Unit 4: Wk 13??

Question 1

You designed an aerobic program for a pt taking a cardioselective beta blocker to control hypertension.

what is the function of this drug?

will the pt experience a training effect and undergo beneficial changes in CV system, or will the beta blocker prevent heart and vasculature from adapting?

Answer 1

Yes, CV function will still improve

• Function: suppress HR and decrease sympathetic nervous system activity
• it will decrease max hr but training effect will still occur w heart under control. It will also lower resting HR, improve vascular endothelial function, and reduce HTN as a result of aerobic training.

Question 2

excessive renin angiotensin activity should be controlled because increased production of ___ causes ______________________

Answer 2

ang II causes vasoconstriction and vascular smooth muscle hypertrophy

Question 3

nitrates such as nitroglycerine help decrease symptoms of angina because they _____ myocardial O2 demand by vasodilating the __________________

Answer 3

decrease O2 demand

vasodilate peripheral vasculature

Question 4

myocarditis definiton, S & S, causes

Answer 4

ACUTE inflammatory disease of cardiac muscle

chest pain, palpitations, diffuse ST segment inversion

Causes: infection, toxins, radiation

Question 5

cardiomyopathy definition

Answer 5

chronic disease of heart muscle caused by A degenerative condition

NOT ACUTE

Question 6

WHAT ARE 3/4 OF THE CLASSIFICATIONS OF CARDIOMYOPATHY

Answer 6

dilation (most common), hypertrophic, restrictive

Question 7

pericarditis

Answer 7

actue inflammation of the outer lining of the heart ; normally protects heart from rubbing mediastinum

Question 8

pericardial effusion

Answer 8

accumulation of fluid within the pericardium; not usually life threatening

Question 9

hemopericardium

Answer 9

blood accumulation in pericardium due to aortic rupture, traumatic perforation, ventricular rupture

*can cause cardiac tamponade

Question 10

amyloidosis

Answer 10

abnormal protein thats produced in BONE MARROW that effects kidney, heart, liver, spleen, nerves

Question 11

signs and symptoms of amylodosis

Answer 11

swelling, enlarged tongue , SOB, low BP, weight loss, purple around eyes

Question 12

Sarcoidosis

Answer 12

systemic disease; formation of granulomas in lungs, eyes, skin

Question 13

Sarcoidosis S & S

Answer 13

rash, nodules, fatigue, weight loss, SOB

Question 14

OKT3

Answer 14

produces initial cytokine surge that makes pts feel very ill

fkr acute reactions

Question 15

what are the two types of heart transplants?

Answer 15

Orthotopic heart

Heterotopic heart

Question 15

types of lung transplants

what/who are they for

Answer 15

Single : pulmonary fibrosis, COPD

double : cf, bronchiectasis

heart lung: pulmonary htn, sarcoidosis, amyloidosis

living donor

Question 15

endocardial biopsy

Answer 15

routine procedure to assess for rejection of heart transplant

Question 16

reverse isolation requires what PPE

Answer 16

mask for you and pt, gloves, gown

Question 17

signs of rejection

Answer 17

flu/fever

sudden decrease in exercise tolerance

SOB

chest congestion

Question 18

who needs prehab

Answer 18

pts before they get transplants

Question 19

what should RPE be for heart/lung transplants

Answer 19

12-14 (somewhat hard

Question 20

IP goals for heart/lung transplants

Answer 20

independent, strength 3+/5, improved posture, independent in pulmonary hygiene

Question 21

what should HR be below for heart/lung transplants

Answer 21

not to exceed 120 at rest

Question 22

“heart rate inertia”

Answer 22

donors heart does not respond to owners nervous system

Question 23

t or f: following lung transplant, the pt has loss of cough reflex and RR may not increase during exercise

Answer 23

true- they will NEED to cough on schedule either

Question 24

after how long would you expect a heart/lung transplant to be off a vent

Answer 24

24 hrs

Question 25

what coughing techniques should be used w lung transplant

Answer 25

volitional coughing
incentive spirometry
PEP or flutter (acapella?)

Question 26

recipeients will need double lung transplant for which diseases (3)

Answer 26

bronchectasis, pulmonary sepsis, CF

Question 27

pulmonary rejection S&S

Answer 27

malsise, myalgia, respirtory difficulty