, TOTAL fatigue, fatigue, sings of insufficient insufficient cardiac output - Reaching a ventilatory maximum
Terminate A patient is in the cardiopulmonary cardiopulmonary lab at a local GET hospital. A Graded Exercise Exercise Test (GET) is being administered in order order to find his functional exercise capacity. During the test, test, the PT notices that PaO ₂has increased to > 20 mmHg. The most appropriate appropriate course of action to take i s:
68.
Terminate GET
A patient is in the cardiopulmonary cardiopulmonary lab at a local hospital. A Graded Exercise Exercise Test (GET) is being administered in order to find his functional exercise ca pacity. During the test, the PT notices that the ECG readings shows Cardiac Ischemia and/or arrhythmias. The most appropriate appropriate course of action to take i s:
64.
Terminate GET
A patient is in the cardiopulmonary cardiopulmonary lab at a local hospital. A Graded Exercise Exercise Test (GET) is being administered in order to find his functional exercise ca pacity. During the test, the PT notices that the patient is showing signs of Maximal Shortness Shortness of Breath. Breath. What is the most appropriate appropriate course of action to take?
143. Thrust
Two pulmonary pulmonary patients have been prescribed two different medications medications to treat treat their a irway reactivity reactivity and decreased mucosal edema. edema. O ne of them is taking Vanceril (beclomethasone, MDI) and an d the other Azmacort (triamcinolone, (triamcinolone, MDI) What is the main side effect of inhaled steroids?
4.
Tidal Tida l volume volume
Defined as: volume of gas inhaled (or exhale) during during a normal no rmal resting breath
12.
Total lung capacity
Defined as: ( IRV + TV + ERV + RV). The amount of air that is contained within the thorax during a maximum max imum inspiratory effort. effort.
113. Tracheal
Stimulation
114. Tracheal
Stimulation
90.
This airway clearance technique is used with patients who are unable to cough on command, such as infants, and patients following brain injury or stroke Wha t airway clearance technique is being used here? - The therapist's fin ger or thumb is pla ced just above the suprasternal suprasternal notch and quick inward and downward pressure on the trachea elicits the cough reflex
Unexplained Bronchogenic Carcinoma referes to a tumor weight loss, which whi ch aris es from the the brochial mucusa. and Smoking and occupational exposures are the Hemoptysis most frequent frequent causal a gents. A pertienent pertienent finding during examination of this condition in addition to dyspnea, weakness, fatigue, wheezing, wheezin g, atelect a telectasi asiss or bacterial bacterial pneumonia will include:
106. Upright
sitting position
The best position for airway clearance technique techniquess s uch as coughing is:
61.
Vague symptoms: weakness, weakness, mental dullness, dullness, possibly early tetany
Signs & Symptoms of metabolic alkalosis are?
73.
Viral Pneumonia
A condition where interstitial interstitial or intra-al veolar inflammatory process caused by by viral viral ag ents (influenza, adenovirus, cytomegalovirus, herpes, parainfluenza, respiratory syncytial virus, measles)
76.
viral pneumonia pneumonia or pneumocystis pneumonia
If a chest X-ray confirms the presence of interstitial infiltrate, What conditions is this finding associated with?
10.
Vital Capaci ty
Defined as: The a mount of air that is under volitional control conventional ly measured as forced expiratory vital vital ca pacity (IRV + TV + ERV)
49.
Wheezes
A musical pitched sound, sound, usually heard during during expiration caused by airway obstruction obstruction (asthma, chronic obstructive obstructive pulmonary pulmonary disease, foreign body aspiration).
75.
Wheezes Wheezes and crackles crackles with decreased breath sounds
In addition to common signs & symptoms such as fever, chills, dry cough, headaches, hypoxemia and hypercapnea, tachypnea, cyanosi s etc. A pertinent finding that may not be found in viral pneumonia pneumonia but found in aspiration pneumonia is :
2.
When more rapi d or or deeper deeper inhalation is required or in disease states
When is a ccessory muscles muscles of ins piration most likely to to be used? used?
174. Whispered
53.
pectoriloquy
Whispered Whis pered pectoriloquy pectoriloquy
Which technique is being demonstrated demonstrated here? here? - Patient is asked to whisper a word. whisper "99", and the whispered words are clearly and distinctly heard through the s tethosc tethoscope. ope. Occurs when whispered sounds are heard clearly during ausculation
