Cardiopulmonary Conditions + OT Interventions Flashcards
1
Q
Heart disease diagnoses
A
- Myocardial Infarction (heart attack)
- Coronary artery disease and angina pectoris (chest pains)
- Congestive heart failure
- Cardiomyopathies
2
Q
Heart disease treatment
A
-Surgery
=Open heart surgery: types include coronary artery bypass graft (CABG) and valve replacement
=Angioplasty
=Atherectomy
-Medication
-Lifestyle changes
3
Q
Cardiac rehabilitation Phase 1
A
Inpatient hospitalization or rehab: Phase 1 of Occupational Therapy Interventions
- Up to ~5-14 days
- Monitoring of electrocardiogram (ECG), blood pressure (BP), an pulse
- Clinical pathway: checklist of therapy treatment for a particular diagnosis; variances from the list are recorded
- Progression of ADLs and activity according to metabolic equivalent (MET) levels
- Monitoring of symptoms of activity tolerance
- Development of a home program describing activity guidelines, pacing and simplification of activities, temperature precautions, social and sexual activity guidelines, risk factors, and symptoms of activity intolerance
4
Q
Cardiac rehabilitation Phase 2
A
Outpatient: Phase 2 of OT Intervention
- Up to 12 weeks post-cardiac event
- Occupational therapy 3 days a week for 4-8 weeks
- Exercise and activity to tolerance with progression of MET levels
- Weight training at 2-4 weeks if symptoms are controlled
- Education in risk factors modification
- Evaluation for psychosocial issues and referral if indicated
- Word hardening if indicated (work hardening = program to help patient return to pre-injury work level)
5
Q
Cardiac rehabilitation Phase 3
A
Community: Phase 3 of OT Intervention
- Physician referral
- Stress test
- Continuation of phase 2 activities and progress as tolerated, with less therapy supervision and in community settings
6
Q
Respiratory condition diagnoses
A
- Chronic obstructive pulmonary disease: condition with damage to the alveolar wall and inflammation of the conducting airways
- Emphysema: condition in which alveoli rupture or enlarge, lungs lose elasticity
- Chronic bronchitis: long-term inflammation of the bronchioles with dyspnea (labored breathing)
7
Q
Respiratory conditions symptoms
A
Symptoms: Dyspnea, fatigue, cough, sputum production, decreased nutrition, anxiety, depression
8
Q
Respiratory conditions OT evaluation
A
- ADL assessment, noting ROM, muscle strength, sensation, cognition, and psychosocial status
- Monitoring of heart rate, blood pressure, and oxygen saturation
- Daily activity interview
- Evaluation of the need for adaptive equipment
9
Q
Respiratory condiitons OT Interventions
A
- Pulmonary rehabilitation medical team including physician, nurse, occupational therapist, physical therapist, respiratory therapist, dietitian, pharmacist
- ADL training, administration of oxygen if Oxygen saturation goes below 90%, bathing and dress of one extremity at a time, frequent rest breaks
- Education of client to use pursed lip and diaphragmatic breathing during activity and to lean forearms on thighs and practice breathing to decrease anxiety and panic and shortness of breath
- Upper-extremity strengthening: weights, elastic bands, arm ergometer (arm bike)
- Adaptation of community activities to foster increased participation
- Training on stress management and relaxation techniques
- Instruction on work simplification and energy conservation techniques
- Training to increase functional endurance
10
Q
Coronary artery disease and angina pectoris (chest pains) OT intervention
A
OT INTERVENTION: STERNAL PRECAUTIONS AND HOME PROGRAM GUIDELINES
11
Q
Stage I
A
- 0-1.4 Sitting
- ADLs: Self-feeding, wash hands and face
- Mobility: bed mobility, transfers
- Leisure & IADLs: table games, reading/kindle, radio/podcasts, light handwork
- Exercise: all extremities in supine, neck & lower extremities seated
12
Q
Stage II
A
- 4-2.0 Sitting
- ADLs: Seated shaving & grooming, seated sponge bath, dressing
- Mobility: unlimited sitting, slow ambulation (in room as tolerated)
- Leisure and IADLs: seated crafts, painting, sewing, knitting
- Exercise: seated exercises to all extremities, NO ISOMETRICS (contractions of muscle groups w/ no change in length and joint movements)
13
Q
Stage III
A
- 0-3.0 Sitting to Standing (client can stand briefly for light items and activities)
- ADLs: Seated showering in warm water
- Mobility: wheelchair mobility, brief standing, walking limited distance ~2 mph
- Leisure and IADLs: begin very light chores tasks such as folding clothes, piano/typing, card playing
- Exercise: light stationary biking, progressive ambulation on 0% grade/incline
14
Q
Stage IV
A
- 0-3.5 Standing
- ADLs: same as stage III but in standing, including standing warm shower
- Mobility: unlimited walking ~3mph, <2 flights of stairs
- Leisure and IADLs: Light chores - vacuuming, dusting, sweeping, laundry, light gardening, home management, driving. Slow canoeing, candlepin bowling, golf putting
- Exercise: mild resistance, treadmill, cycling ~6mph
(at 3.5, the client can discharge from Phase 1 of cardiac rehab from inpatient to outpatient. Driving and outdoor leisure can resume)
15
Q
Stage V
A
- 5-4.0 Standing
- Mobility: walk ~3.5 mph, cycle ~8 mph, stairs as tolerated
- Leisure and IADLs: medium chores - washing dishes, washing clothes, ironing, hanging clothes, making beds, home repair and home management, golfing with bag cart, slow swimming
- Exercise: increased extremity repetitions in standing, 7-10 lbs seated weights, 2-4% grade on treadmill
