Cardiopulm Interventions

Question 1

Metabolic acidosis treatment

Answer 1

bicarbonate infusion

Question 2

Metabolic alkalosis treatment

Answer 2

saline infusion
meds

Question 3

Respiratory acidosis treatment

Answer 3

supplemental O2
meds

Question 4

Respiratory alkalosis treatment

Answer 4

rebreathing mask

Question 5

General breathing exercises for obstructive diseases

Answer 5

-Pursed-lip
-Huffing
-Inspiratory mm training (better for chronic than for acute exacerbations).

Question 6

General breathing exercises for restrictive diseases

Answer 6

Segmental breathing

Question 7

Postural Drainage: indications

Answer 7

to clear secretions (atelectasis, pneumonia, COPD)

Question 8

Postural Drainage: precautions

Answer 8

-Pulmonary edema.
-Hemoptysis.
-Massive obesity.
-Large pleural effusion.
-Massive ascites (abdominal distension).

Question 9

Postural Drainage: contraindications

Answer 9

-Increased ICP.
-Hemodynamically unstable.
-Recent esophageal anastamosis.
-Recent spinal fusion or injury.
-Recent head trauma.
-Diaphragmatic hernia.

Question 10

Postural Drainage: procedure & general rules

Answer 10

-Bronchus of involved segment perpendicular to floor.
-Bad lung UP.
-Maintain position 5-10 min, then clear secretions by coughing or suctioning.

Question 11

Postural Drainage Position for Anterior Apical

Answer 11

Sitting
Recline backward

Question 12

Postural Drainage Position for Posterior Apical

Answer 12

Sitting
Lean fowards

Question 13

Postural Drainage Position for Anterior Upper Lobe

Answer 13

Supine
Pillows under knees

Question 14

Postural Drainage Position for Posterior Upper Lobe (right)

Answer 14

Prone flat
Slightly side-lying to elevate R

Question 15

Postural Drainage Position for Posterior Upper Lobe (left)

Answer 15

Prone fowlers

Question 16

Postural Drainage Position for Middle Lobe (right)

Answer 16

Supine
FOB elevated 12in
1/4 turn to elevate R side

Question 17

Postural Drainage Position for Lingula (left)

Answer 17

Supine
FOB elevated 12in
1/4 turn to elevate L side

Question 18

Postural Drainage Position for Anterior Lower Lobe

Answer 18

Supine
FOB elevated 18in

Question 19

Postural Drainage Position for Lateral Lower Lobe

Answer 19

Side-lying
FOB elevated 18in

Question 20

Postural Drainage Position for Posterior Lower Lobe

Answer 20

Prone
FOB elevated 18in

Question 21

Postural Drainage Position for Superior Lower Lobe

Answer 21

Prone
Pillows under pelvis

Question 22

HRmax =

Answer 22

220 - age

Question 23

HR reserve =

Answer 23

HRmax - HRrest

Question 24

When do we terminate exercise based on vital signs?

Answer 24

-SBP >240
-DBP >110
-SBP decreases >20 from rest
-HR increases too rapidly
-HR fails to increase
-HR decreases with increasing intensity/duration

Question 25

When do we terminate exercise based on signs/symptoms?

Answer 25

-Significant angina
-Severe leg claudication
-Excessive dyspnea
-Excessive fatigue
-Dizziness
-Pallor
-Cold sweats
-Ataxia
-New murmur
-Pulmonary rales
-Onset of 3rd heart sound

Question 26

When do we terminate exercise based on EKG abnormalities?

Answer 26

-2nd or 3rd degree heart block.
-Bundle branch block.
-Acute ST changes.

Question 27

Cardiac rehab phase 1 (Acute): timeline & general interventions

Answer 27

-Starts once medically stable & ends when d/c from acute care.
-Pt education.
-Monitor hemodynamics & EKG.

Question 28

Cardiac rehab phase 2 (Subacute): timeline & general interventions

Answer 28

-Starts as early as 24hr after d/c, lasts up to 6wks.
-Aerobic 50-70% HRmax

Question 29

Cardiac rehab phase 3 (Training): timeline & general interventions

Answer 29

-Indefinite duration.
-Aerobic 70-85% HRmax.
-Begin resistance training.

Question 30

Cardiac rehab phase 4 (Conditioning): timeline & general interventions

Answer 30

-Up to 6-12mo.
-Focus on maintenance & prevention.
-For pts with high risk of MI or want to continue with supervised exercise.

Question 31

Cardiac rehab phase 1 & 2 FITT

Answer 31

F: 2-3x/day.
I: 50-70% HRmax.
T: 10-15min (phase 1) or 30min (phase 2).
T: ADLs, supervised ambulation.

Question 32

Cardiac rehab phase 3 FITT

Answer 32

F: 2-3x/wk.
I: 70-85% HRmax.
T: 30-60min.
T: treadmill, cycle, ergometer.

Resistance Training:
-Bands or light hand weights.
-30-50% of 1RM.
-8-10 reps, progress to 12-15.
-Avoid UE while soft tissue still healing.

Question 33

Cardiac rehab phase 4 FITT

Answer 33

F: 3-4x/wk.
I: 50-85% functional capacity.
T: 45min or more.

Question 34

FITT guidelines for obesity

Answer 34

-At least 250-300min/wk.
-45-60min/day for >5days/wk.
-Initially 40-60% VO2.
-Progress to >60% VO2.