13) Effects of Cardiopulm Diseases Flashcards

1
Q

What are all the categories of problems that can manifest from cardiopulm pathologies?

A
  • Musculoskel
  • Neuro
  • Renal
  • Endocrine
  • Hematologic
  • Nutritional
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2
Q

What needs to be done when tx’ing a cardiac pt?

A
  • ID if the dysfxn can limite the pt’s response to tx
  • Determine if tx should be modified
  • Determine if tx is contraindicated
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3
Q

2° msk effects of cardiopulm disease

A
  • Respiratory muscles

* Skeletal deformities–>scoliosis

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4
Q

Why do cardiac pathos have effects on the msk system?

A

Bc of inactivity

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5
Q

What problems can cardiac pathos cause to the chest wall?

A
  • 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
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6
Q

What CT problems can result from cardiac pathos?

A
  • Scleroderma
  • SLE
  • RA
  • Ankylosing Spondylitis
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7
Q

What can inflammation & tissue injury affect?

A
  • AW
  • Lungs
  • Pleura
  • Pulmonary vasculature
  • Respiratory muscles
  • Heart
  • Pericardium
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8
Q

What should you look for in a pt w/alveolar hemorrhage & pulmonary HTN?

A

SOB

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9
Q

True or false: The electrical conduction system & mechanical behavior of the heart can be affected w/cardiac pathos

A

True

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10
Q

How do problems 2° to cardiac pathos tend to manifest?

A

Like restrictive diseases

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11
Q

Marfan’s Syndrome

A

Abn CT of great arteries, cardiac valves, skeletal system, & skin

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12
Q

How does early renal failure often appear?

A

W/sx’s of malaise, upset stomach, & poor health

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13
Q

CV complications cause what percent of deaths in ESRD?

What are these deaths from?

A
  • 50%

* From MI or heart failure

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14
Q

What kind of HR/BP response to ESRD pt’s on dialysis have to exercise?

A

Hypotension

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15
Q

Why should ESRD pt’s be fed ice chips?

A

Bc their fluid vol needs to be incr but they can’t have too much fluids bc they can’t pee it out

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16
Q

What response to exercise do transplant pt’s have & why?

A

HTN bc of cyclosporine

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17
Q

Should you tx a pt after they get dialysis

A

Prob not bc they’ll be wiped out

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18
Q

What will decr RBC’s cause?

A

Fatigue & exertional dyspnea

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19
Q

What is the renal complication that can manifest w/CP pathos?

A

Early Renal Failure

20
Q

What are the hematologic sequelae of CP pathos?

A
  • RBC abn’s
  • Hgb abn’s
  • O2 transport abn’s
  • Sickle cell
  • CHF
21
Q

W/what Hgb range is exercise contraindicated?

A

<7

22
Q

If exercise is contraindicated bc of high Hgb, are low level mobes safe?

A

Yes

23
Q

What can happen if PaO2 is <50torr?

A

Dysrhythmias

24
Q

What endocrine problem can occur as a result of CP pathos?

A

DM

25
Q

What nutrition-related problem can occur as a result of CP pathos?

A

Obesity

26
Q

What problems can arise when a pt is obese?

A
  • Digestive disorders
  • ASHD
  • CVA
  • DM
  • CA
  • Death!
27
Q

Pt’s w/DM have decr sensitivity to what?

A

Inspiratory loading

28
Q

Pt’s w/DM have 2x greater risk for what?

A

V-Fib & HTN

29
Q

Sx’s of Autonomic Dysfxn

A
  • 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
30
Q

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.

A

True

31
Q

What pulmonary problems can result from CP pathos?

A

Sleep apnea & Obesity hypoventilation syndrome

32
Q

What percent of obese individuals have pulmonary HTN at rest or exercise?

A

> 75%

33
Q

What does nutritional depletion result in?

A
  • Decr myocardial muscle mass
  • Ventricular dysfxn
  • Decr glycogen stores
  • Myofibril destruction
34
Q

Sx’s of Anorexia

A
  • Bradycardia
  • Relative HTN
  • Blunt HR & BP
  • Abn exercise tol (50% of predicted norm)
  • ECG abn’s
35
Q

What accounts for most deaths associated w/nutritional disorders?

A

Cardiac complications

36
Q

What are the 3 basic patterns of neuro problems from CP pathos?

A
  • CNS
  • ANS
  • PNS
37
Q

Where are the primary centers for breathing & heart control?

A

Midbrain

38
Q

What is neurogenic pulmonary edema?

A

Systemic pulmonary + intracranial HTN & Bradycardia mediated by the medulla

39
Q

Insult to the CNS can cause what, and then cause what else?

A

CV response–>Neurogenic Pulmonary Edema

40
Q

What effects can a CVA have on the CP system?

A
  • Respiratory muscle weakness
  • Pharyngeal muscle weakness
  • Abdominal muscle weakness
  • Central involvement that affects CP regulation/fxn
41
Q

What can weak pharyngeal muscles cause?

A
  • Loss of AW protection
  • Loss of cough reflex
  • Loss of gag reflex
  • Sleep apnea
42
Q

True or False: Weak abdominals can contribute to an ineffective cough.

A

True

43
Q

What are the general ways that a CVA can effect CP fxn?

A
  • Impaired mucociliary transport
  • Impaired alveolar ventilation
  • Incr work of breathing
  • Decr aerobic capacity
44
Q

What does PNS involvement effect?

A
  • Motor neurons
  • Peripheral nerves
  • NMJ
  • Muscle
45
Q

For a pt w/hemiparesis, what breathing pattern would you expect to see & how would you tx it?

A
  • Asymmetrical Rib Movement

* Lateral Costal Breathing

46
Q

What is aspiration common w/ & why?

A

Neuromuscular disorders of the larynx, pharynx, & tongue bc it can lead to upper AW obstruction & incr AW resistance