cardiac & pulmonary Flashcards
bradyarrhythmia
- Abnormally slow heart rate <60 bpm
- Medical interventions: pacemaker
Tachydysrhythmia
- Abnormally fast heart rate > 100 bpm
- Common in children
- Can lead to congestive heart failure
- Presents as irritability, poor eating habits, pallor (pale)
what MET level is at phase 1 of cardiac rehab?
MET level 1-2
what MET level is at phase 2 of cardiac rehab?
MET levels 4-5
what type of therapy is phase 3 of cardiac rehab?
maintenance- not covered by medicare
what occurs in phase 1 of cardiac rehab?
inpatient rehab
- monitor vitals
- clinical pathway checklist for some dx
- progress ADLs according to MET levels
- monitor for activity intolerance
- HEP: guidelines, pacing, activity simplification, temperature precautions, social/sex guidelines, risk factors, symptoms of activity intolerance
- energy conservation, work simplification
what occurs in phase 2 of cardiac rehab?
outpatient rehab
- progress with activity according to METs
- weight training 2-4 weeks if symptoms controlled
- educate in risk factor modification, psychosocial issues/referral if needed
- work hardening
how often are OT services in phase 2 rehab?
3x per week for 4-8 weeks
what occurs in phase 3 of cardiac rehab?
- maintenance, in community settings
- physician referral
- stress test
- continue phase 2 activities, progres as tolerated
- less therapy supervision
erythrocytosis
too many RBCs & WBCs (transient leukemia)
transient leukemia
too many WBCs
- in down syndrome children
hemophilia
blood disorder, hereditary
- males
- absence of one of clotting proteins
- excessive or spontaneous bleeding/bruising without known cause, nose bleeds
mild hemophilia
bleeding after trauma/injury (not otherwise)
moderate hemophilia
bleeding after minor injuries
severe hemophilia
bleeding after injury of without cause
- may affect muscles/joints
anemia
iron deficiency in the blood
- diet of iron rich food
- indicates lead poisoning, vitamin deficiency, leukemia, sickle cell disease
sickle cell anemia
- form of anemia, abnormal shaped RBCs
- mostly African Americans
- risk of organ damage, have pain (do intervention for pain management)
bronchopulmonary dysplasia
- due to prolonged mechanical ventilation for acute respiratory problems
- thick airway, excess mucus, restricted alveolar growth
- risk of respiratory infections/problems
respiratory distress syndrome/hyaline membrane disease
- premature infants (mother tx with steroids before delivery to stimulate surfactant)
- low surfactant (at 34th week gestation)
- compromised O2 absorption, CO2 elimination
- chronic lung problems (collapse after each breath)
- mild case = supplemental O2 or with positive airways pressure (O2 + air) in nose
- severe case: intubation, O2 + air by ventilator under positive end-expiratory pressure (PEEP)
asthma
bronchial smooth muscle hyperreactivity
- causes airway constriction in lower respiratory tract, difficulty breathing, wheezing
- 1st symptom before 5 yo
- triggered by allergens, smoke, cold air, exercise, inhaling irritants
intervention for asthma
- reduce irritant exposure
- self management strategies (pacing, stress management)
- structured peer group activities to reduce social isolation
- breathing exercises (controlled/counted breathing) to manage attacks
- stretching
controlled breathing
counted breathing
- technique for increasing O2 body needs during stress, focuses attention on breathing (puts other thoughts/worries aside briefly)
pursed lip breathing
- controls oxygenation and ventilation
- inspire through the nose and exhale through the mouth at a slow controlled flow
- Breathe in through your nose, almost like you’re smelling something, for about two seconds. Use your abdominal muscles to help fill your lungs with air.
- Pucker your lips as if you’re about to blow out a candle and then breathe out slowly through your mouth. Breathe out twice as long as when you inhaled. Make a quiet hissing sound as you exhale.
eupnea
normal quiet breathing that requires contraction of the diaphragm and external intercostal muscles
deep breathing/belly breathing
- Sit or stand in a comfortable position, with your elbows positioned slightly back. This position allows your chest to expand more fully.
- Take a deep breath and hold it for as long as you can.
- Let the air out and then cough strongly.
- Repeat these steps up to 10 times every hour.
costal breathing
shallow breathing
- requires contraction of the intercostal muscles
hyperpnea
forced breathing
- requires muscle contractions during both inspiration and expiration such as contraction of the diaphragm, intercostal muscles, and accessory muscles
- occurs normally after exercise or abnormally with fever or various disorders
diaphragmatic breathing
- Lie on a flat surface. Make sure you support your head and bend your knees.
- Place one hand just below your ribs and the other in the middle of your chest over your breastbone.
- Breathe in slowly and deeply through your nose.
- Tighten the muscles just below your ribs and breathe out slowly through pursed lips. Tip: Use the hand you placed below your ribs to gently push in and up while you tighten your muscles.
- Repeat
breathing techniques for COPD
diaphragmatic, deep, pursed lip breathing
cystic fibrosis
- degenerative condition, chromosome 7
- mucus-producting glands malfunction
- produce thick, viscous, water-lacking secretions
- small intestine blockage (ab distension), salty-tasting skin (high sodium levels), greasy foul-smelling stools (pancreatic insufficiency, vitamin absorption issues)
most serious complications of CF
chronic pulmonary disease
- chronic cough, wheezing, lower respiratory infections
- exercise intolerance
- poor nutrition due to malabsorption (developmental delays)
intervention for CF
- educate about disease progression
- energy conservation
- techniques for affective breathing (belly breathing)
COPD
- alveolar wall damage
- airway inflammation
- dyspnea, fatigue, cough, septum production, decreased nutrition, anxiety, depression
emphysema
- alveoli rupture/enlarge
- lungs lose elasticity
- dyspnea, fatigue, cough, septum production, decreased nutrition, anxiety, depression
chronic bronchitis
- long term inflammation of bronchioles with dyspnea
- dyspnea, fatigue, cough, septum production, decreased nutrition, anxiety, depression
how to handle fatigue for COPD, emphysema, chronic bronchitis
- bathe/dress 1 extremity at a time
- frequent rest breaks, work simplification, energy conservation
- pursed lip & diaphragmatic breathing
- lean FAs on thighs & practice breathing to decrease anxiety, panic, SOB
when should O2 be administered?
when below 90%
BORG RPE scale light activities
6-7 = very very light
8-9 = very light
10-11 = fairly light
BORG RPE scale medium activities
target range: how you should feel with exercise/activity
12-13 = somewhat hard
14-15 = hard
BORG RPE scale hard activities
17 = very hard
18-19 = very very hard
20 = max exertion
