Acute Interventions for CardioPulm Conditions Flashcards
Functional Loss Factors
Acute inflammation Severity of illness Marginal baseline function Exposure to corticosteroids Neuromuscular blockers Prolonged immobilization Length of stay Acute cardiopulmonary conditions Acute cardiopulmonary dysfunction
Cardio Effects of immobilization:
increased basal HR decreased maximal HR decreased maximal O2 uptake orthostatic hypotension increased venous thrombosis decreased total blood volume dereased hemoglobin concentration
Respiratory effects of immobilization:
decreased vital capacity decreased residual volume decreased PaO2 impaired ability to clear secretions increased ventilation-perfusion mismatch
MSK effects of immobilization
decreased strength decreased girth decreased efficiency of contractions joint contractures ulcers
Metabolic system effects of immobilization:
hypercalcemia
osteoporosis
CNS effects of immobilization:
emotional and behavioral disturbances
altered sensation
Airway Clearance Techniques
Precautions for Postural Drainage Precautions:
pulmonary edema hemoptysis massive obesity large pleural effusion massive ascites
Airway Clearance Techniques
Precautions for Postural Drainage Relative Contraindications:
increased intracranial pressure hemodynamically unstable recent esphageal anastomosis recent spinal fusion or injury recent head trauma diaphragrmatic hernia recent eye surgery
Airway Clearance Techniques
Precautions for
Percussion & Vibration Precautions:
uncontrolled bronchospasm osteoporosis Rib fractures metastatic cancer to ribs tumor obstruction of airway anxiety conagulopathy convulsive or seizure disorder recent pacemaker placement
Airway Clearance Techniques
Precautions for
Percussion & Vibration Relative Contraindications:
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
Pursed-lip breathing
Decreases patient’s symptoms of dyspnea
Slows RR
Paced breathing
Volitional coordination of breathing during activity
Inspiratory hold technique
Involves prolonged holding of breath at maximum inspiration
Stacked breathing
Series of deep breaths that build on top of previous breath without expiration
Diaphragmatic controlled breathing
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
Lateral costal breathing
Addresses rib cage mobility and intercostal muscles
Upper chest inhibiting technique
Inhibiting the upper chest can help a patient recruit the diaphragm during inhalation
Used after implementation of other techniques
Thoracic mobilization techniques
Simple thoracic mobilization techniques to increase the ability of the thorax to expand during breathing
Counterrotation
Increases tidal volume and decreases respiratory rate by reducing neuromuscular tone and increasing thoracic mobility
Butterfly
Upright version of counterrotation technique
If Patient has good motor control
Indications for Mobilization
Alveolar hypoventilation pulmonary consolidation pulmonary infiltrates inflammation of bronchioles and alveoli pleural effusion acute lung injury and pulmonary edema systemic effects of immbolization
Contraindications/Precautions to Exercise
untreated DVT
unstable vital signs
patient cannot follow commands
high ventilatory support
Abnormal responses to exercise (per 1 MET):
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
Stage 1 stable angina
initial perception of discomfort
Stage 2 stable angina
increasing intensity of level 1 to other areas
Stage 3 stable angina
relief is obtained only through cessation of activity
Stage 4 stable angina
infarction pain
Three factors contribute to noncompliance
barriers patients perceive, lack of positive feedback, perceived helplessness
