Cardiopulmonary Conditions Flashcards by Lindsey Novakovic

True or false: Cardiopulmonary conditions are a leading cause of death and disability in the United States.

True

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True or false: Many pulmonary conditions are genetic or environment based.

True

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What are 3 non-controllable factors or heart disease?

Age
Family history
Gender

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List at least 3 controllable factors of heart disease.

Smoking
Hyperlipidemia
Hypertension
Sedentary lifestyle
Obesity
Diabetes
Stress

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What type of heart disease is described below?

Blood and oxygen to the heart muscle are reduced because of a rupture in coronary artery blood vessel plaque or thrombus formation.

Myocardial infarction (heart attack)

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If a patient has suffered a myocardial infarction, early activity after acute MI should not exceed _________ METs, and should stay in the ________ MET range for a recommended home exercise program.

Early activity after acute MI should not exceed 1–2 METs; it should stay in the 2–4 MET range for a recommended home exercise program.

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What type of heart disease is described below?

Ischemic disease; commonly due to atherosclerosis which can narrow vessels over time and occlude blood supply to the heart muscle

Coronary artery disease (CAD)

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What type of heart disease is described below?

A complication of CAD; heart muscle constricts with increased activity demand, due to decreased blood supply, causing discomfort or pain in the chest or left shoulder, arms, neck, back or jaw; other symptoms that individuals may experience include shortness of breath, nausea, a fast or irregular heartbeat, diaphoresis (sweating), or a feeling similar to indigestion.

Angina pectoris

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What type of heart disease is described below?

Results from impaired structure and/or function of the ventricles; affects the heart’s ability to pump and leads to collection of fluid in the lungs or extremities.

Congestive heart failure

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Clients with ______ ventricular dysfunction may present with increased fatigue, shortness of breath, and pulmonary edema.

Left

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Clients with ______ ventricular dysfunction may present with peripheral and/or abdominal edema (swelling).

right

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True or false: congestive heart failure (CHF) has an acute onset.

FALSE

CHF may have an acute onset OR progress slowly and become chronic.

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What type of heart disease is described below?

Heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction. Usually exhibit inappropriate ventricular hypertrophy or dilation. Result from a variety of causes that frequently are genetic.

Cardiomyopathies

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What type of heart disease is described below?

Narrowing of the arteries to limbs and pelvis but not to the heart. Common symptom: intermittent claudication (cramping and pain when walking); could lead to cold extremities, occasional numbness and tingling of lower extremity, absence of hair, painful ulcers on pressure points, and claudication. Can lead to gangrene and amputation if untreated
Vacuum assisted closure (VAC), wound vac, or negative pressure wound therapy are used for managing acute and chronic wounds.

Peripheral artery disease (PAD)

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What type of heart disease is described below?

Bacterial infection in the endocardium and heart valves. Symptoms include fever; fatigue; dyspnea; weight loss; night sweats; joint pain; numbness in arms/legs; heart murmurs; and splenic, renal, cerebral, or pulmonary infarctions.

Endocarditis

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What type of heart disease is described below?

Inflammation of the myocardium or heart muscle secondary to viral, bacterial, parasitis, or fungal infection. Associated with immunosuppression, allergic reactions, exposure to certain chemicals and systemic diseases.

Myocarditis

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What type of heart disease is described below?

Inflammation of pericardium. Secondary to heart attack, open heart surgery, immunologic conditions, uremia, kidney failure, or infection.

Pericarditis

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What type of heart disease is described below?

Results from increased pericardial effusion.

Cardiac tamponade

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Sternal precautions are common in open heart surgery. What are sternal precautions?

–Do not lift more than 8 pounds
–Do not push or pull with arms when getting into and out of bed or to stand from a chair
–Do not raise elbows above shoulders
–Do not twist or bend deeply
–Hug a pillow when coughing or sneezing
–Do not drive until cleared by surgeon

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What type of heart device is described below?

Used for inpatient clients with end-stage heart failure as a bridge to transplantation or as destination therapy for those who are not candidates for heart transplantation.

VAD: mechanical device that assists the ventricles’ normal pumping action

What type of heart device is described below?

Catheter with an attached balloon threaded through femoral artery and into aorta. During diastole, balloon inflates; just before systole, balloon deflates, decreasing afterload and increasing ejection fraction and cardiac input.

IABP: intra-aortic balloon pump used to augment low cardiac output.

Which of the following devices has the following precautions?

No vigorous activity for first few weeks, no lifting of more than 10 pounds, no shoulder flexion or abduction greater than 90° of upper extremity on side where device is implanted.

A. VAD
B. IABP
C. Pacemaker

C. Pacemaker

What key area can occupational therapy support clients with heart disease in?

Lifestyle changes (e.g., sedentary–>active, managing stress)

Blood clots that form in the deep veins of the arm, leg, or groin (most commonly in the leg) are called…

Deep vein thrombosis

Symptoms: pain, swelling, redness, warmth, and tenderness

Blood clots that form in the superficial veins of the arm, leg, or groin are called...

**Superficial thrombophlebitis** *Symptoms*: pain, swelling, redness, warmth, and tenderness *Treatment* may include warm, moist compresses; medication for pain or inflammation; antibiotics; support stockings; and surgery to prevent progression to deep veins. **These usually do NOT lead to pulmonary embolism**.

This condition results from a hemorrhage, edema, or both within a closed compartment, external compression, or arterial occlusion that occurs before postischemic reperfusion. Symptoms including pain, swelling, loss of voluntary movement of the involved muscles, sensory changes, and paresthesia. What condition is this?

**Compartment syndrome** *Treatment*: fasciotomy, rest, ice, and nonsteroidal anti-inflammatory drugs.

This condition is caused by a DVT that breaks loose and flows through the venous system toward the pulmonary arterial circulation. It Lodges in the lungs and blocks blood flow from the right side of the heart to the lungs. What is it?

**Pulmonary embolism** *Symptoms*: sudden dyspnea, tachycardia, tachypnea, chest pain, syncope, cyanosis, sweats and low-grade fever *Most frequent treatment*: intravenous heparin; additional treatment includes vena cava filter.

This condition is tissue death or necrosis caused by an interruption or absent blood supply to an organ or tissue.

**Gangrene** *Symptoms*: blue or black discoloration of skin, severe pain, numbness, and foul-smelling discharge *Treatment*: IV antibiotics, surgery, amputation, hyperbaric oxygen, pain meds.

This condition develops when vascular changes occur as a result of interruption of blood flow to the digits resulting from vasospastic attacks.

**Raynaud's Syndrome** *Symptoms*: color changes of the digits from white to blue to red, sensory changes *Treatment*: vasodilators, calcium channel blockers.

The 4 main goals of cardiac rehabilitation are to...

1. Prevent muscle loss from immobility 2. monitor and assess client’s functional ability 3. educate and guide client in appropriate home program 4. educate client about individualized risk factors and intervene to minimize risks

In addition to assessing ADLs/IADLs and ROM, occupational therapy intervention areas in cardiac rehabilitation include... (name 3)

--Facilitate **early mobility**. --Provide **education** on integrating **postsurgical precautions**. --Introduce **energy conservation** techniques and recommendations to modify tasks (e.g., adjusting body mechanics) to minimize fatigue and work of breathing. --**Modify the environment or introduce adaptive equipment** to maximize functional independence (e.g., dressing equipment such as a long-handled shoe horn or sock aid). --Introduce an **exercise routine with recommendations for progression while closely monitoring vitals**. Also identify considerations for home program, based on individual needs and discharge disposition. --Facilitate **return to IADLs**; individualize recommendations for modifications. --Provide **education on signs and symptoms of exercise intolerance, risk factors** including smoking, and medication management. --**Address stress and anxiety management** (e.g., introduce relaxation methods, lifestyle balance)

During Phase 1 of inpatient cardiac rehabilitation, occupational therapy should monitor heart rate, blood pressure, EKG response, and symptoms before, during, and after activity. You are working with a patient who has a sudden decrease in blood pressure that occurs when a patient transitions from supine to upright. What do you suspect occurred?

Orthostatic (postural) hypotension

During Phase 1 of inpatient cardiac rehabilitation, occupational therapy should monitor heart rate, blood pressure, EKG response, and symptoms before, during, and after activity. You are working with a patient whose blood pressure drops when transitioning from lying down to standing after eating. You've seen this same thing happen with another older adult client with high blood pressure. What do you suspect is occurring?

Postprandial orthostatic hypotension

During Phase 1 of inpatient cardiac rehabilitation, occupational therapy should monitor heart rate, blood pressure, EKG response, and symptoms before, during, and after activity. You are working with a patient who experiences a drop in blood pressure after standing for an extended period. You have seen this same occurrence affect other adolescents. What do you suspect is occurring?

Neutrally mediated hypotension

Match the activity with the MET. 1. ______ Usually associated with sitting, strolling, dressing, etc. 2. ______ Usually associated with housework, yardwork, brisk walking, etc. 3. ______ Usually associated with running, bicycling, shoveling, etc. A. Vigorous METs (>6) B. Light METs (<3) C. Moderate METs (3–6)

1. **B. Light METs (<3) ** Usually associated with sitting, strolling, dressing, etc. 2. **C. Moderate METs (3–6)** Usually associated with housework, yardwork, brisk walking, etc. 3. **A. Vigorous METs (>6)** Usually associated with running, bicycling, shoveling, etc.

During Phase 2 of outpatient cardiac rehabilitation, how early can OT introduce weight training if symptoms are controlled?

2-4 weeks

What pulmonary condition is described below? *A condition with damage to the alveolar wall and inflammation of the conducting airways*

Chronic obstructive pulmonary disease (COPD)

What pulmonary condition is described below? *A condition in which alveoli rupture or enlarge, lungs lose elasticity*

Emphysema

What pulmonary condition is described below? *Long-term inflammation of the bronchioles with dyspnea*

Chronic bronchitis

What pulmonary condition is described below? *Acute life-threatening inflammatory reaction to illness or trauma; causes injury to the lungs and fluid to build up*

Acute respiratory distress syndrome (ARDS)

What pulmonary condition is described below? *A group of disorders that causes scarring of the pulmonary interstitium; sarcoidosis is the most common of these*

Interstitial lung disease (ILD)

What pulmonary condition is described below? *A chronic autosomal disease affecting exocrine glands*

Cystic fibrosis

What pulmonary condition is described below? *A condition marked by recurrent periods of breathing cessation for at least 10 seconds*

Obstructive sleep apnea

What pulmonary condition is described below? *The inflammation of the lung tissue*

Pneumonia

Dyspnea, deconditioning, sputum production, and cough are symptoms of pulmonary conditions. Name at least 2 more symptoms of pulmonary conditions.

Fatigue Decreased nutrition Anxiety Depression

What are 4 common risk factors for pulmonary conditions?

Smoking Air pollution Chemical exposure Dust

Antiinflammatory agents and bronchodilators (inhaler) are common treatments for pulmonary conditions. What are 2 other treatments?

Expectorants (e.g., iodides) Oxygen therapy

Beside education, what are the 3 main goals of pulmonary rehabilitation?

Build strength Build endurance Build mobility in ADLs/IADLs

In addition to managing stress, what is one of the most important strategies to educate individuals with pulmonary conditions on?

Rest breaks/energy conservation