class 8 : cardio interventions Flashcards by VB VB

what is postural drainage

Bronchus of the involved lung segment is perpendicular to the ground

using gravity, these positions assist the mucociliary transport system in
removing excessive secretions from the tree.

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what are the indication for postural drainage

Pulmonary complications
Weak/elderly patients
Atelectasis, pneumonia, COPD

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how long should you maintain postural drainage positions

Maintain each position for 5-to-10 minutes

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how do we clear the secreations following postural drainage

Secretions cleared by coughing or suctioning

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what do beta blockers end with

LOL

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what is the function of beta blockers

low the heart rate and reduce blood pressure by blocking the effects of hormones like adrenaline and noradrenaline

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prone lying (two pillows under the pelvis) - postural drainage

superior segments of the lower lobes

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sitting in a chair (leaning forward over a folded pillow) - postural drainage

posterior apical segments of the upper lobes

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supine lying - postural drainage

anterior segments of the upper lobes

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sitting in a recliner, leaning backwards - postural drainage

anterior apical segments of the upper lobes

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Precautions to postural drainage

Pulmonary edema
Hemoptysis
Massive obesity
Large pleural effusion
Massive ascites

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does the right or left lung have 3 lobes

the right lung has 3 lobes

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what is Hemoptysis

coughing up blood or bloody mucus from the respiratory tract

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Relative Contraindications to postural drainage

Increased intracranial pressure
Hemodynamically unstable
Recent esophageal anastomosis
Recent spinal fusion or injury
Recent head trauma
Diaphragmatic hernia

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what is Massive ascites

a severe accumulation of fluid in the abdomen that can cause pain, discomfort, and difficulty moving

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why do COPD pt’s have elevated shoulder girdle

they are using their accessory muscle to breath

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what is esophageal anastomosis

a surgical procedure that reconnects the digestive tract after an esophagectomy

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what is HR Max

220 - age

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what is Heart rate reserve

the difference between your maximum heart rate and your resting heart rate

Exercise Hypertension

SBP: >240 mmHg
DBP:>110 mm Hg or until controlled

Systolic Hypotension

> 20 mm Hg drop from
upright resting SBP

what is an Unusual heart
response

Too rapid increase in HR
Failure to increase in HR
Decrease in HR with increased exercise intensity/duration

ECG abnormalities

second- or third-degree heart block
Onset of right or left bundle branch block
Acute ST changes

I- Acute: Monitoring

timeline: When patient is
medically stable

exercise prescription: Patient education, and hemodynamic
and ECG monitoring

II- Subacute: Conditioning

timeline: As early as 24hr after discharge up to 6 weeks exercise prescription: 50% to 70% of HRmax

III- Training: Intensive rehab

timeline: ~5-6 weeks from discharge extends indefinitely exercise prescription: 70%-to-85% Resistance training begins here

IV- Conditioning: Maintenance or prevention

timeline: Lasts up to 6-12 months exercise prescription: Patient who are at high risk for infarction and patient who wish to continue under supervision of trained personnel

what is the function of ECG

measures the heart's electrical activity and is used to assess the heart's health

Phase I & II do we do resistance training

No resistance training.

Phase I & II: FITT principle

* F - Short sessions 2-3 times a day * I - 50%-70% HR max * T - 10-15 mins (phase I) and 30 mins (phase II) per session * T - ADLs, supervised ambulation

to clear the right lobe do you lay on the right or left side

left side

Phase III - what do we do

* Begin with the use of elastic bands and light hand weights (1-3 pounds) or 30-50% of max weight used to complete 1RM * Begin with 8-10 reps, progress to 12-15 reps * Avoid upper extremity resistance as soft tissue is still healing

Phase IV - location

Community centers, YMCA, or clinical facilities

Phase IV - Exercise

Clinically stable angina, medically controlled arrhythmias during exercise

Phase IV - Progression:

50-85% of functional capacity, 3-4/week, 45 minutes or more/session

Phase IV - Discharge:

Typically, 6-12 months

freq for weight loss

Greater than 5 days/week

intesity and time for Weight Reduction Guidelines

40-60% V02 45-60 min/day

pt with no comorbidites what HRmax can we go to

70-80% of HRmax

older pt with no comorbidities what HRmax can we go to

60-70%

pt with comorbidities - HR max

50-70%

what is diaphoresis

excessive sweating that's not caused by physical activity or hot temperatures

what do we do if pt presents with resp alk

breath into a bag rebreather mask

what do we do if pt presents with resp acid

supplemental oxy med - brochodilators too much CO2

what do we do if the patient present with metabolic acid

bicarbinate infusion

what do we do if the patient present with metabolic alk

meds to reduces presentation

if the secreation are in the lower part of the lungs how do we need to be placed

in a supine postion if sercreation are in the upper part we can be sitting