Med Con - Procedural Interventions

Question 1

Aerobic Exercise

(Describe, 2x Calculations for Intensity)

Answer 1

Sub maximal, rhythmic repetitive exercise of large muscle groups; use of overload and specificity to improve VO2max

HRmax = 220-Age
HRmax X % = Target Heart Rate

Karvonen Formula
Target HR = [(HRmax - HRrest) x %] + HRrest

Question 2

Airway Clearance Techniques

(Description)

Answer 2

To manage or prevent the consequences of impaired mucociliary transport or the inability to protect the airway

Question 3

Active Cycle of Breathing

(Description, Procedure)

Answer 3

Assist secretion clearance

1. Breathing Control - gentle relaxed breathing for 5-10+ seconds
2. Thoracic Expansion - 3-4 deep, slow, relaxed inhalations to Inspiratory Reserve Volume with passive exhalation (can include chest percussion, vibration or shaking)
3. Forced Expiratory Technique - 1-2 huffs at mid-low lung volumes with glottis open into Expiratory Reserve Volume, adduction of the arm may be added to self-compress

Question 4

Autogenic Drainage (AD)

(Description, Procedure)

Answer 4

Mobilize secretions

1. Unsticking phase: slow breaths through nose at low-lung volumes w/ 2-3 second holds (get air behind secretions), exhale to expiratory reserve volume
2. Collecting phase: breathe at tidal volume, interspersed with 2-3 second holds
3. Evacuating phase: deeper inspirations from low-to-mid inspiratory reserve volume, hold breath, huff cough or pursed lip breath

Question 5

Huff Cough

(Describe, Procedure)

Answer 5

Forced expiratory maneuver performed with the glottis open
Similar to fogging glass
Less potential for airway collapse

1. Inhale deeply
2. Contract abdominal muscles during rapid exhalation with glottis open saying “ha, ha, ha”

Question 6

High-Frequency Airway Oscillation

(Description)

Answer 6

Hand-held devices that combine positive expiratory pressure and high-frequency airway vibrations to mobilize mucus secretions

Question 7

Postural Drainage/Percussion/Vibration

(Description)

Answer 7

Positioning the patient so that gravity will help drain bronchial secretions from specific lung segments toward the central airways, assisted by rhythmic cupping/vibration, where they can be removed by cough or mechanical aspiration. Last several minutes and should not be painful.

Question 8

Abnormal Sputum: White or Gray

Answer 8

aka Mucoid

COPD, Asthma

Question 9

Abnormal Sputum: Yellow or Green

Answer 9

Aka Purulent

Bacterial infection, lung abscess, bronchiectasis, chronic bronchitis, cystic fibrosis

Question 10

Abnormal Sputum: Brown or Black

Answer 10

Smoking, black lung disease

Question 11

Abnormal Sputum: Pink or Bloody

Answer 11

Pulmonary edema, lung cancer, pulmonary embolism, brochiectasis, cystic fibrosis, tuberculosis

Question 12

Abnormal Sputum: Rust

Answer 12

Pneumococcal pneumonia

Question 13

Abnormal Sputum: Fetid Odor

Answer 13

Bacterial infection, lung abscess, bronchiectasis

Question 14

Abnormal Sputum: Thick/Tenacious Consistency

Answer 14

Asthma, Cystic fibrosis

Question 15

Abnormal Sputum: Frothy/Foamy

Answer 15

Pulmonary Edema

Question 16

Abnormal Sputum: Increased Volume

Answer 16

Chronic bronchitis, bronchiectasis, pulmonary edema, pneumonia, TB, smoking, exposure to pollution

Question 17

Diaphragmatic Breathing

Answer 17

Predominantly use the diaphragm while minimizing action of accessory muscles and motion of the upper rib cage during inspiration

Question 18

Inspiratory Muscle Training (IMT)

(Description, 2 Types)

Answer 18

Strengthening diaphragm and intercostal muscles

Flow Resistive Breathing: adjustable diameter to alter resistance, while maintaining constant RR, TV & inspiratory time

Threshold Breathing: requires a buildup of negative pressure before flow can occur through a valve set at a critical pressure, consistent and specific pressure for IMT regardless of speed of breathing

Question 19

Pursed Lip Breathing

Answer 19

In slowly through nose for two counts, pucker/purse lips as if going to whistle, exhale through pursed lips for 4 counts

Question 20

Segmental Breathing

Answer 20

Improve regional ventilation and prevent and treat pulmonary complications post-op

Direct inspired air into a particular area by facilitation or inhibition of chest wall movement through hand placement, verbal cues or coordination of breathing

Question 21

Incentive Spirometer - Sustained Maximal Inspiration

Answer 21

Maximal inspiratory effort held for 3+ seconds

Question 22

METs for 4 different paces of walking

Answer 22

2 = slowly at home/office
3-4 = 3mph
4.5-7 = 4mph
6.3 = 4.5mph

Question 23

METs for jogging and running

Answer 23

8 = Jogging 5mph
11.5 = Running 7mph

Question 24

Examples of 1-2 METs

Answer 24

• toileting
• driving a car
• working at computer or desk
• playing cards, arts and crafts

Question 25

Examples of 2-3 METs

Answer 25

- making bed, washing dishes - bathing - cooking - playing musical instrument - fishing (sitting)

Question 26

Example of 3-4 METs

Answer 26

- washing window/car - sweeping, vacuuming - light gardening - slow dancing - table tennis

Question 27

Examples of 4-5 METs

Answer 27

- fast dancing - basketball shooting around - sex - golf (walking) - swimming

Question 28

Example of 5-6 METs

Answer 28

- carrying/stacking wood - power lawn mowing - tennis doubles

Question 29

METs for Bicycling (3 speeds)

Answer 29

6 = 10-12mph 8 = 12-14mph 10 = 14-16mph

Question 30

METs for shoveling, farm work, backpacking, basketball

Answer 30

shoveling: 7 farm work: 8 backpacking: 5-11 basketball: 8