Cardiopulmonary & Musculoskeletal PT Notes

• These study notes cover a range of topics related to cardiopulmonary and musculoskeletal physical therapy, including patient assessment, exercise prescription, and treatment interventions.

Pulmonary Conditions

• Air trapping due to obstructive pathology is the most likely cause of a decreased FEV1/FVC ratio in spirometry.
• Shortness of breath and lightheadedness after minimal exertion can be due to cardiovascular causes, indicated by cyanosis, hypotension, and dizziness.
• Decreased lung compliance is the primary cause of increased work of breathing in patients with interstitial lung disease.
• Decreased lung compliance is cause of increased work of breathing in interstitial lung disease.
• Call the doctor to report the symptoms and request an evaluation of the patient; after transferring supine to sit, the patient reported a sensation of clicking in the sternum with a sudden onset of pain
• Residual volume cannot be measured directly using spirometry.

Cardiovascular Conditions & Exercise

• For patients with CHF NYHA Class II-III, resistance training should be 1-2 days per week, 4-10 reps, 12-15 mins duration, with an intensity of 50%-70% 1RM.
• A laterally displaced point of maximal impulse (PMI) suggests left ventricular enlargement.
• For CHF, Sodium intake should be restricted.
• Stop exercise immediately and monitor vitals when a patient demonstrates an increased heart rate and a decrease in blood pressure during aerobic exercise.
• After myocardial infarction (MI), beta-adrenergic blocking agents minimize HR rise with exercise.
• Decreased lung compliance causes increased work of breathing in individuals with interstitial lung disease
• MET level of 7 indicates the patient can do all household chores.
• Heart rate and rate of perceived exertion should be related to predict maximum oxygen uptake in submaximal exercise tests.
• Rate of perceived exertion is an appropriate self-monitoring method for cardiovascular health improvement.
• Patients recently completing Phase II cardiac rehabilitation will most likely demonstrate a decrease in cardiac output in maximal work.
• During Phase I cardiac rehabilitation, a systolic blood pressure decrease of 25 mmHg from resting level exceeds typical limits.
• Postpone ambulation and report the findings immediately; A physical therapist makes a decision regarding his patients calf tenderness with slight swelling and warmth.

Musculoskeletal & Neurological Conditions

• Decreased anterolateral chest expansion resulting from paralysis of external intercostals is the most likely cause of reduced vital capacity in quadriplegia patients at C5-C6 level.
• Document and verbally report the observations to the patient's nurse who has an extremely dark and has a distinctive foul smelling odor
• Statin drugs may induce muscle pain, which should be reported to the treating physician.
• Edema and diminished pedal pulse are expected with venous insufficiencies; look for darkened skin pigment

Patient Care & Communication

• Patients requiring pre-operative instructions should be given the highest priority.
• Place the palm of the hand lightly on the pulse site Post-exercise is correct
• Assess communication ability, affect, cognition, and learning style during the systems review of a physical therapist's examination.
• Document the incident in the medical record if a patient refuses physical therapy services

Ethical & Legal Considerations

• Request the attorney provide a completed release of patient medical information form before discussing patient information.
• Reschedule the exercise test since the patient signs the informed consent; however the patient's parent dropped him off at a clinic and are now unavailable to sign the form.

Other

• Stop exercise and allow patient to recover: respiratory rate increases to 30 breath per minute with accessory muscle use.
• The intrapleural pressure varies from negative to positive during normal unforced breathing.
• Contact a member of the patient's family to take the patient home If a physical therapist suspects a patient is intoxicated after arriving for his treatment session.
• Orthostatic hypotension poses a risk to the patients
• Assist the patient to a sitting position immediately If a patient ambulating in the physical therapy gym suddenly grabs his therapist's arm and indicates that he feels like fainting
• 1. 2-1.6 is Metabolic equivalent of sitting at ease.
• 60% is the the typical ventricular ejection fraction has what value.
• A patient status post cardiac problem has a MET level of 7. The patient can walk briskly for 5 rounds around the playground
• Atelectasis
• Observation of proximal red streaks and palpation of inguinal nodes include the following of lymphatic system test or measure should also be performed the client walks into a private clinic with a chief complaint of a possible ankle sprain.
• Call the doctor to report the symptoms and request evaluation of the patient; after transferring supine to sit, the patient reported a sensation of clicking in the sternum with a sudden onset of pain.
• Document the incident in the medical record
• Rate of perceived exertion measure is the MOST appropriate for the individual to utilize when exercising with declining health due to unhealthy lifestyle choices.