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OT 401: OP & Context for Older Adults > Final Exam: Week 3 Cardiopulmonary > Flashcards

Final Exam: Week 3 Cardiopulmonary Flashcards

1
Q

1 cause of death for men and women in the U.S

A

Cardiovascular disease

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2
Q

Areas of cardiac disease

A

Hypertension, coronary artery disease (CAD), acute coronary syndrome, congestive heart failure (CHF), peripheral vascular disease (PVD)

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3
Q

What happens to the heart’s pumping cycle during arrhythmia?

A

Atria and ventricles are not working together and become out of sync

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4
Q

Diastole

A

Relaxed phase of cardiac cycle when the chambers of the heart are re-filling with blood

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5
Q

Systole

A

The heart chambers are contracting

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6
Q

Atrial diastole

A

Relaxing of the atria

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7
Q

Ventricular diastole

A

Relaxing of the ventricles

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8
Q

High blood pressure

A

Common, resting systolic BP>140mmHg and/or diastolic>90mmHG on repeated exam

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9
Q

Persistent high force of blood through blood vessels creates…

A

Significant stress on the heart, increases risk of CAD, MI, CVA

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10
Q

Hypertension risk factors

A

Family history, stress, high sodium intake, obesity, excessive alcohol intake

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11
Q

Hypertension treatment

A

Medication to lower BP and lifestyle changes

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12
Q

Effect on kidneys from hypertension

A

Narrowing lumen decreases blood supply and will increase vasoconstriction

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13
Q

What is the most common cardiac related disorder?

A

Coronary artery disease (CAD)

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14
Q

Coronary artery disease

A

Buildup of fatty, fibrous plaque in arteries that can narrow vessels over time
Occludes blood supply to heart muscle, increased risk of angina pectoris

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15
Q

Coronary artery disease and aging

A

Arteries narrow in aging, heart muscle constricts with activity causing pain in chest, left shoulder, neck, back, jaw, shortness of breath

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16
Q

Coronary artery disease modifiable risk factors

A
  • High cholesterol
  • High homocysteine
  • Smoking
  • Inactivity
  • High BP
  • Diabetes
  • Weight
  • Stress
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17
Q

Arteriosclerosis vs. atherosclerosis

A

Arterio: hardening/stiffening of vessels
Arthero: plaque that occurs

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18
Q

Complications of coronary artery disease

A

Ischemia and infarction

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19
Q

Disease continuum of coronary artery disease

A

Stenosis (narrowing) → thrombosis (clot) → embolus (circulating clot) → aneurysm

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20
Q

What causes angina pectoris?

A

People ignoring the symptoms of angina (chest pain)
Vasospasm, severe anemias, respiratory disease

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21
Q

What are the permanent changes in heart rate after an MI?

A

Without oxygen for 20 mins → necrosis begins and can become scarred over, heart function compromised, will cause arrhythmias

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22
Q

How to diagnose CAD?

A

Medical history, physical exam, and diagnostic tests (echocardiogram, stress test, cardiac catheterization, angiogram)

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23
Q

Treatment for CAD

A

CABG (coronary artery bypass graft): surgery to detour around blocked vessels
PCI (percutaneous coronary intervention): coronary angioplasty with or without stent placement to open artery

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24
Q

Acute coronary syndrome

A

Refers to unstable angina and acute MI…irreversible damage to the heart muscle as a result of coronary artery obstruction or prolonged lack of oxygen to the cardiac tissue

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25
What happens if blood flow is not restored quickly?
Cardiac muscle begins to die and the infarction may be fatal
26
Prevalence of acute coronary syndrome
- In the U.S a heart attack happens every 43 seconds - 1/5 is asymptomatic - About 50% of people with an MI die within an hour of onset
27
T/F: Men are more likely to have a heart attack
True, but women increase risk after menopause
28
Risk factors for MI
Hypertension, high cholesterol, smoking
29
Two types of MI
Non-ST segment elevation and ST segment Elevation MI (STEMI)
30
How to determine the type of MI?
Presence or absence of ST segment elevation or Q waves on an EKG
31
Treatment focus for acute coronary syndrome
Minimizing complications, restoring normal function, exploration of lifestyle modifications
32
Post discharge acute coronary syndrome
Cardioprotective medications, cardiac rehab, ongoing dietary/lifestyle education
33
Lifestyle modifications for acute coronary syndrome
Low-fat and sodium diet, smoking cessation, and increased physical activity
34
Congestive heart failure (CHF)
Heart muscle becomes stretched beyond its ability to contract resulting in fluid in lungs or extremities
35
What happens during CHF?
Loop/pump fails to bring blood back to heart and out of heart, failure/decreased efficiency
36
T/F: CHF begins asymptomatic
True, however some cases may begin with acute onset and progress to chronic
37
T/F: Left sided failure leads to right sided dysfunction
True
38
Most common symptoms of CHF
Shortness of breath, fatigue, and muscle weakness
39
Why does CHF cause ventricular hypertrophy (enlargement)?
Compensation for failed pump and builds up muscle to try to increase efficiency
40
Left CHF
Dyspnea Anxiety Paroxysmal nocturnal dyspnea Pulmonary congestion
41
Causes of heart failure
High blood pressure, high blood sugar, obesity, blood clots or plaque in the vessels, stroke, virus, a family history, and some types of toxic medications
42
Symptoms of heart failure
*Must know symptoms so they can be treated quickly* - Having trouble thinking or being sleepy - Feeling dizzy - Feeling weak - Unable to walk or do activity like in the past - Being short of breath - Cough - Unable to lay flat - Having chest pain or tightness - Feeling heart beat fast - Gaining weight - Having abdomen swell or feeling sick to stomach - Ankle swelling - Cold hands and feet
43
Symptoms of heart failure
*Must know symptoms so they can be treated quickly* - Having trouble thinking or being sleepy - Feeling dizzy - Feeling weak - Unable to walk or do activity like in the past - Being short of breath - Cough - Unable to lay flat - Having chest pain or tightness - Feeling heart beat fast - Gaining weight - Having abdomen swell or feeling sick to stomach - Ankle swelling - Cold hands and feet
44
Peripheral vascular disease (PVD)
Any abnormality in blood vessels outside the heart
45
Atheroma
Degeneration of the walls of the arteries caused by accumulated fatty deposits and scar tissue, and leading to restriction of the circulation and a risk of thrombosis
46
Most common site of atheroma
Abdominal aorta and femoral and iliac arteries
47
Symptoms of PVD in lower extremities
- Pain - Weakness - Sensory impairment - Bluish tinge
48
Complications of PVD
Amputation and gangrene
49
PVD gangrene
- Can develop when the supply of blood to an area of your body is interrupted - This can occur as the result of an injury, an infection, or an underlying condition that affects your circulation
50
Changes to heart with age
- Collagen becomes stiffer and less elastic - Fattier within muscle tissue - Coronary artery is less elastic - Conduction system changes → controls efficiency and rhythm of the heart - Vessels thicken and harden, fill with plaque - Coronary arteries “feed” the heart muscle→ surround the heart
51
EKG and ECG irregularities common in people over 65...
- Premature ventricular contractions - Atrial fibrillation (Afib) - Heart blocks
52
Functional changes with changes in heart as people age
- Decreased max heart rate→ less efficient muscle (heart) pump - Decreased myocardial contractibility (strength and force of each contraction) - Decreased stroke rate→ amount ejected with each heartbeat and decreased cardiac output (stroke volume x heart rate)
53
Effects on organ system due to heart changes
- Each vessel/artery could have plaque and will decrease blood supply to your organs and body parts - Vessels: if plaque builds up, pressure will be higher (leads to hypertension) - Kidneys and some other organs are very sensitive to hypertension - Occlusion: plaque can completely close off the vessel - Blood: both volume and constituents change
54
Consequences on CV function
- Reduced capacity for oxygen transport at rest - Reduced ability to tolerate activity that requires more oxygen
55
Metabolic demand
Activities associated with a low metabolic demand (low RPE) are perceived as physically demanding
56
Sternal precautions after heart surgery
- No lifting (greater than 9 lb) - No pushing - No pulling
57
How to get up from a bed/chair after heart surgery
- To move from lying to sitting, cross your arms over your chest, roll to the side, and gently push up with your elbows - To stand, use your leg muscles to push up (only use arms for balance)
58
Caregiver assistance after heart surgery
Do not grab under the armpits when helping to stand or move in bed Ask the staff for help if you have any questions
59
Purpose of a pacemaker
Stimulate the heart to beat at a normal rate and pump more effectively
60
Pacemaker precautions
- No lifting/pulling/putting arms above head - Activity on side of the pacemaker limited for 4-6 weeks
61
Electromagnetic interference
Affect pacemaker's ability to sense an abnormal rhythm
62
Safe items to use with a pacemaker
Microwave ovens, computers, VCRs, small electrical tools, garage door openers
63
Items to avoid with a pacemaker
- Strong electric or magnetic fields - Cellphones should be held at least 6 inches from pacemaker - Walking through a metal detector
64
Functional impairment related to cardiac disease
- Increased workload to heart effects the ability to manage disease safely or problem solve daily routines - Decline in function leads to anxiety, depression, low self esteem
65
How long does it take for heart muscle to heal?
2-4 weeks
66
Cardiac education
- Energy conservation and work simplification - Includes: (a) prioritizing tasks, (b) reorganizing environment access items w/little exertion, and (c) using adaptive equipment
67
OT considerations for heart disease
- Maximize occupational performance and function, where cardiovascular capacity is a significant determinant - Endurance - ADLs and exercise - Monitoring - Safety
68
Common parameters that are measured during activity include...
- Heart rate - Systolic and diastolic blood pressure - Rate pressure product (perceived exertion) - Breathing frequency

OT 401: OP & Context for Older Adults (12 decks)

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