Answer 5

  1. Deconditioning 
  • Use the modified BORG scale to monitor symptoms. Educate the patient on using it whenever they are mobilizing and/or exercising. 
  • Reassess by using the modified BORG scale or by using 6MWT. 
  • Modify treatment plan by changing mobilization distance, focusing on positions of ease, pacing education, and changing the gait aid. 
  1. Shortness of breath on exertion
  • Use the MRC dyspnea scale. Educate the patient on using it whenever they are mobilizing and/or exercising. 
  • Reassess using MRC dyspnea scale or 6MWT or modified BORG scale when mobilizing
  • Modify treatment plan by changing mobilization distance, focusing on positions of ease, pacing education, and changing the gait aid. 
  1. Smoking cessation
  • Ask the patient how many cigarettes they are smoking (per day/week/month/year)
  • Could educate them on the effects of smoking long-term, the importance of lifestyle modification, and/or refer to smoking cessation therapy.
    • Continue to evaluate readiness to change, making goals with the patient, and assist with maintenance/prevent relapse if the patient does quit smoking 
  1. Comorbidities
  • Monitor/reassess by asking them the number of hospital admissions since their last appointment
  • Modify treatment by changing mobilization distance, focusing on positions of ease, pacing education, and changing the gait aid.
    • This is dependant on how symptomatic their angina is throughout exercise, activities of daily living, and mobilization