Cardio/Pulmonary Disorders Flashcards Preview

COTA Clinical Conditions > Cardio/Pulmonary Disorders > Flashcards

Flashcards in Cardio/Pulmonary Disorders Deck (35):

Coronary Artery Disease

Artherosclerotic disease process that narrows the lumen of coronary arteries resulting in ischemia to the myocardium
Involves a spectrum of clinical entities ranging from angina to infartion to sudden cardiac death

Risk Factors
Nonmodifiable: heredity, gender, age
Modifiable: cholesterol lvls, cigarette smoking, inactive lifestyle, b/p
Contributory: diabetes, stress, obesity


Angina Pectoris

Ischemia characterized by mild to mod substernal chest pain/discomfort most commonly felt as pressure or dull ache in the chest and left arm; usually lasts <20min

Brought on by increased demands on the heart (exertion, emotional upsets, smoking, extreme temps, overeating, tachyarrhytmias) and vasospasm


Myocardial Infarction

Prolonged ischemia, injury, and death of an area of the myocardium caused by occlusion of 1+ more coronary arteries

Severe substernal pain >20min
Dyspnea, rapid respiration, sob
Indigestion, vomiting, nausea
Pain misinterpreted as indigestion
Pain unrelieved by rest and/or sublingual nitroglycerin


Heart Failure

Heart is unable to meet the needs of the body

Left-sided (CHF): blood is not adequately pumped into the systemic circulation. Symptoms:
Cough, rales, wheezing
Weakness, fatigue

Right-sided: blood is not adequately returned from the systemic circulation to the heart: Symptoms:
Peripheral edema: wt gain, edema, venous stasis
Nausea, anorexia
Change in heart sounds


Occlusive Peripheral Arterial Disease (PAD)

Chronic, occlusive arterial disease of med and large vessels; associated with hypertension and hyperlipidemia

Early Stages
Pan described as burning, searing, aching, tightness, or cramping. Occurs regularly and predictably with walking and is relieved with rest

Late Stages
Patients exhibit rest pain, muscle atrophy, trophic changes (hair loss, skin/nail changes)


Buerger's Disease

Chronic inflammatory vascular occlusive disease of the small arteries and veins; most common in young males who smoke

Symptoms include pain, paresthesias, cold extremities, diminished temp sensation, fatigue; risk of ulceration and gangrene


Diabetic Angiopathy

inappropriate elevation of blood glucose lvls and accelerated artherosclerosis; ulcers may lead to gangrene and amputations


Raynaud's Phenomenon

episodic spasm of small arteries and arterioles; abnormal vasoconstriction reflex exacerbated by exposure to cold or emotional stress; fingertips develop pallor, cyanosis, numbness and tingling; affects largely females


Varicose Veins

distended, swollen superficial veins; tortuous in appearance; may lead to varicose ulcers


Superficial Vein Thrombophlebitis

clot formation and acute inflammation in a superficial vein; localized pain


Deep Vein Thrombosis DVT

Inflammation of a vein in association with the formation of a thrombosis; usually occurs in the LE

Associated with bed rest, lack of leg exercise, hyperactivity of blood coagulation and vascular trauma

Symptoms: may be asymptomatic early; progressive inflammation with tenderness; change in LE temp, color, appearance, or tenderness/pain



Chronic disorder with excessive accumulation if fluid due to obstruction of lymphatics; causes swelling of soft tissues of LE/UE

Primary: congenital condition with abnormal lymph node or vessel formation

Secondary: acquired, due to injury of one or more parts of the lymphatic system


Bacterial Pneumonia

An infection acquired in the community or in a host with a underlying chronic condition, acute illness, or recent antibiotic therapy


Viral Pneumonia

An inflammatory process caused by viral agents


Aspiration Pneumonia

aspirated material causes an acute inflammatory reaction within the lungs


Pneumocystis Pneumonia

Pulmonary infection caused by fungus in immunocompromised host



Airborne infection caused by bacterium

Risk Factors
Contact w/infected person
Weakened immune systems
Infants, young children, and elderly
IV drug users

Bad cough >2wks
Chest pain
Blood tinged sputum/phlegm
Wt loss
Loss of appetite
Night sweats


Chronic Obstructive Pulmonary Disease COPD

Disorder characterized by poor expiratory flow rates. Includes:

Peripheral airways disease: inflammation of distal conducting airways; associated w/smoking

Chronic bronchitis: chronic inflammation of the tracheobronchial tree with cough and sputum production lasting at least 3mos for 2 consecutive yrs

Emphysema: permanent abnormal enlargement and destruction of air spaces distal to terminal bronchioles; cause dyspnea/exertion, wheezing, sputum production


Pulmonary Edema

excessive seepage of fluid from the pulmonary vascular system into the interstitial space; may eventually cause alveolar edema


MET Level 1-2

ADLs- eating, seated; trans, bed>chair; washing face and hands; brushing hair; walking 1mph

IADLs- hand sewing, machine sewing, sweeping floors, driving automatic car, drawing, knitting


MET Level 2-3

ADLs- seated sponge bath, standing sponge bath, un/dressing, seated warm shower, walking 2-3mph, w/c propulsion 1-2mph

IADLs- dusting; kneading dough; hand washing small items; vacuuming, electric; preparing a meal; washing dishes; golf


MET Level 3-4

ADLs- standing shower, warm; BM on toilet; climbing stairs at 24ft/min

IADLs- making a bed, sweeping, mopping, gardening


MET Level 4-5

ADLs- hot shower, BM on bedpan, sexual intercourse

IADLs- changing bed linens, gardening, raking, weeding, rollerskating, swimming 20 yards/min


MET Level 5-6

ADLs- sexual intercourse, walking up stairs at 30ft/min

IADLs- biking 10mph level ground


MET Level 6-7

ADLs- walking with braces and crutches

IADLs- swimming breaststroke, skiing, playing basketball, walking 5mph, shoveling snow, spading soil


Phase 1: Inpatient Rehab/Acute Hospitalization
Cardiopulmonary Rehab

Activity program initiated if person is pain free, no arrhythmia, norm pulse

Begin at MET lvl 1-2 activities, energy conservation, breathing exercises, and monitoring (vitals, tolerance, pain). Once pt tolerates an activity with appropriate responses, they can progress to the next level

Avoid overhead activities; isometric exercise, straining, and breath holding; lateral arm movements that stretch the chest and pull incision

Pts d/c to Phase 2 when they are able to perform at MET lvl 3.5 (stairclimbing, standing warm shower)


Phase 2: Outpatient Rehab/Sub-acute
Cardiopulmonary Rehab

Patient education
Graded exercise program with slow/gradual wt increase
MET lvl activities 4-5 (gradually increase with tolerance)
Use of energy conservation and compensatory techniques in daily tasks
Improve IADLs and community tasks


Phase 3: Maintenance/Training
Cardiopulmonary Rehab

Generally attended once a week after completion of Phase 2

OT intervention is provided as needed for IADL, leisure pursuits, and work

Maintenance gym program


Cystic Fibrosis CF

Chronic, progressive lung disease (production of abnormal mucus)

Causes exercise intolerance; poor nutrition due to malabsorption may contribute to developmental delays.

Reduced life expectancy of up to 26yrs


Cystic Fibrosis
Evaluation and Intervention

Environment for adaptions
Psychological status

Energy conservation
Environmental adaptions
Positioning to promote postural drainage
Neurodevelopmental treatment to improve strength/endurance
Facilitation of fine, gross, visual motor, cognitive, and psychological development
Parent ed


Respiratory Distress Syndrome (RDS)

Lungs collapse after each breath.
Caused by premature birth; insufficient production of surfactant to keep alveoli open

Risk of severe intracranial hemorrhage; bronchopulmonary dysplasia (BPD); DD

Effect on Function
For infants with BPD or severe intracranial hemorrhage may have motor, sensory, cognitive, and/or language impairments.
RDS deficits include visual defects,hypotonia, and other health issues that may impact development


Bronchopulmonary Dysplasia BPD

Respiratory disorder often as a result of barotrauma; complication of premature birth.
The walls of the premature lungs thickens, making the exchange of oxygen and carbon dioxide difficult

>risk for hypotonia and gross motor delays
Feeding problems may lead to malabsorption and fragile bones
Delays in motor, speech, sensory, and cognitive development

Effects on Function
Impact on alert state needed for proper feeding
Poor activity tolerance
Isolation due to long periods of poor health


RDS and Bronchopulmonary Dysplasia
Evaluation and Intervention

Asses for DD; environment to determine adaptions and energy conservation

Facilitate sensorimotor and cognitive development
Address psychosocial issue
Adapt environment
Parent ed on handling, positioning, energy conservation, and methods to facilitate normal development
Advocacy for needed services/equipment


Pacemaker precautions

include no shoulder flexion or abduction greater than 90° on the side on which the pacemaker was implanted for the first 4 weeks.


_______ ____________ will have poor _________, resulting in a ________ _________ to the skin and lips, along with _________.

chronic bronchitis; oxygenation; bluish tinge; edema.