Cardiopulm Interventions Flashcards
Metabolic acidosis treatment
bicarbonate infusion
Metabolic alkalosis treatment
saline infusion
meds
Respiratory acidosis treatment
supplemental O2
meds
Respiratory alkalosis treatment
rebreathing mask
General breathing exercises for obstructive diseases
-Pursed-lip
-Huffing
-Inspiratory mm training (better for chronic than for acute exacerbations).
General breathing exercises for restrictive diseases
Segmental breathing
Postural Drainage: indications
to clear secretions (atelectasis, pneumonia, COPD)
Postural Drainage: precautions
-Pulmonary edema.
-Hemoptysis.
-Massive obesity.
-Large pleural effusion.
-Massive ascites (abdominal distension).
Postural Drainage: contraindications
-Increased ICP.
-Hemodynamically unstable.
-Recent esophageal anastamosis.
-Recent spinal fusion or injury.
-Recent head trauma.
-Diaphragmatic hernia.
Postural Drainage: procedure & general rules
-Bronchus of involved segment perpendicular to floor.
-Bad lung UP.
-Maintain position 5-10 min, then clear secretions by coughing or suctioning.
Postural Drainage Position for Anterior Apical
Sitting
Recline backward
Postural Drainage Position for Posterior Apical
Sitting
Lean fowards
Postural Drainage Position for Anterior Upper Lobe
Supine
Pillows under knees
Postural Drainage Position for Posterior Upper Lobe (right)
Prone flat
Slightly side-lying to elevate R
Postural Drainage Position for Posterior Upper Lobe (left)
Prone fowlers
Postural Drainage Position for Middle Lobe (right)
Supine
FOB elevated 12in
1/4 turn to elevate R side
Postural Drainage Position for Lingula (left)
Supine
FOB elevated 12in
1/4 turn to elevate L side
Postural Drainage Position for Anterior Lower Lobe
Supine
FOB elevated 18in
Postural Drainage Position for Lateral Lower Lobe
Side-lying
FOB elevated 18in
Postural Drainage Position for Posterior Lower Lobe
Prone
FOB elevated 18in
Postural Drainage Position for Superior Lower Lobe
Prone
Pillows under pelvis
HRmax =
220 - age
HR reserve =
HRmax - HRrest
When do we terminate exercise based on vital signs?
-SBP >240
-DBP >110
-SBP decreases >20 from rest
-HR increases too rapidly
-HR fails to increase
-HR decreases with increasing intensity/duration
When do we terminate exercise based on signs/symptoms?
-Significant angina
-Severe leg claudication
-Excessive dyspnea
-Excessive fatigue
-Dizziness
-Pallor
-Cold sweats
-Ataxia
-New murmur
-Pulmonary rales
-Onset of 3rd heart sound
When do we terminate exercise based on EKG abnormalities?
-2nd or 3rd degree heart block.
-Bundle branch block.
-Acute ST changes.
Cardiac rehab phase 1 (Acute): timeline & general interventions
-Starts once medically stable & ends when d/c from acute care.
-Pt education.
-Monitor hemodynamics & EKG.
Cardiac rehab phase 2 (Subacute): timeline & general interventions
-Starts as early as 24hr after d/c, lasts up to 6wks.
-Aerobic 50-70% HRmax
Cardiac rehab phase 3 (Training): timeline & general interventions
-Indefinite duration.
-Aerobic 70-85% HRmax.
-Begin resistance training.
Cardiac rehab phase 4 (Conditioning): timeline & general interventions
-Up to 6-12mo.
-Focus on maintenance & prevention.
-For pts with high risk of MI or want to continue with supervised exercise.
Cardiac rehab phase 1 & 2 FITT
F: 2-3x/day.
I: 50-70% HRmax.
T: 10-15min (phase 1) or 30min (phase 2).
T: ADLs, supervised ambulation.
Cardiac rehab phase 3 FITT
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.
Cardiac rehab phase 4 FITT
F: 3-4x/wk.
I: 50-85% functional capacity.
T: 45min or more.
FITT guidelines for obesity
-At least 250-300min/wk.
-45-60min/day for >5days/wk.
-Initially 40-60% VO2.
-Progress to >60% VO2.
