Answer 2

  1. Deconditioning
  • Short term: Increase distance mobilized by 10m by 2 weeks OR decrease support when mobilizing to bathroom (from supervision to independent) by 1 week. 
  • Long-term: Maintain or slightly decrease shortness of breath when mobilizing up or down the stairs by 6 months.
  • Be aware that because fibrosis is progressive, the patient will not likely make a full recovery, so you have to cater your goals differently.
  1. Shortness of breath on exertion
  • Short term: Decrease shortness of breath on exertion when using a gait aid to mobilize to the bathroom by 2 weeks
  • Long term: Have patient join a cardiovascular exercise program by 6 months. 
  1. Smoking cessation
  • Long term: Join smoking cessation group/therapy by 6 months. 
  • May consider using the transtheoretical model of behavior change. ie. assess the patient’s readiness to change. If they are in the contemplation or preparation stage then this may be a short-term goal. if pre-contemplation, then long-term goal
  1. Comorbidities
  • Short-Term: Have the patient be independent in recognizing symptoms of angina by 1 day 
  • Long-term: Have the patient join a cardiovascular exercise program by 6 months.