Cardiopulmonary Rehabilitation Flashcards Preview

618 Phys Dys 2 Quiz1 > Cardiopulmonary Rehabilitation > Flashcards

Flashcards in Cardiopulmonary Rehabilitation Deck (31)
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1

Pain or pressure radiating to jaw, teeth, arm or midback

Acute coronary syndrome

2

Lack of blood flow leading to tissue death (heart attack)

Myocardial Infarction

3

Heart muscle is stretched beyond ability to contract; ineffective pump

Congestive Heart Failure (CHF)
Usually a chronic condition. Pt.'s have specialized diets (i.e. low sodium)

4

Secondary effects of CHF

Edema (in LE), SOB, fatigue, cough or SOB in side lying.
Pt.'s should be weighing themselves daily, if there is a 3lb increase they need to call the Dr

5

Enlarged heart, decreased pumping & leads to CHF

Cardiomyopathy
75% of cases are dilated

6

Abnormal heart rhythm which usually leads to CHF

Artial fibrillation (afib)
Afib= increase in clot production

7

high blood pressure d/t narrowing of blood vessels

Hypertension (HTN)
Systolic 140
Dystolic >90

8

Congestive Heart Failure: Overview

Coronary artery disease or coronary heart disease (CAD or CHD): buildup of plaque on wall vessels
Diuretics = increase in urination & increased fall risk due to frequency & urgency of bathroom trips
Digitals
Heart transplant
Decreased salt and fluid intake

9

Cardiac Catheterization

Insert tube and dye into the heart muscle to elevate blood pumping (?)

10

Angioplasty & stent placement

Mini step before CABG by pass
Pushes plaque against vessel wall to decrease Bp

11

Bypass Surgery or CABG : Overview

Open heart procedure
Transfer of donor vein- usually great saphenous from LE
Sternomoty precautions for 6-8 weeks following

12

Sternotomy Precautions

No pushing or pulling
No lifting anything greater than 5lbs
No sh flexion greater than 90 degrees
No UE retraction
Holf pillow when coughing
No driving

13

Pacemaker : Overview

Creates artificial action potential
Control arrhythmia
SA node disorders- bradycardia
AV nodes disorders: tachycardia

14

Ventricular Assistive Device (VAD): Definition

May be a left (LVAD), right (RVAD), or both (BiVad)
For end-stage heart disease as a bridge to heart transplant

15

VAD Function

Produces continuous flow of blood
-No pulse, hard to get BP read
-Must be careful of driveline or power source

16

VAD precautions

No driving, No contact sports
No pregnancy, No bike riding
No showers w/o clerance & bag
No swimming, no static, no vacuming
Sternotomy precautions for 6-8 weeks
No touch screen on computer or tv monitor
Not chest compressions unless unit stop
Avoid magnets and metal detectors
No MRI
Avoid exposure to infections

17

Theracotomy : Overview

Incision to chest to Tx
-Artificial airway
-Daohragm, esophagus, kidneys, lung
-liver, spleen

18

Anestheisa: Phrenic N. Irritation/Compression

Decreased diaphragm contraction
Several days duration
O2 decreased hypoxemia
Confusion & mental effects can be long lasting

19

Narcotics

Interruption of normal breathing & HR
Causes alveoli collapse

20

Post - Op ICU : Overview

Mobility
Positioning
Endurance
Light ADL's
Incentive spirometer

21

Metabolic Equivalent Level

Unit of measure of oxygen that body needs for a given activity
Used in cardiac rehab to determine activity tolerance during recovery
1 MET = 3.5 ML/02/min/kg body weight = oxygen consumption at rest

22

Cardiac Rehab : Candidates

Post MI
Post CABG
Poor ventricular fxn
Cardiomyopathmy
Cardiac transplant
Elderly - deconditioned
Assymptomatic at risk population
Pt.s have to be stable and beyond the point of sternal precautions

23

Phases of Cardiac Rehab

Phase 1: Acute
Phase 2: Out pt. or home health (4x weekly typically out pt. )
Phase 3: Community program (i.e. smoking programs)
Phase 4: Maintenance

24

Non Candidates for cardiac rehab

Overt CHF
Unstable agina=chest pain
Serious arrythmia
Uncontrolled HTN

25

Benefits of cardiac rehab

Weight loss
Decreased lipid levels
Elevation of HDL
Decreased BP
Increased Glucose

26

Exercise guidelines

HR : 20-30 bpm above resting
BP: 15-20 mmHG from resting
Monitor SOB, dizziness, chest pain, nausea, diaphoresis (i.e. sweating and clammy feeling), fatigue
Check vitals regularly
Give frequent and regular rest breaks
Move slowly
Work w/in MET levels prescribed

27

Exercises Precautions

DVT (appears in calf: redness & swelling)
Unstable angina
Increased BP
Uncontrolled arrythmia (blood clot)
Active pericarditis
Temp of 100 or more
No isometices (breath holding and increase in BP)
No valSalva
No UE overhead
No lateral UE ex.
Sternal Precautions
No driving

28

Pulmonary Dysfunction (COPD) : overview

Progressive and irreversible destruction of alveolar walls
Lungs lose elasticity and air is trapped
Decrease airflow during expiration; lung cannot shrink
Result of chronic bronchitis & emphysema
#5 cause of death
Use of Borg Scale

29

Respiratory Arrest

May be related to recent surgical procedure, frail health or complex co-morbidities
May lead to anoxia and decline in cognitive processes

30

OT Eval & Tx

UE function: limited to 90 degress FF
ADL performance
Home safety accessibility
Endurance: stanima to do daily tasks: use of energy conservation and pacing
Strength: No MMT: look at it in terms of function (i.e. walking to the bathroom)
Cognition and insight into limitations
Vocational abilities
Incorporation of precautions (sternotomy) into ADL's

31

Occupational therapy Eval & Tx : Continued

Pt. self monitoring & Pacing: Recognize when they are SOB, know how to follow sternal precautions
Psychosocial
Caregiver education
Community re-entry
pt. education