Acute Interventions for CardioPulm Conditions

Question 1

Functional Loss Factors

Answer 1

Acute inflammation
Severity of illness
Marginal baseline function
Exposure to corticosteroids
Neuromuscular blockers
Prolonged immobilization
Length of stay
Acute cardiopulmonary conditions
Acute cardiopulmonary dysfunction

Question 2

Cardio Effects of immobilization:

Answer 2

increased basal HR
decreased maximal HR
decreased maximal O2 uptake
orthostatic hypotension
increased venous thrombosis
decreased total blood volume
dereased hemoglobin concentration

Question 3

Respiratory effects of immobilization:

Answer 3

decreased vital capacity
decreased residual volume
decreased PaO2
impaired ability to clear secretions
increased ventilation-perfusion mismatch

Question 4

MSK effects of immobilization

Answer 4

decreased strength
decreased girth
decreased efficiency of contractions
joint contractures
ulcers

Question 5

Metabolic system effects of immobilization:

Answer 5

hypercalcemia

osteoporosis

Question 6

CNS effects of immobilization:

Answer 6

emotional and behavioral disturbances

altered sensation

Question 7

Airway Clearance Techniques

Precautions for Postural Drainage Precautions:

Answer 7

pulmonary edema
hemoptysis
massive obesity
large pleural effusion
massive ascites

Question 8

Airway Clearance Techniques

Precautions for Postural Drainage Relative Contraindications:

Answer 8

increased intracranial pressure
hemodynamically unstable
recent esphageal anastomosis
recent spinal fusion or injury
recent head trauma
diaphragrmatic hernia
recent eye surgery

Question 9

Airway Clearance Techniques
Precautions for
Percussion & Vibration Precautions:

Answer 9

uncontrolled bronchospasm
osteoporosis
Rib fractures
metastatic cancer to ribs
tumor obstruction of airway
anxiety
conagulopathy
convulsive or seizure disorder
recent pacemaker placement

Question 10

Airway Clearance Techniques
Precautions for
Percussion & Vibration Relative Contraindications:

Answer 10

hemoptysis
untreated tension pneumothorax
platelet count below 20,000
unstable hemodynamic status
open wounds, burns in thoracic area
PE
subcutaneous emphysema
recent skin graft or flaps on thorax

Question 11

Pursed-lip breathing

Answer 11

Decreases patient’s symptoms of dyspnea

Slows RR

Question 12

Paced breathing

Answer 12

Volitional coordination of breathing during activity

Question 13

Inspiratory hold technique

Answer 13

Involves prolonged holding of breath at maximum inspiration

Question 14

Stacked breathing

Answer 14

Series of deep breaths that build on top of previous breath without expiration

Question 15

Diaphragmatic controlled breathing

Answer 15

Used to manage dyspnea, reduce atelectasis, increase oxygenation
Facilitating outward motion of abdominal wall while reducing upper rib cage motion during inspiration
Sniffing can be added to engage the diaphragm
Manual Cues

Question 16

Lateral costal breathing

Answer 16

Addresses rib cage mobility and intercostal muscles

Question 17

Upper chest inhibiting technique

Answer 17

Inhibiting the upper chest can help a patient recruit the diaphragm during inhalation
Used after implementation of other techniques

Question 18

Thoracic mobilization techniques

Answer 18

Simple thoracic mobilization techniques to increase the ability of the thorax to expand during breathing

Question 19

Counterrotation

Answer 19

Increases tidal volume and decreases respiratory rate by reducing neuromuscular tone and increasing thoracic mobility

Question 20

Butterfly

Answer 20

Upright version of counterrotation technique

If Patient has good motor control

Question 21

Indications for Mobilization

Answer 21

Alveolar hypoventilation
pulmonary consolidation
pulmonary infiltrates
inflammation of bronchioles and alveoli
pleural effusion
acute lung injury and pulmonary edema
systemic effects of immbolization

Question 22

Contraindications/Precautions to Exercise

Answer 22

untreated DVT
unstable vital signs
patient cannot follow commands
high ventilatory support

Question 23

Abnormal responses to exercise (per 1 MET):

Answer 23

HR increases more than 20-30 bpm above resting HR
HR decreases below resting HR
Systolic BP increases more than 20-30 above resting level
Systolic BP decreases more than 10 below resting, dizziness
ECG changes
O2 levels drop
SOB
color changes
diaphoresis
accessory mm use
agitation

Question 24

Stage 1 stable angina

Answer 24

initial perception of discomfort

Question 25

Stage 2 stable angina

Answer 25

increasing intensity of level 1 to other areas

Question 26

Stage 3 stable angina

Answer 26

relief is obtained only through cessation of activity

Question 27

Stage 4 stable angina

Answer 27

infarction pain

Question 28

Three factors contribute to noncompliance

Answer 28

barriers patients perceive, lack of positive feedback, perceived helplessness