Cardiorespiratory Physiotherapy G

Summary

This transcript follows a physiotherapy student's interaction with a patient, Polly, admitted to the hospital with respiratory issues. Polly, who has a history of pneumonia and diabetes, experiences ongoing shortness of breath and coughing, often resulting in hospital visits. The physiotherapy student, Amy, assesses Polly’s condition through chest and lung evaluations, explains her condition of bronchitis, and demonstrates breathing exercises to help clear mucus from her lungs. The conversation also touches on Polly’s family life and work, and aims to help her regain her mobility and manage her symptoms effectively.

Takeaways

• 😀 The patient, Polly, has a history of shortness of breath and coughing, which has been ongoing for about a year and a half, with increased severity over the past 6 days.
• 😀 Polly was admitted to the hospital after presenting with respiratory issues, with elevated white blood cell count and CRP levels indicating an infection.
• 😀 Chest x-ray revealed shadowing in the lower right zones, likely due to a respiratory condition, but the film was well-exposed and not rotated.
• 😀 Polly has been on oxygen therapy at 4 liters per minute with an oxygen saturation level of 93%, indicating respiratory distress.
• 😀 Her arterial blood gas (ABG) results showed a low pH (7.3), high CO2 (55), and a Pao2 of 65, confirming the presence of respiratory acidosis.
• 😀 The patient has a history of diabetes, but she does not smoke, and her pneumonia admission occurred 10 years ago.
• 😀 Polly's breathing has been affected by coughing up yellow and greenish mucus, with pain in her lower ribs due to the coughing.
• 😀 Despite her illness, Polly tries to continue household tasks, but her shortness of breath limits her activities, including walking and exercising.
• 😀 Physiotherapy interventions were introduced to help Polly with lung secretions through breathing exercises like coughing and huffing, which can alleviate symptoms and improve lung function.
• 😀 The treatment plan included monitoring Polly's exercise tolerance with a short walk while checking her oxygen saturation levels to assess her functional ability.
• 😀 Polly's condition requires regular physiotherapy exercises to help clear mucus from her lungs and reduce hospital readmissions, although these exercises may not prevent infections completely.

Q & A

What is the patient's primary issue upon admission?

The patient, Mrs. Polly Carter, was admitted due to respiratory issues, experiencing shortness of breath and cough with greenish sputum. She has a history of pneumonia and diabetes.

What are the key findings in the patient's medical chart?

The patient's chart reveals a history of pneumonia 10 years ago and ongoing respiratory issues for the past year and a half. Her blood results show elevated white blood cell count and CRP, indicating an infection.

What were the results of the patient's blood tests?

The patient's white blood cell count and CRP were elevated, suggesting an infective process. Her arterial blood gas (ABG) results showed a PaO2 of 65, a low pH of 7.3, and a high CO2 of 55, indicating respiratory acidosis.

What did the chest x-ray reveal about the patient's condition?

The chest x-ray showed some shadowing in the lower right lung zones, but the heart and diaphragmatic borders appeared clear. The film was well-exposed and properly aligned.

What was the patient's condition based on the vital signs?

The patient had a higher-than-normal heart rate of 105 beats per minute, a respiratory rate of 26 breaths per minute, and was on 4 liters of oxygen with an oxygen saturation of 93%.

What kind of support did the physiotherapist plan to provide for the patient?

The physiotherapist planned to assess the patient's mobility, respiratory function, and ability to cough effectively. They also provided exercises to help clear mucus and improve lung function.

What is the role of the breathing exercises recommended to the patient?

The breathing exercises, such as huffing and coughing, are designed to help move mucus out of the lungs and improve lung function. These exercises are important for managing the patient's bronchitis and preventing further infections.

How did the physiotherapist assess the patient's breathing during the examination?

The physiotherapist performed a physical examination, listening to the patient's chest, and felt for breathing patterns. The patient demonstrated crackles in the lower lungs and difficulty holding deep breaths, indicating a need for further respiratory intervention.

What challenges did the patient face before being admitted to the hospital?

Before admission, the patient had been struggling with shortness of breath for over a year and a half, which made daily tasks like walking and doing household chores difficult. Despite seeing her GP and receiving antibiotics, her condition did not improve.

What lifestyle factors did the patient mention that affected her condition?

The patient, Polly, lives with her husband and four children, which has made it challenging for her to manage her condition. She also works part-time at a shelter, performing food preparation, but her condition is impacting her ability to perform her job due to frequent coughing and sputum production.