Midterm 2 - Lecture 7b (Lung Transplants) Flashcards Preview

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1

describe the history of lung transplants

2

candidates - general indicaition for lung transplants

3

candidates - absolute contraindications for lung transplants

4

candidates - relative contraindications for lung transplants

5

describe the evaluation process for lung transplants

6

describe what the initial Pt assessment does

File opening

Explanations of the LT/HLT process from physio perspective (pre, post, out-patient)

Information about current and past levels of physical activity limitations

Assessment

Oxygen needs

Education+++

Clinical impression of patient’s candidature

7

what are the factors affecting the wait times for lungs?

8

what would allow a pt to go on the emergency transplant list?

9

what is the organ donor per million people died in canada compared to other countries?

10

what are top causes of death of donor organs and reasons of refusal

11

describe the PHYSIOTHERAPY FOLLOW-UP DURING WAITING TIME

12

describe the surgery - frequency and duration

13

describe the lung transplant

14

describe the heart-lung transplant

15

scars from transplants

16

intensive care - how long do you stay there, PT intervention, extubation

17

what is the post-op meds like?

18

what are specific post-op complications for lung transplants?

19

what are other complications for lung transplants?

20

Pt interventions:

what are the sectors, what is the frequency, duration, and intensity?

21

describe physio in intensive care

- From medical stabilization
- Without a prescription
- Discussion with the medical team in doubt

- Fields of treatment (Ventilation, Secretions, Mobility)

- Pt on mechanical ventilation (VS or VAC mode) (Deep breathing)

- Once extubated:
¤ Incentive inspirometer (5 min/hour)
¤ Coughing with splinting
¤ Active mobilisations UE’s and LE’s
¤ Sitting in bed -> on the edge of the bed -> in the chair

¤ Walking with rolling walker (Equipment management)

22

describe when the pt transfers to the transplant unit from intensive care

23

describe transplant unit interventions

- Increase walking endurance
- Progressive weaning of walking aid ̈ Stationary bike and/or treadmill
- Weight training LE’s and UE’s
- Stretching UE’s / neck / trunk
- Stairs training
- *** Focus on self-management ***

- Communication with team

24

describe the discharge preparation process

25

what are physical restrictions for pts? (as part of the discharge planning)

26

look over the long temr medication list

Bone density

¤ Vitamine D

¤ Calcium
¤ Biphosphonate (Actonel, Fosamax)

¤ Bone formation agent (Fortéo)

Miscellaneous
¤ Anti-Nausea (Gravol)
¤ Pain killers (Tylenol, Dilaudid, Empracet, MS Contin, Fentanyl patch) ¤ Gastric (Motilium, Pantoloc)
¤ Constipation (Lactulose, Senekot, Colace, glycerine)
¤ Diarrhea (Imodium)
¤ Diuretics (Lasix)
¤ Insulin

27

describe pt follow-up immediately after hospital discharge

28

describe the out pt PT follow-up (frequency, goals)

29

what is the long-term surgical mortality rate?

30

describe the progression of the lung and heart-lung transplant waiting list