13) Effects of Cardiopulm Diseases Flashcards
What are all the categories of problems that can manifest from cardiopulm pathologies?
- Musculoskel
- Neuro
- Renal
- Endocrine
- Hematologic
- Nutritional
What needs to be done when tx’ing a cardiac pt?
- ID if the dysfxn can limite the pt’s response to tx
- Determine if tx should be modified
- Determine if tx is contraindicated
2° msk effects of cardiopulm disease
- Respiratory muscles
* Skeletal deformities–>scoliosis
Why do cardiac pathos have effects on the msk system?
Bc of inactivity
What problems can cardiac pathos cause to the chest wall?
- Decr lung vol
- Decr flow rates
- Decr inspiratory & expiratory pressures
- Incr atelectasis
- Incr dynamic A/W compression
- VQ mismatch
- Inefficient breathing pattern
- Incr risk of aspiration
- Incr risk of obstruction bc of mucous
- Restricted mobility
- Mediastinal compression
- Impaired cough & gag reflex
What CT problems can result from cardiac pathos?
- Scleroderma
- SLE
- RA
- Ankylosing Spondylitis
What can inflammation & tissue injury affect?
- AW
- Lungs
- Pleura
- Pulmonary vasculature
- Respiratory muscles
- Heart
- Pericardium
What should you look for in a pt w/alveolar hemorrhage & pulmonary HTN?
SOB
True or false: The electrical conduction system & mechanical behavior of the heart can be affected w/cardiac pathos
True
How do problems 2° to cardiac pathos tend to manifest?
Like restrictive diseases
Marfan’s Syndrome
Abn CT of great arteries, cardiac valves, skeletal system, & skin
How does early renal failure often appear?
W/sx’s of malaise, upset stomach, & poor health
CV complications cause what percent of deaths in ESRD?
What are these deaths from?
- 50%
* From MI or heart failure
What kind of HR/BP response to ESRD pt’s on dialysis have to exercise?
Hypotension
Why should ESRD pt’s be fed ice chips?
Bc their fluid vol needs to be incr but they can’t have too much fluids bc they can’t pee it out
What response to exercise do transplant pt’s have & why?
HTN bc of cyclosporine
Should you tx a pt after they get dialysis
Prob not bc they’ll be wiped out
What will decr RBC’s cause?
Fatigue & exertional dyspnea
What is the renal complication that can manifest w/CP pathos?
Early Renal Failure
What are the hematologic sequelae of CP pathos?
- RBC abn’s
- Hgb abn’s
- O2 transport abn’s
- Sickle cell
- CHF
W/what Hgb range is exercise contraindicated?
<7
If exercise is contraindicated bc of high Hgb, are low level mobes safe?
Yes
What can happen if PaO2 is <50torr?
Dysrhythmias
What endocrine problem can occur as a result of CP pathos?
DM
What nutrition-related problem can occur as a result of CP pathos?
Obesity
What problems can arise when a pt is obese?
- Digestive disorders
- ASHD
- CVA
- DM
- CA
- Death!
Pt’s w/DM have decr sensitivity to what?
Inspiratory loading
Pt’s w/DM have 2x greater risk for what?
V-Fib & HTN
Sx’s of Autonomic Dysfxn
- Postural Hypotension
- Blunt HR & BP response to exercise
- Incr RHR
- Incr SA node & AV conduction abn’s
- Altered ventilatory responses to hypoxia & hypercapnia
- Altered respiratory patterns & apnea during sleep
- Altered bronchial reactivity
- Impaired cough
True or False: Pt’s w/type 1 DM have blunted HR responses to exercise, post-exercise hypotension, & reach anaerobic metabolism at lower HR’s.
True
What pulmonary problems can result from CP pathos?
Sleep apnea & Obesity hypoventilation syndrome
What percent of obese individuals have pulmonary HTN at rest or exercise?
> 75%
What does nutritional depletion result in?
- Decr myocardial muscle mass
- Ventricular dysfxn
- Decr glycogen stores
- Myofibril destruction
Sx’s of Anorexia
- Bradycardia
- Relative HTN
- Blunt HR & BP
- Abn exercise tol (50% of predicted norm)
- ECG abn’s
What accounts for most deaths associated w/nutritional disorders?
Cardiac complications
What are the 3 basic patterns of neuro problems from CP pathos?
- CNS
- ANS
- PNS
Where are the primary centers for breathing & heart control?
Midbrain
What is neurogenic pulmonary edema?
Systemic pulmonary + intracranial HTN & Bradycardia mediated by the medulla
Insult to the CNS can cause what, and then cause what else?
CV response–>Neurogenic Pulmonary Edema
What effects can a CVA have on the CP system?
- Respiratory muscle weakness
- Pharyngeal muscle weakness
- Abdominal muscle weakness
- Central involvement that affects CP regulation/fxn
What can weak pharyngeal muscles cause?
- Loss of AW protection
- Loss of cough reflex
- Loss of gag reflex
- Sleep apnea
True or False: Weak abdominals can contribute to an ineffective cough.
True
What are the general ways that a CVA can effect CP fxn?
- Impaired mucociliary transport
- Impaired alveolar ventilation
- Incr work of breathing
- Decr aerobic capacity
What does PNS involvement effect?
- Motor neurons
- Peripheral nerves
- NMJ
- Muscle
For a pt w/hemiparesis, what breathing pattern would you expect to see & how would you tx it?
- Asymmetrical Rib Movement
* Lateral Costal Breathing
What is aspiration common w/ & why?
Neuromuscular disorders of the larynx, pharynx, & tongue bc it can lead to upper AW obstruction & incr AW resistance
