Cardiovascular: Treatment Flashcards
(21 cards)
Target Heart Rate (THR) Method 2
HRR (Karvonen)
Lower THR = [(HRmax - HRrest) x 40%] + HRrest
Upper THR = [(HRmax - HRrest) x 85%] + HRrest
Target Heart Rate (THR) Method 1
HRmax
Lower THR = HRmax x 55%
Upper THR = HRmax x 90%
HRmax
220 - age
Active Cycle Of Breathing (ACB)
- Breathing control
Gentle, relaxed breathing
5-10 seconds or until prepared for phase 2 - Thoracic expansion exercise
3-4 deep, slow, relaxed inhalations
Passive exhalation - Forced exploratory technique
1-2 huffs at mid-low lung volumes with glottis open into ERV
Can add brisk adduction of arms
*Splinting of postoperative incisions
*Bronchospasm/hyperactive airway = contraindications
Autogenic Drainage (AD)
Sit upright with back support
1. Unsticking phase:
Slow nose inhaling at low lung volumes
2-3 second breath-hold
Exhale down into ERV
2. Collecting phase:
TV interspersed with 2-3 second breath-holds
3. Evacuating phase:
Deeper inspirations low-mid IRV with breath holding then huff
Exhalation through pursed lips
30-45 minutes
High-Frequency Airway Oscillation
Acapella/Flutter Combines positive expiratory pressure and high frequency airway vibrations to mobilize mucous secretions Device in mouth, lips sealing Slow inhale to 75% Hold breath 2-3 seconds Exhale into device 3-4 seconds Repeat 10-20 breaths Remove device, cough or huff 2-3 times
PDPV
Postural drainage
Maintain PD position 2-3 min/segment
Percussion
Cover skin with thin material
Rhythmically strike with cupped hand 2-3 min/segment
Vibration
One hand on the other prone on each side of rib cage
Vibrate during exhalation in direction of rib movement
Cough or huff after 2-3 vibrations
Diaphragmatic Breathing (DB)
Semi-Fowler’s position
Sniffing
Patient put one hand on chest, other on abdomen just below ribs
*Precaution/contraindictions: COPD/hyperinflation of lungs, paradoxical breathing patterns
Inspiratory Muscle Training (IMT)
Strengthen the diaphragm and intercostal muscles
Flow resistive breathing: inspire through mouthpiece and adapter with adjustable diameter
Decreased diameter = increased resistance
If RR, TV, inspiratory time kept constant
Threshold breathing: consistent specific pressure regardless of how quickly/slowly you breathe
Requires buildup of negative pressure before flow through valve that opens at a critical pressure
*Inspiratory muscle fatigue: Tachypnea, reduced TV, increased PaCO2, bradypnea and decreased minute ventilation
IMT: Threshold
Inhale into mouthpiece with enough force to open valve
Adjust spring tension to prescribed pressure
Marked every 2cm H2O, higher setting = higher effort required
Beginn 30-40% of MIP
Breate at TV 5-15 minutes
Increase resistance gradually to 40-60% of MIP over 4-6 weeks
IMT: PFLEX
Breathe into mouthpiece at TV Regulate the resistance Begin 30-40% of MIP 10-15 Minutes daily Gradually increase to 20-30 minutes 3-5 Days/week Increase resistance after able to easily tolerate 30 minutes at given setting
Segmental Breathing
PT applies firm pressure at end of exhalation over cheat area to be expanded
Inhale deeply, slowly expand rib cage under PT’s hands (reduced pressure during inhalation)
Sitting - basal atelectasis
Sidelying - lung uppermost
Postural drainage positions - lung uppermost, secretion removal
RPE
6-20
12-13 (Somewhat hard) = 60% HR range
16 (Hard) = 85% HR range
HR
70-85% HRmax = 60-80% VO2max
METs
40-85% of max METs on ETT
Exercise Duration
15-60 min
Mod: 20-30 min
Severe Pathology: Several 3-10 min intervals
Warm-up and Cool-down: 5-10 min
Exercise Frequency
3-5x/week Moderate intensity and duration > 5 METs Daily or many daily sessions Low intensity < 5 METs
PCTA
Hold ex 2 weeks for inflammation to decrease
CABG
Limit UE ex while incision healing
No lifting/pushing/pulling 4-6 wks
Phase 2 OP Cardiac Rehab
Strength training
3 Weeks cardiac rehab
5 Weeks MI
8 Weeks CABG
Lymphedema
Massage: Proximal then extremities, direct flow distal to proximal
Exercise: Trunk then limbs proximal to distal
Compression: Pressure > 45 mmHg contraindicated
