Pulmonary Rehabilitation

2660 Words6 Pages
bulb-icon

Recommended: Ventilator-Associated Pneumonia in the ICU

It is widely recognized that the intensive care unit (ICU) is a different environment setting from those in which pulmonary rehabilitation (PR) services are performed. Pulmonary rehabilitation usually involves patients who have chronic stable disease, who most often are treated as outpatients, while the ICU is occupied with critically ill patients who have multiple dynamic medical or surgical problems. However, some patients admitted to the ICU also suffer from body deconditioning, neuropathy, myopathy, body weakness, increase length of ICU stay, prolonged ventilatory support, delayed weaning and prolonged pulmonary rehabilitation post-ICU (Schweickert & Hall, 2007). MacIntyre has pointed out that there are approximately 40% of ICU patients receive ventilatory support due to acute illness comlicating chronic disease and also the frquency of mechanical ventilation seems to be increasing (MacIntyre et al., 2005). In addition, some patients who require prolong mechanical ventilation become ventilator dependent. In the ICU, the need for pulmonary rehabilitation has become clear for all ventilated patients or non-ventilated patients. Starting pulmonary rehabilitation in the intensive care unit (ICU) is an important instrument to optimize resource utilization, prevent and treat some of the ICU complications and to facilitate, improve long term recovery and decrease the patient’s dependency on mechanical ventilator. In this paper, I will review the strategies of starting pulmonary rehabilitation in the ICU.

Definition

“Pulmonary rehabilitation is an evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities. Integrated into the individualized treatment of the patient, pulmonary rehabilitation is designed to reduce symptoms, optimize functional status, increase participation, and reduce health care costs through stabilizing or reversing systemic manifestations of the disease” (Carlin, 2009; L. Nici et al., 2006). This definition focuses on important number of factors that may influence the patient’s health and healthcare resources. These factors are multidisciplinary approach, individualized treatment of the patient, and attention to physical, social and healthcare cost (Ries, 2008).

The scope of pulmonary rehabilitation

All patients with stable chronic lung disease who is disabled by respiratory diseases are candidate for pulmonary rehabilitation (Ries, 2008). The intensive care unit (ICU) is extremely specilaised, busy and expensive area comparing to pulmonary rehabilitation program as outpatient. However, critically ill patients who admitted to the intensive care unit (ICU) most often suffer from sever manifestations of deconditioning and immobility. The causes for the intensive care units (ICU) admissions are varied and the

Show More
Related

  • Is Oral Care an Effective Intervention for Reducing the Incidence of Pneumonia in Mechanically Ventilated Patients?

    695 Words  | 2 Pages

    Many interventions are already in place to improve patient outcomes while on a ventilator. For example, elevating the head of the bed to 30 degrees, preventing venous thrombus via sequential compression devices or anticoagulant drugs, initiating early mobilization and practicing good hand hygiene were among the interventions listed by Fields, L.B., 2008. However, oral care was n...

    Read More

  • Case Study Of Jerry's Paramedic Collapse

    1287 Words  | 3 Pages

    There are a variety of ways to treat a collapsed lung, and different methods are used depending on the severity of the situation. The ultimate goal of the treatment is to restore lung function by removing external pressure on the

    Read More

  • Cystic Fibrosis Pathophysiology

    557 Words  | 2 Pages

    In spite of the fact that there is no cure for cystic fibrosis, treatment can ease symptoms and decrease complications. Other forms of treatment include, chest physical therapy (CPT) used to loosen mucus up to four times each day. Pulmonary rehabilitation (PR) is another treatment physician’s recommend. PR is utilized to enhance lung capacity and general prosperity.

    Read More

  • Respiratory Assessment In Nursing

    894 Words  | 2 Pages

    Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses

    Read More

  • Acute Exacerbation in Copd

    672 Words  | 2 Pages

    This exacerbation of her COPD revealed the need for inhaler re-education. This education holds more importance due to her exacerbation that possibly could have been prevented with proper inhaler use. An education plan should be developed to assess her readiness to learn and to map out a schedule of sessions. Several sessions over an extended period of time with continuous re-evaluations is essential. Research has shown that this approach has better long term outcomes (M., Duerden & D., Price, 2001).

    Read More

  • The Use of BiPAP on COPD Patients

    939 Words  | 2 Pages

    Introduction BiPAP is a form of noninvasive mechanical ventilation used in patients with acute respiratory failure. Many of these patients go on noninvasive ventilation due to COPD exacerbations that are infectious, with congestive heart failure, and ventilator parameters based on their clinical assessment and changes in arterial blood gases. Two different studies were conducted on COPD patients, using a BiPAP machine to improve exacerbations and their activities of daily living. There are many positive outcomes for using these noninvasive ventilators, however when used incorrectly, negative outcomes or no changes at all are always possible. Positive Use for COPD Exacerbations

    Read More

  • Response And Treatment Of Deteriorating Patients

    730 Words  | 2 Pages

    As explained in the presentation, the model consists of an individual’s ability to carry out self-care tasks such as functional mobility, self-feeding, personal hygiene and grooming (Roper, Logan & Tierney, 1980). Thus, any change in these may be considered a deteriorating patient. However, this approach not only lacks objectivity, but it also fails to acknowledge the abnormal physiology that precedes this breakdown in self-care. For instance, it has been reported that 70% of patients preceding cardio-pulmonary arrest had a physiological decline in respiratory or mental function (Schein et al. 1990). Observing deterioration in activities of daily living alone does not accurately mirror underlying physiological deterioration occurring in patients....

    Read More

  • Nursing Case Study: Chronic Obstructive Disease

    903 Words  | 2 Pages

    To effectively manage COPD it is essential for patients to monitor themselves by writing a list of dates and times when experiencing symptoms and reactions to treatments. (Lung Chicago Managing COPD, 2016). Understanding a patient’s personal disease characteristics will help in determining treatment to prevent exacerbations. To maintain stable condition of the disease, COPD patients need to understand and reduce risk factors. Counseling programs such as smoking cessations need to be available for COPD patients as part of their treatment. Pharmacotherapy for the disease is also used to reduce its symptoms and difficulties on

    Read More

  • case study

    1592 Words  | 4 Pages

    This paper will discuss a case study of Pritesh, a 26 years old man who is transferred from the emergency department (ED) to the high dependency unit (HDU) with the developing of a tension pneumothorax. Initially, a general description of the patient’s chief complaint which is tension pneumothorax will be introduced, following by assessments of the patient’s need. The paper will focus on the discussion of nursing care and management for the patient, and a brief summary and evaluation of the care will be given. Lastly, a conclusion of what author has learned from this case study will be present.

    Read More

  • A Discussion of Emphysema and COPD

    1252 Words  | 3 Pages

    Carone M, D. C. ( 2007). Clinical Challenges In COPD[e-book]. (Oxford: Clinical Pub) Retrieved March 24, 2014, from (EBSCOhost).

    Read More

  • Respiratory Therapy Personal Statement

    144 Words  | 1 Pages

    Caring for people is my passion. My senior year of high school is when I witnessed my grandmother live on a ventilator for about a week. It awakened a new level of passion in me to care for people with cardiopulmonary problems. The Respiratory Therapy Care profession has intrigued me with how they improve the quality of life in their patients. I will enjoy working closely with patients in addition to working high tech equipment. By entering into this program and graduating out of this program I know that this will satisfy my personal goals for the next five years in many ways. The continues challenges of trying to figure out what’s wrong the heart that day or what’s wrong with the lung the next day will always keep me on my toes. It will always

    Read More

  • The Right to Physician Assisted Suicide

    1874 Words  | 4 Pages

    Medical technology today has achieved remarkable feats in prolonging the lives of human beings. Respirators can support a patient's failin...

    Read More

  • Chronic obstructive pulmonary disease (COPD)

    3105 Words  | 7 Pages

    Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992). The diagnosis of COPD is predominantly based on the results of a lung function assessment (Larsson, 2007). Chronic bronchitis is differentiated from emphysema by it's presentation of a productive cough present for a minimum of three months in two consecutive years that cannot be attributed to other pulmonary or cardiac causes (Marx, Hockberger & Walls, 2014) (Viegi et al., 2007). Whereas emphysema is defined pathologically as as the irreversible destruction without obvious fibrosis of the lung alveoli (Marx, Hockberger & Walls, 2014) (Veigi et al., 2007).It is common for emphysema and chronic bronchitis to be diagnosed concurrently owing to the similarities between the diseases (Marx, Hockberger & Walls, 2014).

    Read More

  • Chronic Bronchitis Essay

    783 Words  | 2 Pages

    Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.

    Read More

  • Challenge of Maintaining Homeostasis with Geriatric Patients

    1625 Words  | 4 Pages

    One of the greatest challenges with geriatric patients is maintaining homeostasis and managing pain during multisystem failure. With geriatric patients the body’s ability to regulate itself physiologically in response to changes due to illness is decreased, there by leading to multisystem failure. Elderly display shock with minimal signs and symptoms which leaves little time for intervention. The best treatment form multisystem failure is prevention. This can be obtained by collaborating with multidisciplinary team including; MD, nurse, lab, radiology, respiratory and spiritual care. The prevention of infection can be obtained by using universal precautions , discontinuing IV lines, frequent turning, encouraging cough and deep breathing as well as using a Incentive Spirometer to prevent pneumonia. To ensure optimal oxygen perfusion and to decrease workloads on the heart supplemental oxygen may be required.

    Read More

More about Pulmonary Rehabilitation

Open Document