which conditions lead to muscle weakness
-COPD
-Kyphoscoliosis
-obsesity
test to assess respiratory muscle strength
- MIP(NIF)
2.MVV
3.VC
what are the most commonly used test for assessing muscle weakness at bedside
-MIP (NIF)-forced generated by inspiratory muscle (Normal:-50- -100, critical >-20)
-FVC- amount of air pt can exhaled forcefully after taking a deep breath
-MVV- muscle endurance
define RSBI
-Rapid shallow breathing Index
1. indicator of how a pt is compensating when respiratory muscle strength limited
- when muscular strength is limited, pt struggle to meet minute vent, meet requirements by increasing frequency (f) while decreasing Vt
3, continuously increasing frequency >30 is a sign of ventilatory muscle decompensation.
when evaluating if a pt can be weaned of mechanical ventilation what is the key indicator
RSBI
-(f/Vt ratio): frequency(RR)/tidal volume
- indicated whether mechanically vent pt can breath without mechanical assistance
other parameters: rr,vt,hr,BP,NIF, VC
what RSBI amount is considered successful for extubation
f/Vt ratio < 105 breaths/min per L with the first minute of weaning trial
define VC (vital capacity)
- performed at bedside w/spirometer connect to pt airway
2.effort depedent, accurate measurement can be obtained only if the pt is awake,conscious and cooperative
- 3 measurements should be obtained
- healthy individuals generate 1.0-1.5L if less indicated muscle weakness
define MIP/NIF
- provides information based on maximum output of the inspiratory muscle
2.important for pt with Myasthenia gravis and guillain barre syndrome
- -50- -100 normal,
>-20 impending respiratory failure
define what MVV
- measure used to assess respiratory muscle reserve endurance or fatigue
- determine ability of pt to sustain ventilation over time
- performed w/spirometer take deep fast breaths for 10-15 seconds
define cultural diversity
patterns of beliefs and behaviors shared by members of population
define health literacy
-degree to which an individual have to the capacity to obtain,process and understand basic health information and services needed to make appropriate health decisions
RT role in pt education
- provide info about disease processes, meds and treatment procedures
2.RT teach pt how to perform diagnostic test , educate pt about health promotions issues such as tobacco cessation
- education include the use of inhalers,oxygen concentrators, O2 tanks, ventilatory and cpap machines
4.educate all ages, and their families
- provide education programs to pt with: COPD, Asthma, cystic fibrosis
- use brochures,magazines, literature to educate pt
- tailor approach to align with cultural values
what are the 3 learning domains
- cognitive domain
-knowlegde needed to succeed (descrining concepts and understaning) - psychomotor domain
-physical skills needed to be successful (demonstrations) - affective domain
-attitude needed to succeed (importance)
goal of pulmonary rehabilitation
- Maximize functional ability and minimize the impact of the disability on the pt and family
2.Other goals:
Control symptoms, alleviate symptoms, restore functional capabilities and improve the overall quality of life
teaching adults
- internally motivated
- self directed
3.question teacher - have rich experiences
- learn for the present
- learn more slowly
- problem oriented
teaching children
- externally motivated
2.directed by others - trust teacher
4.limited experiences - learn for the future
- learn quickly
7.subjected oriented
health education primary goal
behavior change
4 broad goals of healthy people 2020
1.promote quality of life, healthy development and healthy behaviors across all life
- achieve healthy equality, eliminate disparities and improve the health of all groups
- attain high quality longer lives free of prventable disease, disability, injury, and premature death
- creat social and physical environements to promote good health
top 3 causes of death in US
- heart disease
2.cancer - COPD
disease management goals
- improve the health of the person
- improve pt satisfaction
- reduce mortality
4.improve quality of life
5.eliminate unnecessary medical treatment
rt role in health and disease prevention
1.asthma education- teach how to manage conditions, avoid triggers and use meds correctly
2.smoking cessation education, provide resources, support and counseling to quit smoking
