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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
Q

What happens if blood flow is not restored quickly?

A

Cardiac muscle begins to die and the infarction may be fatal

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26
Q

Prevalence of acute coronary syndrome

A
  • 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
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27
Q

T/F: Men are more likely to have a heart attack

A

True, but women increase risk after menopause

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28
Q

Risk factors for MI

A

Hypertension, high cholesterol, smoking

29
Q

Two types of MI

A

Non-ST segment elevation and ST segment
Elevation MI (STEMI)

30
Q

How to determine the type of MI?

A

Presence or absence of ST segment elevation or Q waves on an EKG

31
Q

Treatment focus for acute coronary syndrome

A

Minimizing complications, restoring normal function, exploration of lifestyle modifications

32
Q

Post discharge acute coronary syndrome

A

Cardioprotective medications, cardiac rehab, ongoing dietary/lifestyle education

33
Q

Lifestyle modifications for acute coronary syndrome

A

Low-fat and sodium diet, smoking cessation, and increased physical activity

34
Q

Congestive heart failure (CHF)

A

Heart muscle becomes stretched beyond its ability to contract resulting in fluid in lungs or extremities

35
Q

What happens during CHF?

A

Loop/pump fails to bring blood back to heart and out of heart, failure/decreased efficiency

36
Q

T/F: CHF begins asymptomatic

A

True, however some cases may begin with acute onset and progress to chronic

37
Q

T/F: Left sided failure leads to right sided dysfunction

A

True

38
Q

Most common symptoms of CHF

A

Shortness of breath, fatigue, and muscle weakness

39
Q

Why does CHF cause ventricular hypertrophy (enlargement)?

A

Compensation for failed pump and builds up muscle to try to increase efficiency

40
Q

Left CHF

A

Dyspnea
Anxiety
Paroxysmal nocturnal dyspnea
Pulmonary congestion

41
Q

Causes of heart failure

A

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
Q

Symptoms of heart failure

A

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
Q

Symptoms of heart failure

A

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
Q

Peripheral vascular disease (PVD)

A

Any abnormality in blood vessels outside the heart

45
Q

Atheroma

A

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
Q

Most common site of atheroma

A

Abdominal aorta and femoral and iliac arteries

47
Q

Symptoms of PVD in lower extremities

A
  • Pain
  • Weakness
  • Sensory impairment
  • Bluish tinge
48
Q

Complications of PVD

A

Amputation and gangrene

49
Q

PVD gangrene

A
  • 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
Q

Changes to heart with age

A
  • 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
Q

EKG and ECG irregularities common in people over 65…

A
  • Premature ventricular contractions
  • Atrial fibrillation (Afib)
  • Heart blocks
52
Q

Functional changes with changes in heart as people age

A
  • 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
Q

Effects on organ system due to heart changes

A
  • 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
Q

Consequences on CV function

A
  • Reduced capacity for oxygen transport at rest
  • Reduced ability to tolerate activity that requires more oxygen
55
Q

Metabolic demand

A

Activities associated with a low metabolic demand (low RPE) are perceived as physically demanding

56
Q

Sternal precautions after heart surgery

A
  • No lifting (greater than 9 lb)
  • No pushing
  • No pulling
57
Q

How to get up from a bed/chair after heart surgery

A
  • 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
Q

Caregiver assistance after heart surgery

A

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
Q

Purpose of a pacemaker

A

Stimulate the heart to beat at a normal rate and pump more effectively

60
Q

Pacemaker precautions

A
  • No lifting/pulling/putting arms above head
  • Activity on side of the pacemaker limited for 4-6 weeks
61
Q

Electromagnetic interference

A

Affect pacemaker’s ability to sense an abnormal rhythm

62
Q

Safe items to use with a pacemaker

A

Microwave ovens, computers, VCRs, small electrical tools, garage door openers

63
Q

Items to avoid with a pacemaker

A
  • Strong electric or magnetic fields
  • Cellphones should be held at least 6 inches from pacemaker
  • Walking through a metal detector
64
Q

Functional impairment related to cardiac disease

A
  • 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
Q

How long does it take for heart muscle to heal?

A

2-4 weeks

66
Q

Cardiac education

A
  • Energy conservation and work simplification
  • Includes: (a) prioritizing tasks, (b) reorganizing environment access items w/little exertion, and (c) using adaptive equipment
67
Q

OT considerations for heart disease

A
  • Maximize occupational performance and function, where cardiovascular capacity is a significant determinant
  • Endurance
  • ADLs and exercise
  • Monitoring
  • Safety
68
Q

Common parameters that are measured during activity include…

A
  • 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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