Take My Breath Away
A patient with pneumonia is unable to clear secretions effectively.
What is the PRIMARY goal of pulmonary toilet?
Improve gas exchange and airway patency.
A patient following myocardial infarction is taking Metoprolol (Beta-Blocker).
What is the MOST important consideration during exercise?
Use RPE because HR response may be blunted
A patient taking Atorvastatin (Statin) reports new onset muscle soreness and weakness.
What should the physical therapist suspect?
Myopathy
A mechanically ventilated patient has FiO₂ 40% and PEEP 8 cmH₂O.
What is the MOST appropriate action? Mobilize, Stop, or Dischare.
Consider progressive mobilization if medically stable
You are treating a patient in Cardiac Phase I rehabilitation. To ensure safe exercise intensity, the patient's heart rate should not increase more than how many beats per minute above their resting heart rate?
20 BPM over resting HR
During ambulation, a patient's SpO₂ decreases from 94% to 86%.
What is the BEST therapist response?
A patient is two weeks post CABG. The patient is walking in the hallway, performing ankle pumps and deep breathing exercises in bed, and lifts his 15 lb grocery bag of candy to his bedside table.
Which activity violates sternal precautions?
Lifting a 15-pound grocery bag
A patient taking Pseudoephedrine (α1-Adrenergic Agonist Decongestant).
These medications will (increase or decrease) HR and BP?
increase!
A patient has a platelet count of 15,000/µL.
What is the BEST action?
Avoid mobilization and consult the team
A patient with COPD is prescribed Albuterol (Short-Acting β2-Adrenergic Agonist).
When should therapy ideally occur?
Shortly after medication administration
A 67-year-old patient with COPD reports severe dyspnea when walking short distances. Testing reveals a maximal inspiratory pressure (PImax) of 45 mmHg.
Which intervention would be MOST appropriate?
Continuous IMT beginning at 10% PImax.
A patient is beginning Phase II Cardiac Rehabilitation.
What setting and supervision level is this patient in?
Monitored outpatient exercise sessions
A patient with severe asthma is taking Prednisone (Glucocorticoid Corticosteroid).
Which finding should concern the therapist?
Hyperglycemia and muscle weakness
A ventilated patient suddenly deteriorates. The therapist remembers the "DOPE" assessment.
What does the "D" represent?
Dislodged Tube
A patient requires precise oxygen delivery because of severe COPD.
Which oxygen delivery device is MOST appropriate?
Venturi mask
A patient following abdominal surgery avoids coughing because of pain.
Which intervention would BEST improve secretion clearance?
Splint the incision and perform assisted coughing
A patient with heart failure is taking Sacubitril/Valsartan (ARNI – Angiotensin Receptor-Neprilysin Inhibitor).
What is its primary purpose?
Reduce cardiac workload and improve heart failure outcomes
A patient with heart failure takes Digoxin (Cardiac Glycoside Positive Inotrope).
What are 3 main indications of toxicity?
fatigue, arrhythmias, vision disturbances
You are asked to mobilize an ICU patient who has been on bed rest.
What should you do before getting the patient out of bed due to the risk of stasis blood forming a blood clot?
Bed Mobility
A patient attempting smoking cessation reports severe cravings and asks about a medication that partially stimulates nicotine receptors while blocking nicotine from cigarettes.
Which medication and/or class are being described?
Varenicline (Nicotine Receptor Partial Agonist)
A patient with cystic fibrosis has difficulty mobilizing thick secretions from smaller airways.
Which technique is specifically designed to move mucus from smaller airways toward larger airways through controlled breathing?
Autogenic drainage.
A patient underwent PTCA with placement of a drug-eluting stent.
What is the primary purpose of the procedure?
Compress plaque and restore coronary blood flow
A patient with COPD is prescribed Tiotropium (Anticholinergic Bronchodilator).
Which side effect is MOST expected?
Dry Mouth
You are mobilizing a patient following a splenectomy. During therapy, you observe poorly healing wounds, and the patient reports a headache and nausea.
What serious complication should the physical therapist suspect, and what is the appropriate action?
Sepsis/ infection following splenectomy; Stop/Modify/Refer
A patient with stable angina takes Nitroglycerin (Organic Nitrate) immediately before walking.
What should the therapist monitor most closely?
Hypotension and dizziness