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PT - CardioResp > Midterm 2 - Lecture 7b (Lung Transplants) > Flashcards

Midterm 2 - Lecture 7b (Lung Transplants) Flashcards

1
Q

describe the history of lung transplants

A
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2
Q

candidates - general indicaition for lung transplants

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3
Q

candidates - absolute contraindications for lung transplants

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4
Q

candidates - relative contraindications for lung transplants

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5
Q

describe the evaluation process for lung transplants

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6
Q

describe what the initial Pt assessment does

A

File opening

Explanations of the LT/HLT process from physio perspective (pre, post, out-patient)

Information about current and past levels of physical activity limitations

Assessment

Oxygen needs

Education+++

Clinical impression of patient’s candidature

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7
Q

what are the factors affecting the wait times for lungs?

A
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8
Q

what would allow a pt to go on the emergency transplant list?

A
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9
Q

what is the organ donor per million people died in canada compared to other countries?

A
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10
Q

what are top causes of death of donor organs and reasons of refusal

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11
Q

describe the PHYSIOTHERAPY FOLLOW-UP DURING WAITING TIME

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12
Q

describe the surgery - frequency and duration

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13
Q

describe the lung transplant

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14
Q

describe the heart-lung transplant

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15
Q

scars from transplants

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16
Q

intensive care - how long do you stay there, PT intervention, extubation

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17
Q

what is the post-op meds like?

A
18
Q

what are specific post-op complications for lung transplants?

A
19
Q

what are other complications for lung transplants?

A
20
Q

Pt interventions:

what are the sectors, what is the frequency, duration, and intensity?

A
21
Q

describe physio in intensive care

A
  • From medical stabilization
  • Without a prescription
  • Discussion with the medical team in doubt
  • Fields of treatment (Ventilation, Secretions, Mobility)
  • Pt on mechanical ventilation (VS or VAC mode) (Deep breathing)
  • Once extubated:
    ¤ Incentive inspirometer (5 min/hour)
    ¤ Coughing with splinting
    ¤ Active mobilisations UE’s and LE’s
    ¤ Sitting in bed -> on the edge of the bed -> in the chair

¤ Walking with rolling walker (Equipment management)

22
Q

describe when the pt transfers to the transplant unit from intensive care

A
23
Q

describe transplant unit interventions

A
  • Increase walking endurance
  • Progressive weaning of walking aid ̈ Stationary bike and/or treadmill
  • Weight training LE’s and UE’s
  • Stretching UE’s / neck / trunk
  • Stairs training
  • *** Focus on self-management ***
  • Communication with team
24
Q

describe the discharge preparation process

A
25
Q

what are physical restrictions for pts? (as part of the discharge planning)

A
26
Q

look over the long temr medication list

A

Bone density

¤ Vitamine D

¤ Calcium
¤ Biphosphonate (Actonel, Fosamax)

¤ Bone formation agent (Fortéo)

Miscellaneous
¤ Anti-Nausea (Gravol)
¤ Pain killers (Tylenol, Dilaudid, Empracet, MS Contin, Fentanyl patch) ¤ Gastric (Motilium, Pantoloc)
¤ Constipation (Lactulose, Senekot, Colace, glycerine)
¤ Diarrhea (Imodium)
¤ Diuretics (Lasix)
¤ Insulin

27
Q

describe pt follow-up immediately after hospital discharge

A
28
Q

describe the out pt PT follow-up (frequency, goals)

A
29
Q

what is the long-term surgical mortality rate?

A
30
Q

describe the progression of the lung and heart-lung transplant waiting list

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31
Q

what are the 2016 stats on average age, length of hospital stay, and waiting time? (urgent and all)

A
32
Q

what are main causes of death after transplant?

A
33
Q

describe the relationship btw bronchiolitis obliterans and years lived with new lungs

A
34
Q

what are reasons for rehospitalization?

A
35
Q

describe rehospitalization physio follow-up

A
36
Q

describe the exvivo system

A

System from Sweden (Dr Stig Steen)

More portable than the one in Toronto

2 system purchased by the CHUM (1 research, 1 at Notre-Dame for the patients)

Operational since march 2014
2 transplants done in 2014 with the EVLP

*helps surgeon make call - can watch the lung on this machine to see how it does then make decision whether to use or not

37
Q

conclusion to lung transplant lecture

A

PT - CardioResp (7 decks)

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