Cardiopulmonary Rehab & GI System & Ca Flashcards Preview

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Flashcards in Cardiopulmonary Rehab & GI System & Ca Deck (39):
1

MET

Metabolic Equivalent of Task (MET) > physiological measure expressing the energy cost of physical activities; Must take into consideration phys status, act patterns, reported exertion level

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Energy conservation & work simplification techs

Pacing, monitor body position, organization of daily activities and work areas, delegate responsibilities

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Abdominal diaphragmatic breathing & PLB

Strengthen diaphragm, decreases need to use neck/shoulder muscles, decreased energy required for activity & controls resp rate/helps remove trapped air from lungs

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Absolute Contraindications for Cardiac Rehab

Acute MI (w/in 2 days), unstable angina, uncontrolled cardiac arrhythmia, acute PE or pulmonary infarction, acute pericaditis/myocarditis or acute aortic dissection

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Relative Contraindications for Cardiac Rehab

L main coronary stenosis, mod stenotic valvular heart disease, electrolyte abnorm, severe arterial HTN, tachyarrhythmias or bradyarrhythmias, hypertophic cardiomyopathy/other outflow occlusions, mental/phys impairment leading to inability to exercise adequately or high-degree atrioventricular block

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CAB

Compressions - Airway - Breathing; exception is newborn babies (30:2)

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CF

Gentically inherited autosmal recessive trait - both parents must be carriers. Life span 30s-40s and sometimes more.

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CF Eval

Assess for developmental delays related to decreased strength & endurance & decreased attn d/t pain. Assess environment w adaptions for energy conservation. Assess psychological status.

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CF Tx

Energy conservation, environmental adaptations, position to promo postural drainage, NDT to improve endurance/postural stability, facilitation of fine, gross, visual, cog and psychosoc development, parent edu including advocacy skills, tx protocols & teacher edu including energy con techs, encourage phys act, playground precautions, observe medical precautions

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RDS

Resp Distress Syndrome. D/t premature birth. Characterized by insuff production of surfactant to keep alveoli (lung air pockets) open > lungs collapse after each breath

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RDS Tx

Monitor development, facilitate sensori-motor/cog development, address psychosco issues, parent edu regarding handling, positioning, energy con & methods to facilitate norm development, adapt environment as needed, observe medical precautions, referral as necessary

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Bronchopulmonary Dysplasia (enlargement of organ)

Resp dx often as a result of barotrauma: High inflating pressures, infection, meconium aspiration, asphyxia. Complication of prematurity. Walls of immature lungs thicken, making exchange of O and CO2 more difficult. Mucus lining & airway diameter reduced > months/years of O therapy and artificial ventilation

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Bronchopulmonary Dysplasia Tx

facilitate sensori-motor/cog development, address psychosco issues, parent edu regarding feeding, positioning, energy con & adapt environment as needed, observe medical precautions

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Praxis Deficits of Gastrointestinal System

Inability to effectively chew & coordinate tongue mvmts to propel bolus to base of tongue, residual food centrally located in oral cavity, diff w bolus formation

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Sensory Impairments of Oral Cavity

Lack of awareness of residual food > pocketing food & spillage into airway when vocal cords are open > choking

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Weakness of Tongue/Base of Tongue Structures

Insufficient propulsion of bolus to pass base of tongue into pharyngeal cavity; Lack of closure at cricopharyngeal junction > interference w normal timing of swallowing sequence

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Vocal Cord Paralysis

Insufficient closure of vocal folds during pharyngeal phase of swallow > if vocal cord fail to meet/close to protect airway, aspiration could occur

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Diminished Esophageal Motility (muscle contraction to move food)

Bolus sits in esophagus and can slowly either move toward stomach or upward to pharynx > person feels food is stuck in esophagus or aspirates when food propels upward

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Bedside Swallow Eval

Assess level of alertness, ability to follow instructions, level of awareness of impairment and orientation to activity. Assess sensory/motor components of swallowing. Assess ability to manage own secretions (hearing and clinical observation)

20

Modified Barium Swallow (MBS)

In diagnostic radiology suite (swallow team and radiologist). Pt seated upright - must have adequate balance, supervised at all times. Trial boluses admin laced with barium of puree, thick, solid and thin. Video records moving xray of swallow; if aspirates=test ceases

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Flexible Endoscopic Esophageal Swallow (FEES)

May be done at beside or in office. Food consistencies laced w green food coloring. Flexible endoscopic catheter containing mini video camera passed thru nasal into pharyngeal cavity.

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Tx for Gastrointestinal Dx

Provide fam-centered intervention to determine acceptable dinner table interactions. Work w person toward developing new roles/occs to transition from old. Provide ongoing edu/info to fam regarding pt feeding/nutrition. Pyschosoc intervention

23

Gastric Esophageal Reflex Disease (GERD)

Involves lower esophageal/gastric sphincter. Food enters stomach and mixes w stomach acid/digestive juices. Lower esophageal sphincter closes insuff; stomach contraction propels acid/acidic bolus into esophagus >heartburn, indigestion or mild chest pain. Other symptoms: regurgitating, feeling somethings stuck in throat

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GERD Tx

Test: MBS or Flexible endoscopy. Sleeping w more than 1 pillow for elevation. Drug therapy. Diet mods w less spices, smaller/frequent meals & lower alcohol intake. Stress mngt.

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Neurogenic Bowel

Sympathetic nerve impairment, generally occurring in pts who have SCI above T-6 level; loss of control of anal sphincter/flaccidity > incontinence. Autonomic dysreflexia can result!

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Risk Factors of Kidney Disease

DM, HTN, Lupus

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Tx for Kidney Disease

Prevention & early intervention. Control of HTN/DM, diet, meds, exercise, stress reduction & smoking cessation.

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Impact of Renal Disease on Client Factors

Motor dysfunction including fatigue, pain, weakness, edema; Nuropathy; Vision loss; Cog dysfunction including delusions/dementia; Anxiety, depression, mood/adjustment d/o

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Stress Incontinence

Local damage to bladder sphincter associated w aftereffects of bearing children, morbid obesity, weakening of accessory musculature associated w norm aging

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Tx for Stress Incontinence

Kegels to strengthen pelvic floor, time emptying routines, incont. support garments, meds, potentially e-stim

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Stage 1 Cancer

Tumor present, no perceived spread of disease; Lesion operable; Prognosis good > not in lymph nodes/no metastatic lesions

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Stage 2 Cancer

Localized spread of turmor; Lesion is operable/removed w margins; Spread is limited & usually responds well to tx (5yr survival rate=50%)

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Stage 3 Cancer

Extensive evidence of prim tumor that has spread to other organs; Tumor can be surgically debulked but some cells may remain; Deeper spread of the tumor cells in lymphatics (5yr survival rate=20%)

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Stage 4 Cancer

Inoperable prim lesion; Survival rate is dependent on depth/extent of tumor spread as well as tumor response tx (Multiple metastases)

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Pre-op Ca Tx

Fx'al assessments and prep for post op phase/care; Pt/fam edu on recovery/follow up care

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Post-op Ca Tx

Tx planning based on pt med status and blood level guidelines. Post-op precautions. Hemo levels: Adult males: 14-18 gm/dl - Adult women: 12-16 gm/dl - Elder men: 12.4-14.9 gm/dl - Elder Women: 11.7-13.8 gm/dl

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Tx for Ca

Rehab of motor, sensory, neurobehavioral & cog impairments; Psychosoc support; Promo of health supporting behaviors

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Palliative Care for Ca

Prevent/relieve suffering thru early ID, assessment, pain tx; Address physical, psychosoc and spiritual needs; Enhance QOL by supporting engagement in occs; Consider environment/contextual and client factor that could lim abilities/satisfaction; fam collaboration thru whole process

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Hospice Care for Ca

Support QOL, provide pt w as much control as possible, Be present/accountable/listen/counsel; Encourage planning for death, Empower life celebration/reflection; Refer for legal support if needed