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Physical Conditions in Adults > Cardiopulmonary Disorders > Flashcards

Cardiopulmonary Disorders Flashcards

1
Q

What is the main organ of the circulatory system?

A

the heart

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2
Q

Where is the heart located?

A

middle chest, towards the left side

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3
Q

The heart is roughly the size of what?

A

a fist

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4
Q

What is the heart surrounded by?

A

pericardium

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5
Q

What is the pericardium?

A

fluid-filled sac

protects from trauma and infection

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6
Q

What are the 3 layers of the heart?

A
  • Epicardium: outermost layer
  • myocardium: muscle
  • endocardium: innermost layer w/ valves, vessels, chordae tendineae
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7
Q

What are the chordae tendineae?

A

attaches to valves and allows them to open and close

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8
Q

What is the general route of blood in the cardiopulmonary system?

A
  • oxygen-poor blood enters right side of heart from the body and goes out to lungs
  • oxygen-rich blood enters the left side of heart from the lungs and goes out to the body
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9
Q

What are the 3 sections of the pulmonary system?

A
  • Lung parenchyma
  • upper airway
  • lower airway/bronchial tree
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10
Q

What is housed in lung parenchyma

A
  • right lung (3 lobes)

- left lung (2 lobes)

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11
Q

What is housed in upper airway?

A
  • nose
  • pharynx
  • larynx
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12
Q

What is housed in the lower airway/bronchial tree?

A
  • trachea
  • bronchii
  • lungs
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13
Q

Where does O2 (gas) exchange occur?

A

alveoli

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14
Q

What happens in the upper airway when we breathe in air?

A

air is humidified and filtered

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15
Q

What happens in upper airway when we speak?

A

air passes through larynx, causing vocal chords to vibrate creating sound

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16
Q

What is the purpose of the epiglottis?

A
  • protective measure to flap over trachea when we are eating

- Flaps over pharynx to prevent aspiration into larynx and trachea

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17
Q

What happens during gas exchange at the alveoli?

A

CO2 is removed and blood is re-oxygenated

O2 crosses from alveoli to capillaries surrounding it via diffusion and binds with hemoglobin

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18
Q

What is the diaphragm doing as we breathe?

A
  • creates pressure between outside and inside to allow air entering lungs
  • moving down: creates negative pressure, so air moves into lungs
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19
Q

Which nerve is responsible for respiration?

A

vagus nerve (X)

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20
Q

Define ventilation

A

breathing (inspiration/expiration)

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21
Q

Why does ventilation occur?

A

occurs through pressure changes between the inside and outside of the body

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22
Q

What is the relationship between lung pressure and outside pressure?

A
  • outside pressure > lung pressure = inspiration

- lung pressure > outside pressure = expiration

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23
Q

What is respiratory rate and what is it a function of?

A

number of times chest rises and falls with each breath (inhaled and exhaled)

12-20 is normal range

function of ventilation

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24
Q

What is perfusion?

A

blood flow through pulmonary capillaries where O2 exchange occurs

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25
Q

What is the pulmonary defense system?

A
  • lungs exposed to many microorganisms
  • 1st line of defense = upper airway filters
  • other defense mechanisms: cough, mucous (acts like a trap), immune system (phagocytosis of unwanted intruders)
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26
Q

What is pulse rate, how is it taken, and what is the normal range?

A
  • # of beats / min
  • taken w/ radial artery
  • normal: 60-100 bpm
  • lower than 60: bradycardic
  • above 100: tachycardic
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27
Q

What is respiratory rate and what is the normal range?

A
  • # beats / min

- normal: 12-20 beats per minutes

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28
Q

What is blood pressure and how is it taken?

A
  • force of blood pushing against artery walls

- taken by flexing muscle and find bicep tendon, just medial is brachial artery where there is pulse

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29
Q

Define the 2 components of taking blood pressure and their averages?

A
  • Systolic: bp in arteries when heart is contracting (higher # - 1st heart beat is when pressure is released on bp cuff)
  • diastolic: pressure in arteries when heart relaxes
  • normal: 120/80 (systolic/diastolic)
  • hypertension: over 90 diastolic
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30
Q

What is O2 saturation and what is the normal range?

A
  • % measure of the amount of oxygen the blood is carrying
  • normal: 95 and above
  • below 90: dont treat unless orders from physician; suffer from pulmonary disease or cardiopulmonary disease
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31
Q

What are the systolic and diastolic ranges for prehypertension?

A

systolic: 120-130
diastolic: 80-89

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32
Q

What are the systolic and diastolic ranges for stage 1 high blood pressure?

A

systolic: 140-159
diastolic: 90-99

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33
Q

What are the systolic and diastolic ranges for stage 2 high blood pressure?

A

systolic: 160 or greater
diastolic: 100 or greater

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34
Q

What is the leading cause of death in men and women?

A

heart disease

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35
Q

What is the most common type of heart disease and why?

A

coronary artery (heart) disease b/c of obesity issue

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36
Q

What is seen in the arteries in coronary heart disease?

A

arteriosclerosis: hardening of arteries in the heart - plaque buildup

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37
Q

What are causes of coronary heart disease?

A

genetics and lifestyle

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38
Q

What are symptoms of coronary heart disease?

A

angina, shortness of breath, fatigue

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39
Q

What is an angioplasty?

A

helps with coronary artery disease

insert a balloon in artery through femoral artery

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40
Q

What are some treatment options for people with coronary artery disease?

A
  • lifestyle changes
  • lowering cholesterol- main mission
  • weight reduction
  • smoking cessation
  • medication (pharmaceuticals)
  • treatment in hospital: CABG or percutaneous coronary intervention (PCI) (aka angioplasty)
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41
Q

What is a CABG?

A

coronary artery bypass graft used to improve blood flow to heart

healthy vein/artery is connected to blocked artery

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42
Q

What can coronary artery disease lead to?

A

heart attack

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43
Q

What is the major determinate of impaired function and disability in coronary heart disease?

A

angina

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44
Q

How can functional impairment and disability be best determined?

A

based on medical history, physical exam, and exercise stress testing

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45
Q

How should the functional capacity of the individual with heart disease be described?

A

according to the classification of the New York Heart Association (NYHA)

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46
Q

What is the Class 1 functional capacity of an individual with heart disease?

A
  • mild
  • asymptomatic at ordinary effort level
  • no limitation of physical activity
  • symptoms with moderate effort
  • ordinary activity does NOT result in fatigue, rapid/irregular heartbeat (palpitation) or shortness of breath (dyspnea)
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47
Q

What is the Class 2 functional capacity of an individual with heart disease?

A
  • mild
  • symptomatic w/ ordinary effort (e.g out of breath walking up stairs)
  • slight limitation of physical activity; comfortable at rest
  • ordinary activity results in fatigue, rapid/irregular heartbeat (palpitation) or shortness of breath (dyspnea)
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48
Q

What is the Class 3 functional capacity of an individual with heart disease?

A
  • moderate
  • symptomatic with minimal effort (eg. out of breath rolling out of bed)
  • marked limitation of physical activity; comfortable at rest
  • less than ordinary activity results in fatigue, rapid/irregular heartbeat (palpitation) or shortness of breath (dyspnea)
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49
Q

What is the Class 4 functional capacity of an individual with heart disease?

A
  • severe
  • symptomatic at rest (no effort)
  • unable to carry out any physical activity w/o discomfort
  • symptoms of fatigue, rapid/irregular heartbeat (palpitation) or shortness of breath (dyspnea) present at rest
  • physical activity increases discomfort
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50
Q

In terms of coronary heart disease, what should be the main mission in all health care professionals?

A

primary prevention

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51
Q

What are some psychological and vocational implications of CHD/CAD

A
  • psychosocial stress response
  • depression
  • type A personality
  • denial
  • economic loss
  • reemployment: Rehab programs w/ multidisciplinary approach incorporating supervised exercise, education, nutritional and psychological counseling prove to be beneficial—improving psychological status and increasing rates of return to work.
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52
Q

What is progressive congestive heart failure (CHF)

A
  • heart becomes weak and cant pump blood efficiently
  • chambers of heart become enlarged and less efficient
  • blood backs up (congests) in venous system
  • tissues become overloaded (edematous)
  • may see swelling in lower legs
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53
Q

What are the risk factors for congestive heart failure?

A
  • hypertension
  • previous damage to heart tissues (ie. from MI)
  • valvular disease
  • congenital defects
  • stress
  • obesity
  • thyroid disease
  • cardiomyopathies
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54
Q

Most patients with CHF have a past medical history of what?

A

hypertension

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55
Q

What is the most common cause of congestive heart failure?

A

coronary artery disease

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56
Q

Does congestive heart failure have a good prognosis?

A

no

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57
Q

American Heart Association heart failure Stage A

A
  • at high risk for heart failure but w/o structural heart disease or symptoms of heart failure
  • ex. hypertension, diabetes mellitus, CAD (port-MI or revascularization), peripheral vascular disease, CVA family history, exposure to cardiac toxins
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58
Q

American Heart Association heart failure Stage B

A
  • has structural heart disease but w/o signs and symptoms of heart failure
  • prior MI, left ventricular hypertrophy or reduced LVEF, asymptomatic valvular disease
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59
Q

American Heart Association heart failure Stage C

A
  • has structural heart disease w/ prior or current symptoms of heart failure
  • known structural heart disease and dyspnea, fatigue, reduced exercise tolerance
  • NYHA class 1-4
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60
Q

American Heart Association heart failure Stage D

A
  • has refractory heart failure requiring specialized interventions
  • marked symptoms at rest despite maximal medical therapy, w/ recurrent hospitalizations
  • NYHA class 3-4
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61
Q

What is a myocardial infarction?

A

-heart attack: occluded blood flow causing heart muscle tissue to be without oxygen

62
Q

What is the leading cause of death in the US?

A

myocardial infarction

63
Q

What is the focus for medical interventions in myocardial infarctions?

A
  • limit damage to the heart
  • relieve pain
  • prevent clot formation
  • improve blood flow to injured tissue
64
Q

How long does it take for a heart muscle to heal after a MI?

A
  • 4-8 weeks (severity dependent)
65
Q

What are some risk factors for MI?

A
  • high BP
  • diabetes
  • smoking
  • sedentary lifestyle
  • excessive alcohol intake
66
Q

What are the symptoms of a MI?

A

chest pain, cold sweats, nausea/vomiting

67
Q

What is a protective factor for MI?

A

estrogen

68
Q

Do most people survive/recover to return to full active lives following MI?

A

yes

69
Q

What are some ways to manage MI?

A
  • aspirin
  • nitroglycerin
  • coronary angioplasty
  • smoking cessation
  • increase exercise
70
Q

What are the 2 types of MI?

A
  • STEMI MI

- NSTEMI MI

71
Q

What is a STEMI MI?

A
  • ST segment elevated MI
  • takes longer for heart to relax and repolarize
  • significant damage
  • affects all layers of the heart
72
Q

What is NSEMI MI?

A
  • non-ST elevated MI
  • less damage than STEMI
  • limited to 1-2 layers of the heart
73
Q

What are the determinants of extent of damage from MI?

A
  • location of occlusion
  • length of time of occlusion
  • presence of collateral circulation
74
Q

What is the max MET levels of early activity following acute MI?

A

should not exceed 1-2 MET levels

75
Q

What are the therapy contraindications for a MI?

A
  • Active signs and symptoms of MI
  • Active infection
  • Acute myocarditis or pericarditis
  • Digoxin toxicity
  • Uncontrolled arrhythmias
  • Severe CHF
  • Recent pulmonary embolism
  • Abnormal vital signs or blood counts*
76
Q

What are the ADLs, IADLs, work, play, and leisure at 1-2 MET level

A
  • ADLs: Eating seated, transfers bed->chair, washing face and hands, walking 1mph
  • IADLs/work/play/leisure: Hand sewing, machine sewing, sweeping floors, driving automatic car, drawing knitting
77
Q

What are the ADLs, IADLs, work, play, and leisure at 2-3 MET level

A
  • ADLs: Seated sponge bath, standing sponge bath, dressing and undressing, seated warm shower, walking 2-3 MPH, wheelchair propulsion 1.2 MPH
  • IADLs/work/play/leisure: Dusting, kneading dough, hand washing small items, using electric vacuum, preparing a meal, washing dishes, golfing
78
Q

What are the ADLs, IADLs, work, play, and leisure at 3-4 MET level

A
  • ADLs: Standing warm shower, BM on toilet, climbing stairs at 24 ft/min
  • IADLs/work/play/leisure: Making a bed, sweeping, mopping, gardening
79
Q

What are the ADLs, IADLs, work, play, and leisure at 4-5 MET level

A
  • ADLs: Hot shower, BM on bedpan, sexual intercourse

- IADLs/work/play/leisure: Changing bed linen, gardening, raking, weeding, roller skating, swimming 20 yards/min

80
Q

What are the ADLs, IADLs, work, play, and leisure at 5-6 MET level

A
  • ADLs: Sexual intercourse, walking up stairs 30 feet/min

- IADLs/work/play/leisure: Biking 10 mph on level ground

81
Q

What are the ADLs, IADLs, work, play, and leisure at 6-7 MET level

A
  • ADLs: Walking with braces and crutches
  • IADLs/work/play/leisure: Swimming breaststroke, skiing, playing basketball, walking 5 mph, shoveling snow, spading soil
82
Q

What is hypertension?

A
  • high bp

- persistently above 140/90

83
Q

What causes secondary hypertension?

A

coexisting condition

84
Q

In which population is hypertension most prevalent?

A

African American women

85
Q

What are the symptoms of hypertension?

A

asymptomatic

86
Q

What may be damage from hypertension?

A

kidneys

heart

87
Q

What may help control hypertension?

A
  • medications
  • lifestyle changes
  • diuretics
88
Q

What are arrhythmias?

A

Irregularity in rate/rhythm due to conduction disturbance

may be benign or serious

89
Q

What are the causes of arrhythmias?

A
  • Drug toxicity
  • Electrolyte imbalance
  • Heart disease, hypertension
  • Acid-base imbalance
  • Congenital defects
  • Connective tissue disorders (i.e. Marfan Syndrome)
90
Q

What initiates the heart’s electrical conduction and is considered the natural pacemaker of the heart?

A

SA node

91
Q

Where do impulses travel from the SA node?

A

to the AV node and ultimately the purkinje fibers of the ventricles

92
Q

Where do conduction problems that cause arrhythmias occur?

A

anywhere along route

93
Q

How are arrhythmias categorized?

A

by where problem originates, the rate, and the regularity

94
Q

What is asystole?

A

absence of any cardiac activity

results in death

95
Q

What is fibrillation?

A

uncoordinated, extremely rapid and irregular contraction of the atria or ventricles

96
Q

What is atrial fibrillation?

A

-one of the most common arrhythmias
-HR can be as high as 350-600 bpm
-Can be a chronic condition- treat w/ meds or shock to return normal rhythm
-If cleared for therapy:
Determine activity parameters/precautions, Monitor patient’s tolerance to activity, Modify treatment sessions prn

97
Q

What is atrial flutter?

A
  • rapid, irregular HR
  • Distinctive saw tooth pattern on EKG
  • Treated with medication and/or atrial pacing or cardioversion
  • Potential issue after cardiac surgery or MI
98
Q

What are premature ventricular contractions (PVCs)?

A
  • irregular rhythm but normal HR 60-100 bpm)

- may be triggered by stress, caffiene, smoking, digitalis toxicity, heart disease, MI

99
Q

What is ventricular tachycardia?

A
  • HR > 100 bpm
  • defer therapy (pt medically unstable)
  • can be caused by heart disease or acute MI
100
Q

What is ventricular fibrillation?

A
  • ventricle doesn’t contract, may just be fluttering

- serious condition that could lead to cardiac arrest or sudden cardiac death

101
Q

What are the normal HR at the SA node, AV node, and ventricular HR?

A
  • SA node: 60-100bpm
  • AV node: 40-60bpm
  • ventricular HR: 20-40bpm
102
Q

What are the HR ranges for supraventricular tachycardia, atrial flutter, and atrial fibrilation?

A
  • supraventricular tachycardia: 150-250bpm
  • atrial flutter: 250-350bpm
  • atrial fibrillation: >350 irregular bpm
103
Q

What is valvular disease?

A
  • Stenosis of the valves: Poor blood flow due to narrowing
  • Regurgitation occurs: Leakage (backflow) due to poor valve closure
  • Prolapse: Affects the mitral valve cusps (mitral valve prolapse); Leaflets bulge into the left atrium; Usually not problematic, but can lead to more serious issues such as regurgitation
104
Q

What are the causes of valvular disease?

A
  • Endocarditis: Bacterial infection of the endocardium and valves
  • Rheumatic Fever: affects connective tissues of body- can affect heart, joints. May start as strep throat. Usually happens in young kids- teen years
  • Congenital Heart Disease
  • Cardiomyopathy: Group of diseases of the myocardium
  • Aortic Root Dilation: Aneurysm
  • Atherosclerotic Heart Disease
  • Connective Tissue Disorders: Marfan Syndrome
105
Q

What may cause a risk for valvular disease causes?

A

heart conditions or risk factors like heart disease, high bp, smoking, obesity, diabetes, etc

106
Q

What kind of congenital heart defects are commonly seen?

A
  • atrial septal defect
  • coarctation of the aorta
  • patent ductus arteriosus (PDA)
  • transposition of the great arteries
  • tetralogy of fallot
107
Q

What is an atrial septal defect?

A
  • Opening in the septum between then left and right atrium
  • Associated with Down syndrome
  • May cause right side heart enlargement
  • Can also have ventricular septal defect
108
Q

What is coarctation of the aorta?

A
  • Narrowing of the aorta
  • Associated w/ aortic valve abnormalities
  • Associated w/ Turner Syndrome: aka gonadal disgenetis- includes several conditions in women in which theres an absence in an entire sex chromosome on the X chromosome
  • May limit blood flow to the extremities
109
Q

What can coarctation of the aorta lead to?

A

ventricular hypertrophy (enlargement-muscle thickens) and proximal aorta dilation

110
Q

What is patent ductus arteriosus (PDA)?

A
  • Ductus arteriosus normally closes after birth
  • In PDA, duct remains open
  • Allows continuous left to right flow of blood
111
Q

What can PDA lead to?

A

Can cause hypertrophy of the left ventricle, chronic pulmonary artery hypertension, or heart failure

112
Q

What is transposition of the great arteries?

A
  • aka cyanotic heart defect b/c of decrease blood pumping to rest of body
  • Symptoms: shortness of breath, blueish skin, clubbing of finger and toes
  • Risk factors: moms over 40, alcoholism, diabetes, viral illnesses during pregnancy
113
Q

What is tetralogy of fallot?

A
  • multiple defects (People are born with 4 heart defect)
    1. Pulmonary trunk too narrow and pulmonary valve (artery) stenosed results in:
    1. Hypertrophied right ventricle
    1. Ventricular septal defect
    1. Aorta opens from both ventricles
  • Right and left ventricles thicken
  • Baby is cyanotic within minutes of birth
  • Mix of oxygenated and unoxygenated blood
  • Can be corrected with surgery
114
Q

What is chronic obstructive pulmonary disease (COPD)?

A
  • Lung diseases characterized by airflow obstruction that interferes with normal breathing
  • Progressive; increased difficulty breathing
  • Most common: emphysema / chronic bronchitis
115
Q

What is the leading cause of COPD?

A

cigarette smoking

116
Q

Who does COPD affect the most?

A
  • chronic bronchitis affects aged 65 and older more often
  • both emphysema and chronic bronchitis are more common in women
  • more prevalent in smokers
117
Q

What are the symptoms of COPD?

A
  • chronic cough
  • dyspnea
  • wheezing
  • chest tightness
  • cyanosis
118
Q

How can COPD be managed?

A
  • spirometry test
  • lifestyle changes
  • CT scan
  • smoking cessation
  • inhalers
  • antibiotics
  • lung volume reduction surgery / transplant
119
Q

What is the most common pulmonary disease and the 3rd leading cause of death in the US?

A

COPD

120
Q

What is bronchiectasis?

A

a type of chronic obstructive lung disease

121
Q

What is used in a medical evaluation and disability assessment for COPD?

A
  • complete history

- chest x-ray and diagnostic including pulmonary function tests (PFTs)

122
Q

What is Global Initiative for Chronic Obstructive Lung Disease (GOLD)?

A

Classification of COPD severity

123
Q

What is the lung function and symptoms for each stage of the GOLD classification?

A
  • stage 1 (mild): FEV1 >80%; FEV1/FVC <0.7; symptoms: w/ or w/o cough, sputum
  • stage 2 (moderate): FEV1 50-80%; FEV1/FVC <0.7; symptoms: w/ or w/o cough, sputum, dyspnea
  • stage 3 (severe): FEV1 30-50%; FEV1/FVC <0.7; symptoms: w/ or w/o cough, sputum, dyspnea
  • stage 4 (very severe): FEV1 <30%; FEV1/FVC <0.7; symptoms: respiratory or right heart failure
124
Q

Describe dyspnea (shortness of breath) in terms of pulmonary disorder?

A
  • symptom

- Severely affects occupational performance, daily activities, quality of life

125
Q

Dyspnea grade scale

A
  • 0: degree-none; describes being breathless only w/ strenuous exercise
  • 1: degree-slight; describes shortness of breath when hurrying on level ground or walking up slight hill
  • 2: degree-moderate/mod severe; describes on level ground, walk slower then people of the same age b/c of SOB, or having to stop for breath when walking at own pace
  • 3: degree-severe; describes stopping for breath after walking ~100yds or after a few minutes on level ground
  • 4: degree- very severe; describes being too breathless to leave house or even dress.
126
Q

What is bronchitis COPD characterized by?

A
  • chronic cough
  • sputum production
  • hypoxia (the body or a region of the body is deprived of adequate oxygen supply at the tissue level.)
  • hypercapnic (elevated CO2)
  • patients look cyanotic
127
Q

What is emphysema COPD characterized by?

A
  • less cough and sputum production
  • less hypoxic
  • less hypercapnic
  • greater loss of alveoli (decreased elastic recoil of the lungs, resulting in greater hyperinflation
128
Q

What are some COPD intervention strategies?

A
  • pharmacological regime
  • may be on Oxygen therapy (do not make O₂ changes without medical consult!)
  • encourage pt. to receive influenza and pneumococcal vaccinations
  • chest PT
  • pulmonary rehabilitation
  • nutritional counseling
  • exercise
129
Q

What does pulmonary rehab assist with?

A
  • Fatigue
  • Anxiety
  • Breathing
  • Activity tolerance
  • Confidence
  • Independence
130
Q

What is an OTs overall goal in pulmonary rehab?

A
  • enable participation in all occupations
  • Patient-family education
  • Psychosocial support
  • Quality of life
131
Q

What types of goals may an OT develop for pulmonary rehab?

A
  • Patient education re disease process
  • Activity tolerance – graded activities
  • Occupation prioritizing
  • Instruction in dyspnea relief strategies
132
Q

What is cystic fibrosis?

A
  • Chromosome (gene) mutation, inherited
  • Body produces thick sticky mucus in the lungs and blocks pancreas which stops the body from properly absorbing food- malnourished, weaker immune system. May impact liver and cause cirrhosis
  • Avg. life expectancy 32 years
  • Results in airway dehydration
133
Q

What could airway dehydration cause in those with cystic fibrosis?

A
  • Produces thick mucous
  • Adheres to airway surfaces
  • Leads to infection, inflammation, obstruction
  • Multiple hospitalizations for exacerbation of symptoms very common
  • Multi organ system involvement
134
Q

What is cystic fibrosis characterized by?

A

recurrent respiratory tract infections and progressive respiratory insufficiency

135
Q

What does cystic fibrosis affect in cells?

A
  • the mechanism by which sodium and chloride pass out of cells, producing thick mucus secretions that obstructs passages
  • leads to infection and destruction of tissue and mucus clogging bronchioles
136
Q

What characterizes the functional disability aspect of cystic fibrosis?

A
  • Recurrent respiratory tract infection
  • chronic cough with wheezing
  • dyspnea
  • recurrent bronchitis, pneumonia, sinusitis, hemoptysis, and bronchiectasis
  • multiple organ involvement can lead to other issues
137
Q

What is the medical evaluation used for cystic fibrosis?

A

Sweat test: measures amount of salt in sweat and helps diagnose CF, people w/ CF have 2-5x more sodium in their sweat

138
Q

What is the treatment used for cystic fibrosis?

A

Chest physiotherapy / medication / exercise

139
Q

What is asthma characterized by?

A
  • marked reversibility of airway obstruction and bronchial hyperactivity
  • Allergic (extrinsic asthma)
  • Nonallergic (intrinsic) asthma
  • shortness of breath and wheezing, often accompanied by cough and mucus production
140
Q

Mechanisms of an asthma attack

A
  • Constriction of the bronchial smooth muscle lining the RT
  • Excessive mucous production plugs small airways obstructing airflow
  • severe attacks can lead to respiratory arrest
141
Q

Types of asthma

A

Reactive airways dysfunction syndrome (RADS)

irritant-induced asthma (IIA)

142
Q

What is recorded in a medical evaluation for asthma?

A
  • Complete history
  • Laboratory evaluation for cystic fibrosis (CF)
  • Psychological evaluation
  • PFTs
  • The AMA Guides to the Evaluation of Permanent Impairment 2008
143
Q

Treatments for asthma

A

Inhalers

Pills

OT: managing and working around it during ADLs

144
Q

Vocational Implications for asthma

A

Avoid irritants

Vocational modification or rehabilitation

145
Q

What are the 3 graft sites for a CABG

A

saphenous vein from leg

radial artery from the arm

internal mammary artery from the chest wall

146
Q

What is a bypass pump?

A
  • also called heart-lung machine
  • Does the work of the heart and the lungs when the heart is stopped for a surgical procedure to maintain blood circulation and oxygen content of the body
  • may be used in a CABG
147
Q

What does a CABG off-pump do?

A

Slows heart rate and surgeons developed ways to stabilize a beating heart

148
Q

Where are the CABG incisions located?

A
  • minimally invasive: 2-3in incision in chest wall between ribs
  • traditional CABG: 6-8in incision made down center of sternum
149
Q

Purpose of precautions following CABG

A
  • used to help protect sternum
  • to prevent the sternum from coming apart from an injury
  • prevent pain and bleeding
150
Q

Sternal precautions include..

A
  • Limit horizontal abduction/Limit bilateral arm extension
  • No lifting greater than 10lbs
  • Hold a pillow when moving, sneezing or coughing
151
Q

What are parameters vital signs?

A

MD may specify certain parameters for BP or HR during activity (IE no activity is BP is >180/100)

152
Q

How do you calculate how much 02 is left in an O2 tank?

A
  • Minutes remaining = PSIG x F/ LPM
  • PSIG = pounds per square inch gauge
  • F = factor
  • LPM = liters per min (Rx)

-So, if there’s 400 PSIG left in an E tank (.28 factor) and the patient is on 4 LPM
(400 * 0.28)/4= 28 minutes of O2 remaining in the tank

Physical Conditions in Adults (7 decks)

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