Cardiopulmonary Interventions Post Test

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post test

You have assessed that your patient has poor airway clearance and an intervention is needed to prevent pneumonia. The BEST intervention would be: *

1 point

bronchoscopy

mobility

Coughing and deep breathing exercises

the A cappella airway clearance device

Your patient has just had abdominal aortic aneurysm surgery with an incision (not a minimally invasive surgery). The patient has a history of COPD and frequent bouts of pneumonia and has not been moving out of bed since surgery. On auscultation you hear rhonchi and patient demonstrates a poor cough. What would be the optimal interventions for this patient? *

1 point

Prone positioning, pursed lip breathing and abdominal support

Incentive spirometry, coughing/huffing instruction with splinting and practice, mobility

Attempt mobilization of secretions with pursed lip breathing and coughing, and if not successful use prone positioning

The vest airway clearance and pursed lip breathing exercises

A 40-year-old traumatic brain injury patient with significant neurological impairments, who is ambulatory for short distances with a walker, was admitted into your facility. He is partially dependent with dressing, feeding, and bathing. His caretaker states he developed a productive cough of yellow-green secretions, had a fever, and was sleeping more than usual. He was diagnosed with right lower lobe aspiration pneumonia. Your P.T. role in treatment is: *

1 point

Ambulation with a walker 20 feet

Bed ROM and strengthening of his legs

Transfers bed to chair

Airway clearance, ambulation, and breathing exercises

68 year old male recently discharged from lengthy stay in hospital for an acute exacerbation for COPD and has difficulty with endurance activities, dyspnea with ADLS and difficulty standing up from a chair.The optimal intervention that would most benefit this patient’s inability to stand would be: *

1 point

incentive spirometry breathing exercises, cough instruction, theraband quad strengthening exercises

sit to stand exercises, pursed lip breathing exercises

UE free weight (2 lbs) exercises and pursed lip breathing exercises

Add supplemental oxygen to his activities

You are seeing a patient with a diagnosis of heart failure for the first time. During your assessment you note that the patient has a normal HR and BP response with upright, and walking short distances (20 feet) but when you attempted 100 feet your patient felt severe shortness of breath and lightheaded. HR was much higher but you did not take BP to know what happened. Based on your assessment, what would be your treatment plan? *

1 point

With training she should be able to do the 100 feet, so you will just keep trying to have her walk that 100 feet.

Instruct in pursed lip breathing exercises and emphasize the breathing exercises during walking the next time.

Work on sit to stands instead of walking at this time

Perform multiple bouts of walking approx 50-60 feet, rest and then walk again measuring dyspnea, HR, and BP

Your patient has recently been discharged from hospital with diagnosis of pneumonia and PMH of COPD. In reading the chart you identify that the patient had Right lower lobe pneumonia. On auscultation you hear rhonchi throughout Right lower lobe and patient has a moist cough, but not always productive. The optimal interventions should include: *

1 point

Instruction in incentive spirometry to be done 3-4 times per day/at least 3 attempts each time and mobility

Instruction in pursed lip breathing exercises at rest and with activity

Postural drainage by at least lying on Left side as much as possible instead of supine, followed by coughing (including cough instruction or huffing) while upright and incentive spirometry after coughing and mobility

Postural drainage by at least lying on right side as much as possible instead of supine, followed by cough instruction when upright and incentive spirometry and mobility

Your patient demonstrates a very weak and ineffective cough and has been in and out of the hospital with pneumonia. Patient has a history of chronic bronchitis. Your interventions would include all of the following EXCEPT *

1 point

Cough instruction with huffing

Abdominal strengthening by doing partial curl ups by leaning back in chair and coming forward to sit

Fit patient with an abdominal binder and perform abdominal strengthening

Instruct in UE ROM exercises with deep breathing while arms over head

An example of a patient who is post coronary bypass surgery NOT performing sternal precautions would be: *

1 point

Pushing off of bed or chair while keeping arms at sides

Lifting a 5 lb bag of groceries with one arm

Carrying a box with items in it close to abdomen/chest that weighs approximately 10 lbs.

Rolling like a log in bed instead of using one arm to pull onto bed rail to pull body over

Your patient has problems with BP dropping when sitting or standing. Which activity can assist the patient in maintaining the upright position? *

1 point

Ankle pumps

Deep inspirations

Coughing and deep breathing

UE exercises over the head or level with shoulder

Your patient is taking 20 mg prednisone daily and has been taking this medication for years. This medication is a steroid and can cause the following effect on an individual: *

1 point

Core muscle weakness; patient will not be able to come to sit without assistance

Core muscle weakness: patient will have difficulty performing sit to stand without use of arms to get up

Peripheral muscle weakness: patient will not be able to assume sitting without assistance

Peripheral muscle weakness: patient will have difficulty with quad strength

To work on sitting balance in individuals who have had a prolonged hospitalization one should have them *

1 point

sitting supported in a chair as long as possible throughout day

sitting unsupported over edge of bed with supervision or assistance as long as possible throughout the day

sitting upright in bed as long as possible throughout the day

Walk with a rolling walker to gain mobility and core muscle strength

True/False: Aerobic exercise training can improve diastolic dysfunction in individuals with heart failure preserved ejection fraction *

1 point

True

False

The exercise training study by DELAGARDELLE demonstrated that patients with heart failure would benefit the MOST from what type of interventions? *

1 point

Strength training alone to improve muscle size and endurance

Endurance training alone to improve aerobic capacity and cardiac muscle performance

Strength and Endurance training combined to improve aerobic capacity and cardiac muscle performance

Inspiratory muscle training to improve aerobic capacity

The ten year exercise training study in patients with chronic heart failure demonstrates the importance of continuing to exercise patients despite their c/o heart failure as: *

1 point

Hospital readmissions were less in the trained group vs nontrained group

Cardiac events were less in the nontrained group versus the trained group

Cardiac deaths were greater in the trained group versus the nontrained group

Quality of life was better in the trained group versus the nontrained group

Your patient with COPD has problems with SpO2 decreasing and c/o dyspnea with all activities. The first intervention you should try with patient to improve oxygenation and improve ventilation would be: *

1 point

Instruction in incentive spirometry to be done 3-4 times per day/at least 3 attempts each time

Use of a cappella device to help with airway clearance

Instruction in pursed lip breathing exercises at rest and with activity

Sit to stand repetitions 3-4 times per day

You are now finished with this webinar. Thank you! *

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