Cardiac Surgery

Question 1

Patient selection for prehabilitation

Answer 1

Pre-frail or frail individual.
Older patients.
Individual who will undergo elective surgery..

Question 2

What to assess in preoperative phase

Answer 2

Risk for post operative pulmonary complications
Mobility status
Risk of sternal complications
Risks of falls

Question 3

Pre operative respiratory muscle training for cardiac surgery patients

Answer 3

Determine patients maximal inspiratory pressure with manometer or powerbreathe Device.
Then exercise at 30% of maximal inspiratory pressure with threshold device for +-15 minutes or sets of 10 slow controlled breathe with minute rest between sets.

Question 4

Aims of physiotherapy post cardiac surgery

Answer 4

Improve arterial oxygenation.
Improve lung volume.
Improve cough effort.
Reduce risk for or impact of post pulmonary complications.
Normalise mobility status.
Improve ROM.
Improve exercise tolerance.
Educate patient regarding precautions.

Question 5

Precautions and contraindications for intra aortic balloon pump (IABP)

Answer 5

Mobilise patient in bed.
If IABP is in situ, avoid active or passive hip flexion of applicable leg.
Once IABP is removed, avoid active and passive hip flexion for 6-8 hours after removal.

Question 6

Precautions and contraindications for turning cardiac surgery patients to side lying

Answer 6

Take care of lines, drains and etc
Teach patient to hug chest when turning.
Use log roll to turn.

Question 7

Home advice for cardiac surgery patients

Answer 7

If a clicking sound is heard from median sternum inform cardiothoracic surgeon immediately.
Increase in shortness of breath compared to d/c contact cardiologist.
Chest pain contact cardiologist.
Significant increase in weight over a 2 day contact cardiologist.