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OT EXAM > Cardiovascular and Pulmonary Disorders > Flashcards

Cardiovascular and Pulmonary Disorders Flashcards

1
Q

Myocardial infarction symptoms

A
  • severe substernal pain for more than 20 minutes
  • dyspnea
  • indigestion, nausea, vomiting
  • pain unrelieved by rest (unstable angina)
  • more likely to happen to women
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2
Q

left-sided heart failure symptoms

A
  • tachycardia (high heart rate /over 100)
  • dyspnea
  • decreased endurance
  • weakness
  • fatigue
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3
Q

right-side heart failure symptoms

A
  • poor peripheral ciriculation
  • LE edema
  • decreased endurance
  • decreased mobility
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4
Q

NY Heart Association Functional Classification

A

Class 1- no limitation in physical activity
Class 2- slight limitation of physical activity
Class 3- marked limitation of physical activity
Class 4- inability to carry on any physical activity without discomfort

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5
Q

primary muscles of inspiration

A

diaphragm, intercostals

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6
Q

accessory muscles of inspiration

A
  • used when deeper inhalation is required
  • strenocleidomastoid
  • scalenes
  • pecs
  • trapezius
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7
Q

pneumonia

A
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8
Q

COPD symptoms

A
  • complaint of dyspnea on exertion
  • wheezing, diminished breath sounds
  • pursed lip breathing
  • enlarged chest (barrel chest)
  • use of accessory muscles for breathing
  • forward-leaning posture
  • chronic cough
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9
Q

Interventions for COPD

A
  • prevention
  • smoking cessation
  • annual flu shot
  • routine exercise program
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10
Q

Eval for cardiopulmonary conditions

A
  • impact of symptoms on functional performance
  • pain/angina
  • dyspnea
  • fatigue
  • palpitations (hearth rhythm)
  • dizziness
  • edema
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11
Q

sternal precautions

A
  • No lifting objects > 8 lbs
  • No pushing or pulling with UEs
  • Elbows should not go above shoulders
  • Avoid twisting/bending deeply
  • Do not drive
  • Use pillow when coughing & sneezing
  • Do not reach behind back
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12
Q

primary prevention

A

would be things such as a health fair or lecture

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13
Q

secondary prevention

A
  • where we can cease or slow down the progression of patients’ diseases by addressing their risk factors
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14
Q

Borg scale

A

6 no exertion
9 very light exertion (slow walk)
13 somewhat hard but feeling alright to continue engaging
15 hard, but if you continue it’s not too difficult
17 very hard/strenuous, have to push to engage & you are very fatigue
19 extremely strenuous activity
20 max exertion

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15
Q

signs of cardiac distress

A

Angina- chest pain
Dyspnea- shortness of breath
Orthopnea- dyspnea while supine
Nausea/vomiting
Diaphoresis- clammy skin and cold
Fatigue
Orthostatic- drop in BP due to change in position going from supine>sit or sit>stand

  • It’s important we also monitor the patient’s response to activity by monitoring their heart rate and blood pressure constantly
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16
Q

phases of cardiac rehab

A
  • 1-3 days post-heart attack (acute phase) stabilizing their condition
  • Phase 1 -inpatient rehab (monitored lower level activity) (MET level 1-2)
  • Phase 2- outpatient rehab (begins at discharge, exercise can be increased) (MET level 4-5)
    Phase 3- community-based program
17
Q

MET levels 1-2

A

1- Resting in bed
1.5- 2- easy activities while seated (eating, bed to chair transfers, washing face, brushing hair, drawing, knitting)

18
Q

MET levels 2-3

A

Seated activities that require minimal effort (dressing/undressing, sponge bath while seated), dusting, dishwashing, vacuuming)

19
Q

MET levels 3-4

A

Lighter work without exertion ( standing in warm shower, making bed, mopping, sweeping, seated on toilet)

20
Q

MET levels 4-5

A

Lighter activities (hot shower, raking, gardening, seated on bed pan)

21
Q

MET level 5-6

A

sex

22
Q

MET levels 6-7

A

basketball, skiing, walking w/ assistive devices, jogging, bicycling

23
Q

Pulmonary conditions

A

Chronic obstructive pulmonary disease (COPD) Emphysema
Bronchiectasis
Asthma
Cystic fibrosis
Sarcoidosis

24
Q

symptoms for pulmonary conditions

A

-orthopnea- shortness of breath while supine
- dyspnea- shortness of breath; dyspnea on exertion is seen when the patient has SOB with engaging in activity
- tachypnea- increased respiratory rate
- apnea- pauses in breathing
- hypoxia- decreased oxygen in the body
- hypoxemia- decreased oxygen in the blood anoxia no oxygen
- Wheezing
- Cheyne-Stokes respiration- increased respirations with moments of apnea
- Respiratory arrest- patient stops breathing

25
Q

intervention approach for pulmonary conditions

A
  • Monitor their vital signs at all times
  • Modify activities if you see their oxygen saturation levels go below 90%
  • Promote engagement in activity as tolerable
  • Avoid resistive exercises with those who had a thoracotomy or sternotomy
  • Adhere to any aspiration or swallowing precautions they have in place
26
Q

example of modifications for pulmonary conditions

A
  • Avoiding tight clothing due to possible restricting the trunk & chest area
  • Using AE as needed (ex: LB dressing equipment)
  • Sitting to take a bath
  • Sitting to complete meal prep
  • Reorganizing commonly used items to be in a central location (ex: kitchen utensils in one area)
27
Q

eval for lymphatic drainage

A
  • occupational based assessments
  • biomechanical assessments (UE ROM and MMT, pain, activity tolerance, endurance and edema)
28
Q

Lymphedema

A

Lymphedema is a chronic edema that results when a permanent mechanical obstruction of the lymphatic system creates a lymphatic overload.

29
Q

palpation sites for vitals

A

radial
- THE MOST COMMON MONITORING SITE
- radial wrist at base of thumb

temporal
- superior and lateral to eye

carotid
- on either side of anterior neck between strenocleidomastoid and trachea
- BEST REFLECTS CARDIAC FUNCTION

brachial
- medial aspect of antecubital fossa
- USED TO MONITOR BLOOD PRESSURE

30
Q

Heart Rate

A

normal for adult- 60-100 bpm

normal for infant- 120 bpm

tachycardia- over 100 bpm

bradycardia- less than 60 bpm

31
Q

Phase 1- Inpatient Rehab (Acute) Stage objectives

A
  • patient/family education on disease process and recovery (energy conservation, work simplification, MET levels)
  • improve ability to perform self-care activities and low-level functional activities
  • decrease anxiety
  • risk factor modification
  • discharge to home
32
Q

Phase 1- Inpatient Rehab (Acute) Stage eval and intervention

A
  • started bedside with functional assessment of self-care and mobility
  • begin with activities at MET level 1-2
    • bed mob, static standing
    • transfer from bed to chair
    • bed bath, feeding, grooming at sink in sitting
    • AROM, warm-up exercises
    • wheelchair mob/ambulation in room
  • vitals monitored before, during and 4-5 min after activity
  • move to Phase 2 when they able to perform activities at MET level 3.5
  • LOS is 5-14 days
33
Q

Phase 1- Inpatient Rehab (Acute) Stage precautions

A
  • avoid isometric exercises
  • avoid overhead exercises
  • avoid lateral arm exercises and exercises that stretch chest
34
Q

Phase 2- Outpatient Rehab (Subacute) Stage focus

A
  • educate on the importance of exercise
  • build up activity tolerance
  • improve ability to perform IADLs , work activities and community tasks
  • lifestyle changes
35
Q

Phase 3- Maintenance Stage

A
  • community activities
  • maintenance gym program
    • weight training
    • cardiovascular training
35
Q

Phase 2- Outpatient Rehab (Subacute) Stage eval and intervention

A
  • home eval
  • family education
  • graded exercise program w/ slow and gradual increase of weight
  • begin with MET level 4-5
  • perform functional activities in discharge environment
    community activities
  • work site eval
35
Q

CPR guidelines

A

CAB- Compression, Airway and Breathing

OT EXAM (17 decks)

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