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Semester 5 PMCP Exam 3 > Exam and Eval 3 and 4 > Flashcards

Exam and Eval 3 and 4 Flashcards

1
Q

Tx for hypertension - what medications

A 
Diuretics
Beta blockers
Alpha adrenergic blockers
VD
Ca channel blockers
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2
Q

Tx for hypertension - medications - impact of diuretics

A

they will be dry

fatigued

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3
Q

Tx for hypertension - medications - impact of beta blockers

A

blunt their response to activity - they will not tolerate as much

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4
Q

Tx for hypertension - when on medications for it it is important to be monitoring their

A

ECG and recognize if arrhythmias pop up

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5
Q

What other treatment besides medication for hypertension

A

exercise - both aerobic and resistance
weight control
limit Na intake

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6
Q

Hypertension - abnormal response to exercise - pts with normal or borderline HTN may have…

A

excessive inc in sys or dias with activity because of failure to reduce TPR

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7
Q

Hypertension - abnormal response to exercise - pts with moderate HTN may have

A

exaggerated response to isometric and isotonic exercise due to blunted decrease in TPR
They may be unable to inc CO

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8
Q

Hypertension - abnormal response to exercise - pts with severe HTN

A

further impairment of CO and increased TPR

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9
Q

PT - working with patients who have HPTN

A 
Monitor BP frequently
Avoid vasalva 
Know med side effects
Use RPE
Educate!
Caution with sudden changes in position
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10
Q

Pulmonary HPTN - defined as how many mmHg above normal

A

5-10

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11
Q

Pulmonary HPTN - leads to

A

hypertrophy of R heart

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12
Q

Pulmonary HPTN - TX

A

nothing known
usually Ca channel blockers
O2 therapy
Lung transplant

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13
Q

Pulmonary HPTN - PT

A 
Monitor BP
Avoid vasalva
Know med side effects
Use RPE
Educate!
Caution with sudden position change
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14
Q

Pulmonary Edema - ___ first and then ___

A

Interstitium first and then the alveoli

Impacts oxygen saturation moving across membranes

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15
Q

Two main causes of pulm edema

A

Inc capillary pressure from L vent failure

Inc capillary permeability (ARDs)

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16
Q

Pulm Edema - TX

A

O2
Venodilators to dec preload
Diuretics to dec venous return
Possibly ventilator

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17
Q

Pul Edema - PT

A

Gradual inc in activity when stable and have the fluid off
Progress to 30 min aerobic ex (OP)
Monitor all vitals! (HR may be a little high)

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18
Q

Chronic bronchitis - tx

A 
BD
Steroids
Expectorants
Antibiotics
Beta blockers
Diuretics
Antiarrhythmics
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19
Q

Chronic Bronchitis - things to be aware of with them

A

they will be fatigued, coughing a lot, and be careful about their skin

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20
Q

Chronic bronchitis - PT

A 
Educate
Reduce work of breathing
Conditioning
Monitoring 
Chest wall mobility
Body positions
Coughing maneuvers
Relaxation
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21
Q

Asthma - TX

A

BD and antiinflammatories
O2
Corticosteroids
IV fluids

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22
Q

Asthma - PT

A 
Educate
Body positioning
Slow mobilization
Secretion removal 
Optimize strength and endurance
max QOL
Know meds
Mobility, ROM, relaxation, stress management
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23
Q

Asthma - PT - what are we educating them on

A

their triggers, upright positioning, coughing, maybe suctioning

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24
Q

Asthma - PT - exercise prescription parameters are set where

A

below their threshold

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25
Q

Cystic Fibrosis - is what

A

Multisystem disorder y an autosomal recessive gene that effects the exocrine glands - involves all major organ systems

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26
Q

Cystic fibrosis - leads to what

A

ventilatory impairment, chronic airflow limitation

They have a ton of secretions in their lungs so their ventilation is impaired

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27
Q

Cystic fibrosis - TX

A 
Exercise
Nutritional eval
Antibiotics
BD
Lung or lung and heart transplant
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28
Q

Cystic Fibrosis - PT

A 
Exercise tolerance varies
Strength and endurance ex
Postural drainage
Autogenic drainage  
Controlled cough techniques
Airway clearance
Postural changes 
Positioning
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29
Q

Pulmonary fibrosis - TX

A

Reduce inflammation
Corticosteroids, immunosuppressives, O2
Remove them from environment contributing to the fibrosis
Can do lung transplant - but not effective long term

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30
Q

Pulm Fibrosis - PT

A 
Body positioning
Modified ex program
Pulm rehab program
Max QOL
Reduce work of breathing
Inc strength and peripheral oxygen extraction
Education
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31
Q

Strengthening for all CP patients

A

high rep, low weight

32
Q

TB - Symptoms

A 
fatigue
fever
reduced apetite
weight loss
night sweats
hemoptysis
cough
33
Q

TB is usually located where to begin with

A

lower lobes

34
Q

TB - TX

A

No one medication is approved - there is a regimen of 9 to 12
Antibiotics
If severe maybe take part of the lung out - or get chemotherapy

35
Q

TB - PT

A

Modified ex program
Percussion and postural drainage
Other airway clearance
Relaxation and postural alteration

36
Q

TB - Extrapulmonary - if developed in bones, joints, lymph nodes - PT

A

often no PT

Unless just want ROM with them

37
Q

Deep vein thrombosis - key indicators

A

swelling
warmth
pain
red color

38
Q

Wells - if in high category for DVT

A

Not working with them (3 or more)

39
Q

Wells - if in moderate category for DVT

A

Wait for further testing to come back (1-2)

40
Q

Wells - low category for DVT

A

you are okay to work with them

41
Q

DVT - TX

A

Antithrombolytic agents

Used to bedrest - just know what meds they are on and this will tell you

42
Q

DVT - TX - low molecular weight heparin - can you work with them?

A

4 hours after this one

43
Q

DVT - TX - coumadin - can you work with them

A

wait 1 day or 2 to work with them unless they were on coumadin prior

44
Q

DVT - PT

A

Check with MD when to start activity
Monitor and listen to patient sx
Possible bed rest - depends on meds
Make sure they are walking heel to toe

45
Q

Pulmonary Embolism - Wells

A

High - (over 6) - not treating
Mod - (2-6) - waiting
Low (less than 2) - you can work with

46
Q

PE - TX

A

Thrombolytic agents
Sedative (to dec anxiety)
O2
Sometimes (RARE) embolectomy

47
Q

PE - PT

A

Need to get approved by MD for when they can get out of bed
Know their meds
Listen to patient sx
Position upright!

48
Q

Angina - TX

A

monitor

anti-anginal meds

49
Q

PE may present like

A

heart attack

but their O2 will dec readily whereas it may not for MI

50
Q

Angina - PT

A

Monitor with ex
Know if it was Q wave or non
Warm up, steady rate, cool down
No sustained static postures or isometric ex (need to be doing AROM)
Educate them on not laying on left side for prolonged period of time

51
Q

Angina - PT - Heart rate with exercise

A

No more than 20 beats above resting HR

52
Q

MI - TX

A

Monitor

53
Q

MI - PT

A 
Cardiac rehab
Monitor with exercise
RPE
Tx below threshold!
Body positioning (avoid left sl and supine!)
Minimize stress
54
Q

Thoracic Surgery - key notes

A

their shoulder may be sore
incision through intercostal space
chest tube put in to evacuate air and fluid

55
Q

CV surgery - key notes

A

placed on bypass
have high oxygen demand after surgery
might have nightmares too!

56
Q

Thoracic and CV surgery - TX

A 
Monitoring
Many tubes and lines
Medications
Wound management
Need warming blanket after surgery
57
Q

Thoracic and CV surgery - PT

A 
Positioning 
Education
Breathing control and supportive coughing
Cardiac rehab
Maintain ROM for thoracic
Limit UE ROM for CV surgery
58
Q

Emphysema - TX

A

Noninvasive positive pressure vent
Jeopardized by pt compliance
Sometimes will do lung reduction surgery - problem is it will only help with diaphragm but not aeration

59
Q

Emphysema - PT

A 
Max QOL
Education - sleep and rest
Strength and Endurance
Reduce work of breathing - purse lip
Know meds
Chest wall mobility
Body positioning
RPE, Borg, Dyspnea
60
Q

Should you teach someone with COPD diaphragmatic breathing

A

you can always try it but if it creates anxiety you need to stop
If they can do it - it will reduce work of breathing though!

61
Q

Lung cancer - TX

A

surgical intervention if caught early

if metastasized - chemo, radiation

62
Q

Lung cancer - PT

A 
Secretion clearance
Supportive care
Reduce work of breathing
Optimize strength and endurance
Min effects of restrictive mobility
Postural drainage
Know meds they are on
Optimize pain control
63
Q

Valve disease - how will they present

A 
Exertional dyspnea
Excessive fatigue
Palpitations
Fluid retention
Orthopnea 
Most relieved with rest
64
Q

Valve disease - TX

A

Prophylactic antibiotics before dental procedures
Surgical intervention
Wellness program

65
Q

Valve disease - PT

A

Exercise, education, strengthening, chest mobility ex
Energy conservation - use large mm versus small
Upright positions vs. recumbant or supine

66
Q

Peripheral vascular disease - TX

A

Smoking cessation
Tx HPTN, glucose intolerance, diabetes, and monitor cholesterol
Need to be cleared by MD for exercise
Promote weight managemetn

67
Q

Peripheral vascular disease - PT

A

Educate
Max QOL
Self assessment of skin
Know what type of tx they are getting
Recumbant position - dec claudication but inc work of heart
Compression garments to increase venous return

68
Q

Diabetes Mellitus - insulin

A

dependent or non insulin dependent

69
Q

Metabolic syndrome - insulin

A

Insulin resistant

70
Q

Diabetes Mellitus and Metabolic Syndrome - TX

A

Exercise program
Diet
Insulin if needed or meds
Stress management

71
Q

Diabetes Mellitus and Metabolic Syndrome - PT

A 
Educate and lifestyle changes
Exercise 
Strengthening
Know meds and where injects
Monitor vitals
RPE
Check feet with the patient!
72
Q

Diabetes Mellitus and Metabolic Syndrome - PT - Exercise - what level

A

40-85% of peak functional work capacity

73
Q

ARDs - PT

A

Mobilize when stable
Position changes
Monitor vital

74
Q

Atelectasis - PT

A

Position changes
Cough maneuvers and breathing control
Postural drainage

75
Q

Pneumonia - viral - PT

A

Mob coordination with breathing control exercises
Postural drainage
Frequent position changes
Patient education

76
Q

Pneumonia - bacterial - PT

A

Airway clearance techniques
Mobilization
Positioning
Educate

77
Q

Bronchitis - PT

A 
Aid in removal of secretions
Positioning
Postural drainage
Mobilization
Deep breathing

Semester 5 PMCP Exam 3 (6 decks)

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