class 8 : cardio interventions Flashcards
what is postural drainage
Bronchus of the involved lung segment is perpendicular to the ground
using gravity, these positions assist the mucociliary transport system in
removing excessive secretions from the tree.
what are the indication for postural drainage
- Pulmonary complications
- Weak/elderly patients
- Atelectasis, pneumonia, COPD
how long should you maintain postural drainage positions
Maintain each position for 5-to-10 minutes
how do we clear the secreations following postural drainage
Secretions cleared by coughing or suctioning
what do beta blockers end with
LOL
what is the function of beta blockers
low the heart rate and reduce blood pressure by blocking the effects of hormones like adrenaline and noradrenaline
prone lying (two pillows under the pelvis) - postural drainage
superior segments of the lower lobes
sitting in a chair (leaning forward over a folded pillow) - postural drainage
posterior apical segments of the upper lobes
supine lying - postural drainage
anterior segments of the upper lobes
sitting in a recliner, leaning backwards - postural drainage
anterior apical segments of the upper lobes
Precautions to postural drainage
- Pulmonary edema
- Hemoptysis
- Massive obesity
- Large pleural effusion
- Massive ascites
does the right or left lung have 3 lobes
the right lung has 3 lobes
what is Hemoptysis
coughing up blood or bloody mucus from the respiratory tract
Relative Contraindications to postural drainage
- Increased intracranial pressure
- Hemodynamically unstable
- Recent esophageal anastomosis
- Recent spinal fusion or injury
- Recent head trauma
- Diaphragmatic hernia
what is Massive ascites
a severe accumulation of fluid in the abdomen that can cause pain, discomfort, and difficulty moving
why do COPD pt’s have elevated shoulder girdle
they are using their accessory muscle to breath
what is esophageal anastomosis
a surgical procedure that reconnects the digestive tract after an esophagectomy
what is HR Max
220 - age
what is Heart rate reserve
the difference between your maximum heart rate and your resting heart rate
Exercise Hypertension
- SBP: >240 mmHg
- DBP:>110 mm Hg or until controlled
Systolic Hypotension
- > 20 mm Hg drop from
upright resting SBP
what is an Unusual heart
response
- Too rapid increase in HR
- Failure to increase in HR
- Decrease in HR with increased exercise intensity/duration
ECG abnormalities
- second- or third-degree heart block
- Onset of right or left bundle branch block
- Acute ST changes
I- Acute: Monitoring
timeline: When patient is
medically stable
exercise prescription: Patient education, and hemodynamic
and ECG monitoring
II- Subacute: Conditioning
timeline: As early as 24hr after discharge up to 6 weeks
exercise prescription: 50% to 70% of
HRmax
III- Training: Intensive
rehab
timeline: ~5-6 weeks from discharge
extends indefinitely
exercise prescription: 70%-to-85%
Resistance training begins here
IV- Conditioning: Maintenance
or prevention
timeline: Lasts up to 6-12
months
exercise prescription: Patient who are at high risk for infarction and patient
who wish to continue under supervision of trained personnel
what is the function of ECG
measures the heart’s electrical activity and is used to assess the heart’s health
Phase I & II do we do resistance training
No resistance training.
Phase I & II: FITT principle
- F - Short sessions 2-3 times a day
- I - 50%-70% HR max
- T - 10-15 mins (phase I) and 30 mins (phase II) per session
- T - ADLs, supervised ambulation
to clear the right lobe do you lay on the right or left side
left side
Phase III - what do we do
- Begin with the use of elastic bands and light hand weights
(1-3 pounds) or 30-50% of max weight used to complete 1RM - Begin with 8-10 reps, progress to 12-15 reps
- Avoid upper extremity resistance as soft tissue is still healing
Phase IV - location
Community centers, YMCA, or clinical facilities
Phase IV - Exercise
Clinically stable angina, medically controlled arrhythmias
during exercise
Phase IV - Progression:
50-85% of functional capacity, 3-4/week, 45 minutes
or more/session
Phase IV - Discharge:
Typically, 6-12 months
freq for weight loss
Greater than 5 days/week
intesity and time for Weight Reduction Guidelines
40-60% V02
45-60 min/day
pt with no comorbidites what HRmax can we go to
70-80% of HRmax
older pt with no comorbidities what HRmax can we go to
60-70%
pt with comorbidities - HR max
50-70%
what is diaphoresis
excessive sweating that’s not caused by physical activity or hot temperatures
what do we do if pt presents with resp alk
breath into a bag
rebreather mask
what do we do if pt presents with resp acid
supplemental oxy
med - brochodilators
too much CO2
what do we do if the patient present with metabolic acid
bicarbinate infusion
what do we do if the patient present with metabolic alk
meds to reduces presentation
if the secreation are in the lower part of the lungs how do we need to be placed
in a supine postion
if sercreation are in the upper part we can be sitting
