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CardioPulm 3 > Lung & Heart Transplant > Flashcards

Lung & Heart Transplant Flashcards

1
Q

Contraindications for Transplant (9)

A 
Irreversible renal function
Systemic disease
Psychosocial/Cognitive instability
Absence of support
Active Infection
Hx of non-compliance
Active substance abuse
Morbid obesity
Lack of financial coverage
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2
Q

Recommended Criteria for Heart Transplant (5)

A 
CAD
Cardiomyopathy
Hear valve disease w/CHF
Severe congenital heart disease
Poor QoL
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3
Q

Recommended Criteria for Lung Transplant (5)

A 
COPD/Emphysema
IPF
Cystic Fibrosis
Idiopathic pulmonary HTN
Sarcoidosis
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4
Q

UNOS

A

United Network of Organ Sharing

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5
Q

Components of PT Eval (9)

A 
Appearance
Edema
Vitals
Pain
Posture
ROM(general)
Strength(LE b/c sternal precautions)
CardioPulm assessment
Exercise tolerance
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6
Q

Prehab PT Goals(4)

A

Pt/family education
CV endurance training
Strength/Flexibility
Breathing training

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7
Q

Donor Selection Considerations (4)

A

ABO blood compatibility
Histocompatibility
Brain death
Age

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8
Q

Level IA Recipient

A

Mechanical circulatory support
Mechanical ventilation
Continuous medication
Can’t leave the hospital, maybe on biVAD

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9
Q

Level IB Recipient

A

Left or Right VAD needed

Continuous infusion

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10
Q

T/F: When a patient has an LVAD placed, the are permanently take off the transplant list.

A

False. They are temporarily taken off for 6 wks b/c can’t get another surgery and then put back on the transplant list.

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11
Q

Orthotropic Cardiac procedure

A

More common
Requires replacement w/donor heart
Must be done w/in 4-5 hrs
Pt on bypass

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12
Q

Hetertropic Cardiac procedure

A

Rare.
Leaves recipient heart in place.
Connects donor heart to right side of chest.

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13
Q

Lung Transplant Procedure (5)

probably not that important

A 
Open chest.
Separate pulm veins & artery
Remove lung
Reconnect bronchus of donor lung
Reattach pulm artery, veins & other vessels
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14
Q

Medications for Transplants (6)

A 
Immunosuppressants
Anti-inflammatories
Anti-viral
Antibiotics
Mycostatins
Gastric motility agents

*initiated in ICU and continued life long

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15
Q

Sternal Precautions

A

No pushing, pulling or lifting
6-8 wks

*document if pt not following precautions

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16
Q

Focuses of Acute IP PT (5)

A 
Education
Fan'l abilities for self-care
Mobility
Transfers
Ambulation
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17
Q

Acute IP PT Treatments (6)

A 
Pulmonary hygiene
Chest wall mechanics
Strength/ROM (LEs mostly)
Exercises, MET levels 1-3
ADLs
Education on precautions
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18
Q

Documentation: Exercise tolerance (3)

A

Response of vitals
RPE
SOB

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19
Q

T/F: Warm up and cool down are unimportant in cardiac patients.

A

False. They will require longer time for both.

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20
Q

Length of OP PT Treatment

A

Hospital d/c to 8-12 wks post

21
Q

Goals of OP PT (5)

A 
Strength
Aerobic conditioning
Independence w/HEP
Education/Self-monitoring
Musculoskeletal problem solving
22
Q

Symptoms of Heart Transplant Rejection (4)

A

Flu-like symptoms
Fever
Muscle aches
Dysarrhythmia

23
Q

Symptoms of Lung Transplant Rejection (2)

A

SOB

Desaturation

24
Q

Long Term Complications (6)

A 
Steroid myopathy
Osteoporosis
CAD
Cancer
Wound healing
Infection
25
Q

Alternatives to Transplant (3)

A

VADs
Pharmacological mgmt
Cardiomyopathy

26
Q

What is an LVAD? (4)

A

Device that pumps blood from LV to aorta.
Implanted below heart
Advanced failure (bridge to transplant)
End Stage failure (extends life 5-10 years)

27
Q

LVAD Precautions (3)

A

Sternal: Post 6 wks or more
No chest compressions
Fall risk w/increased bleeding risk

28
Q

LVAD Treatment (5)

A 
Bed mobility
Transfers
Gait training
Balance/Safety
Functional Endurance
29
Q

Alternatives to Lung Transplant (2)

A

Lung Volume Reduction Surgery (LVRS)

Pressure release ventilation or BiPAP

30
Q

T/F: Normal activities should not be resumed after transplant.

A

False. Normal activities can be resumed after consulting w/physician. Avoid vigorous activity.

31
Q

Central Venous Pressure

A

Pressure of blood in thoracic vena cava near R. atrium

32
Q

Pulmonary Artery Pressure (PAP)

A

Pressure to pump blood from heart to lungs

Normal: 14 mmHg

33
Q

Pulmonary HTN

A

PAP of 25-30 mmHg

34
Q

Normal MAP

A

70-110 mmHg

35
Q

Intra-aortic Balloon Counter Pulsation (IABP) (3)

A

Balloon located in descending aorta.
Inflated at onset of diastole
Deflated at onset of systole

36
Q

Uses of IABP (4)

A

Wean from bypass
Heart failure
Cariogenic shock
MI

37
Q

Conditions for Ventilation

A

Respiratory depression
Inspiratory muscle fatigue
Inspiratory muscle weakness
Severe hypoxemia/Lung parenchymal disease

38
Q

Modes of Positive Air Pressure

A 
Intermittent Mandatory Ventilation (IMV)
Pressure Support Ventilation (PSV)
Positive End Expiratory Pressure (PEEP)
Constant Positive Airway Pressure (CPAP)
Inspiratory hold
39
Q

What is proper FiO2?

A

21%, higher if sicker

40
Q

Term: IMV

A

Regular breaths scheduled

Adjusted to pt need

41
Q

Term: PSV

A

Pt initiates breath and ventilator delivers preset value support

42
Q

Term: PEEP

A

Pressure support during inspiration to keep alveoli from collapsing
Higher = more ill

43
Q

Term: CPAP

A

Helps keep airway open so they don’t collapse

Use for vent weaning

44
Q

Indications for Ventilation (4)

A

Pulmonary atelectasis
Inability to clear secretions
Hypoventilation
Failure of MDI/Nebulizer

45
Q

Term: Tracheostomy

A

Artificial opening into the trachea for tube insertion

46
Q

Term: Tracheotomy

A

Incision into trachea through skin to create tracheostomy

47
Q

Indications for Tracheostomy

A

Temporary for operation (protect airway from swelling)
Post-laryngectomy
Provide airway access when on ventilator
Post Facial trauma

48
Q

Indications for Intubation

A

Need for positive pressure ventilation
Protect against aspiration of GI contents
Neuromuscular paralysis
Surgical for head, thorax, abdomen

CardioPulm 3 (6 decks)

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