Cardiopulmonary Rehab & GI System & Ca Flashcards
MET
Metabolic Equivalent of Task (MET) > physiological measure expressing the energy cost of physical activities; Must take into consideration phys status, act patterns, reported exertion level
Energy conservation & work simplification techs
Pacing, monitor body position, organization of daily activities and work areas, delegate responsibilities
Abdominal diaphragmatic breathing & PLB
Strengthen diaphragm, decreases need to use neck/shoulder muscles, decreased energy required for activity & controls resp rate/helps remove trapped air from lungs
Absolute Contraindications for Cardiac Rehab
Acute MI (w/in 2 days), unstable angina, uncontrolled cardiac arrhythmia, acute PE or pulmonary infarction, acute pericaditis/myocarditis or acute aortic dissection
Relative Contraindications for Cardiac Rehab
L main coronary stenosis, mod stenotic valvular heart disease, electrolyte abnorm, severe arterial HTN, tachyarrhythmias or bradyarrhythmias, hypertophic cardiomyopathy/other outflow occlusions, mental/phys impairment leading to inability to exercise adequately or high-degree atrioventricular block
CAB
Compressions - Airway - Breathing; exception is newborn babies (30:2)
CF
Gentically inherited autosmal recessive trait - both parents must be carriers. Life span 30s-40s and sometimes more.
CF Eval
Assess for developmental delays related to decreased strength & endurance & decreased attn d/t pain. Assess environment w adaptions for energy conservation. Assess psychological status.
CF Tx
Energy conservation, environmental adaptations, position to promo postural drainage, NDT to improve endurance/postural stability, facilitation of fine, gross, visual, cog and psychosoc development, parent edu including advocacy skills, tx protocols & teacher edu including energy con techs, encourage phys act, playground precautions, observe medical precautions
RDS
Resp Distress Syndrome. D/t premature birth. Characterized by insuff production of surfactant to keep alveoli (lung air pockets) open > lungs collapse after each breath
RDS Tx
Monitor development, facilitate sensori-motor/cog development, address psychosco issues, parent edu regarding handling, positioning, energy con & methods to facilitate norm development, adapt environment as needed, observe medical precautions, referral as necessary
Bronchopulmonary Dysplasia (enlargement of organ)
Resp dx often as a result of barotrauma: High inflating pressures, infection, meconium aspiration, asphyxia. Complication of prematurity. Walls of immature lungs thicken, making exchange of O and CO2 more difficult. Mucus lining & airway diameter reduced > months/years of O therapy and artificial ventilation
Bronchopulmonary Dysplasia Tx
facilitate sensori-motor/cog development, address psychosco issues, parent edu regarding feeding, positioning, energy con & adapt environment as needed, observe medical precautions
Praxis Deficits of Gastrointestinal System
Inability to effectively chew & coordinate tongue mvmts to propel bolus to base of tongue, residual food centrally located in oral cavity, diff w bolus formation
Sensory Impairments of Oral Cavity
Lack of awareness of residual food > pocketing food & spillage into airway when vocal cords are open > choking
Weakness of Tongue/Base of Tongue Structures
Insufficient propulsion of bolus to pass base of tongue into pharyngeal cavity; Lack of closure at cricopharyngeal junction > interference w normal timing of swallowing sequence
Vocal Cord Paralysis
Insufficient closure of vocal folds during pharyngeal phase of swallow > if vocal cord fail to meet/close to protect airway, aspiration could occur
Diminished Esophageal Motility (muscle contraction to move food)
Bolus sits in esophagus and can slowly either move toward stomach or upward to pharynx > person feels food is stuck in esophagus or aspirates when food propels upward
Bedside Swallow Eval
Assess level of alertness, ability to follow instructions, level of awareness of impairment and orientation to activity. Assess sensory/motor components of swallowing. Assess ability to manage own secretions (hearing and clinical observation)
Modified Barium Swallow (MBS)
In diagnostic radiology suite (swallow team and radiologist). Pt seated upright - must have adequate balance, supervised at all times. Trial boluses admin laced with barium of puree, thick, solid and thin. Video records moving xray of swallow; if aspirates=test ceases
Flexible Endoscopic Esophageal Swallow (FEES)
May be done at beside or in office. Food consistencies laced w green food coloring. Flexible endoscopic catheter containing mini video camera passed thru nasal into pharyngeal cavity.
Tx for Gastrointestinal Dx
Provide fam-centered intervention to determine acceptable dinner table interactions. Work w person toward developing new roles/occs to transition from old. Provide ongoing edu/info to fam regarding pt feeding/nutrition. Pyschosoc intervention
Gastric Esophageal Reflex Disease (GERD)
Involves lower esophageal/gastric sphincter. Food enters stomach and mixes w stomach acid/digestive juices. Lower esophageal sphincter closes insuff; stomach contraction propels acid/acidic bolus into esophagus >heartburn, indigestion or mild chest pain. Other symptoms: regurgitating, feeling somethings stuck in throat
GERD Tx
Test: MBS or Flexible endoscopy. Sleeping w more than 1 pillow for elevation. Drug therapy. Diet mods w less spices, smaller/frequent meals & lower alcohol intake. Stress mngt.
Neurogenic Bowel
Sympathetic nerve impairment, generally occurring in pts who have SCI above T-6 level; loss of control of anal sphincter/flaccidity > incontinence. Autonomic dysreflexia can result!
Risk Factors of Kidney Disease
DM, HTN, Lupus
Tx for Kidney Disease
Prevention & early intervention. Control of HTN/DM, diet, meds, exercise, stress reduction & smoking cessation.
Impact of Renal Disease on Client Factors
Motor dysfunction including fatigue, pain, weakness, edema; Nuropathy; Vision loss; Cog dysfunction including delusions/dementia; Anxiety, depression, mood/adjustment d/o
Stress Incontinence
Local damage to bladder sphincter associated w aftereffects of bearing children, morbid obesity, weakening of accessory musculature associated w norm aging
Tx for Stress Incontinence
Kegels to strengthen pelvic floor, time emptying routines, incont. support garments, meds, potentially e-stim
Stage 1 Cancer
Tumor present, no perceived spread of disease; Lesion operable; Prognosis good > not in lymph nodes/no metastatic lesions
Stage 2 Cancer
Localized spread of turmor; Lesion is operable/removed w margins; Spread is limited & usually responds well to tx (5yr survival rate=50%)
Stage 3 Cancer
Extensive evidence of prim tumor that has spread to other organs; Tumor can be surgically debulked but some cells may remain; Deeper spread of the tumor cells in lymphatics (5yr survival rate=20%)
Stage 4 Cancer
Inoperable prim lesion; Survival rate is dependent on depth/extent of tumor spread as well as tumor response tx (Multiple metastases)
Pre-op Ca Tx
Fx’al assessments and prep for post op phase/care; Pt/fam edu on recovery/follow up care
Post-op Ca Tx
Tx planning based on pt med status and blood level guidelines. Post-op precautions. Hemo levels: Adult males: 14-18 gm/dl - Adult women: 12-16 gm/dl - Elder men: 12.4-14.9 gm/dl - Elder Women: 11.7-13.8 gm/dl
Tx for Ca
Rehab of motor, sensory, neurobehavioral & cog impairments; Psychosoc support; Promo of health supporting behaviors
Palliative Care for Ca
Prevent/relieve suffering thru early ID, assessment, pain tx; Address physical, psychosoc and spiritual needs; Enhance QOL by supporting engagement in occs; Consider environment/contextual and client factor that could lim abilities/satisfaction; fam collaboration thru whole process
Hospice Care for Ca
Support QOL, provide pt w as much control as possible, Be present/accountable/listen/counsel; Encourage planning for death, Empower life celebration/reflection; Refer for legal support if needed
