Reference no: EM133563966
Scenario 1
Bill is a 62-year-old man with severe COPD. He is a high school educated, a retired truck driver who lives with his wife and son. He walks without an assistive device and has difficulty walking on the flat, showering, and carrying heavy loads. These activities produce breathlessness and low back pain as he has had a previous fracture to the pelvis. As a result, his wife assists him with most ADLs. He stopped smoking three months ago following an 80 pack-year history of smoking. The respiratory medications he uses are Symbicort, Ventolin, and Spiriva.
On assessment, his weight is 198 lbs, height 70 cm, BMI = 28.4. Resting HR = 85 beats/min; resting SpO2% = 93%. The supervising RT asks you to test his performance on a six-minute walk test.
How would you prepare the patient?
What measurements need to be taken?
What equipment will you need?
What questions/observations do you need to record before, during, and after the test?
He can walk 300 yards with two rests in the best of two six-minute walk tests but desaturated to 86% on room air and felt very severely breathless (dyspnea score = 7) at the end of the walk.
How would you interpret the results of his test? What recommendations would you make?
Scenario 2
You are asked to evaluate Ima T. Smoker for home oxygen. She is a COPD patient, who has never worn oxygen in the past, but in the hospital has been unable to be weaned off the oxygen. You record the following:
Pre:
HR - 86 at rest
RR - 22 and unlabored
SpO2 92% on 2 lpm
During:
HR - 110
RR - 28, using pursed-lip breathing
SpO2 - 84% on 2 lpm
Post:
HR - 90 (after 3 minutes)
RR - 24, using pursed-lip breathing
SpO2 - 90% (after 3 minutes) on 2 lpm
Based on your findings, what would you recommend for this patient before discharge?
Scenario 3: Your patient is in for their second 6 Minute Walk Test. You have received the following results. What is your interpretation of the current results