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PHTH 564 - ICU > Organ Transplants > Flashcards

Organ Transplants Flashcards

1
Q

Selection of recipients is if they have a _______ __-___ disease

A

progressive end stage

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2
Q

6 selection criteria for transplant pts ?

A
  1. age
  2. no alcohol or tabacco dependency
  3. no CI’s to immunosuppression
  4. otherwise healthy
  5. social support
  6. psychological factors
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3
Q

Best transplant pt survival rate?

A

liver and heart

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4
Q

Worst transplant pt survival rate ?

A

lungs

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5
Q

4 transplant complications?

A
  1. rejection
  2. immunosuppresion
  3. infection
  4. graft failure
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6
Q

3 times transplants can be rejected?

A
  1. hyper acute
  2. acute
  3. chronic
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7
Q

Chronic transplant rejection is most common in _____ transplants

A

lung

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8
Q

5 common s/s of transplant rejection?

A
  1. pain at site
  2. fever/feeling unwell
  3. weight change
  4. swelling
  5. decreased urine output
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9
Q

Immunosuppressive drugs increase likelihood of CAD (T/F)

A

TRUE

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10
Q

What are 3 ways infection is avoided post transplant?

A
  1. D/C invasive lines
  2. early ambulation
  3. prophylactic antibiotics
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11
Q

Early post transplant failure = high risk of ______

A

mortality

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12
Q

There is a constant low risk of _____ failure once pt is out of early phase

A

graft

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13
Q

After heart transplant, pt will have no ______ due to denervated heart

A

angina

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14
Q

Peak HR reaches ___% of normal post transplant

A

80

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15
Q

Donor ___ node determines HR

A

SA

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16
Q

There are 2 __ waves seen post heart transplant

A

2

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17
Q

The first P wave in an ECG of someone with a heart transplant is followed by a QRS complex (T/F)

A

FALSE

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18
Q

There is no ______ innervation to control transplanted heart, so there is a resting tachycardia

A

autonomic

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19
Q

Normally heart is usually more influenced by the ___ via _____ nerve

A

PNS; vagus

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20
Q

What is the normal resting HR post transplant ?

A

90-110

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21
Q

Higher HR post transplant allows normal CO despite lower ___ ____ and ______ _____ fraction

A

stroke volume; ventricular ejection

22
Q

No sympathetic stimulation to denervated heart = unable to respond quickly to situations that require _____ HR or _____ contractility to maintain CO

A

increased x2

23
Q

______ ______ can be problematic post heart transplant due to no sympathetic stimulation

A

orthostatic hypotension

24
Q

No parasympathetic control post heart transplant = longer _____ _____ needed post exercise (to avoid big drop in CO as there is a dec in venous return)

A

cool down

25
Q

Watch for _______ post heart transplant, due to ______ imbalance and irritation from surgery / handling

A

arrhythmias; electrolyte

26
Q

Denervation post lung transplant causes a V-Q imbalance until recovery of _______ function occurs

A

autonomic

27
Q

Decreased _______ clearance post lung transplant

A

mucociliary

28
Q

Cough may be ineffective due to lack of sensation when there is irritation below _____ ______ line

A

tracheal suture

29
Q

Need care post lung transplant suctioning past _____ line due to danger of _______

A

suture; dehiscence

30
Q

There is abnormally thick _______ post lung transplant

A

mucus

31
Q

There is increase in extravascular ______ post lung transplant from disrupted pulmonary ______

A

water; lymphatics

32
Q

Increased reliance on ______ metabolism post lung transplant

A

anaerobic

33
Q

Regular chest clearance techniques required as pt not usually able to clear effectively without assistance (T/F)

A

TRUE

34
Q

Limited _____ suction post lung transplant

A

deep

35
Q

Use mechanical ______-

______ machine for feedback for diaphragm PT rx

A

insufflation - exsufflation

36
Q

May need to rehab ______ post lung transplant

A

diaphragm

37
Q

Most complications from liver transplant are due to pre op end stage liver disease (T/F)

A

TRUE

38
Q

4 liver transplant considerations pre op?

A
  1. hemorrhage
  2. muscle weakness + tremor
  3. confusion/decrease LOC
  4. fluid retention (low albumin)
39
Q

2 post op issues liver transplant?

A
  1. CV instability and tachycardia

2. LBP

40
Q

PT management pre - transplant?

A
  1. exercise testing
  2. exercise training
  3. muscle strength
  4. resp assessment and treatment
  5. educate
41
Q

PT management post transplant?

A
  1. secretion removal and long reexpansion
  2. early ambulation
  3. ROM/mobility/strength
  4. rehab programs with self management teaching
  5. ongoing yearly monitoring of function
42
Q

5 outcome measures to monitor pts?

A
  1. borg scale / perceived exertion scale
  2. talk test
  3. BP
  4. HR
  5. O2 sat
43
Q

VO2 max post heart transplant ?

A

70% age predicted max

44
Q

VO2 max post lung transplant ?

A

4-60% age predicted max

45
Q

VO2 max post kidney and liver transplants ?

A

normal exercise capacity

46
Q

Recommended exercise prescription guideline for Canada?

A

150 minutes of mod intensity a week

47
Q

Mod intensity programs (__-__ RPE) recommended for organ transplant pts, can build up to hight intensity

A

3-5

48
Q

Need longer _____ __ / ____ ____ when exercising with post organ transplant pts

A

warm up / cool down

49
Q

Precautions when working with transplant pts?

A

infection control; wiping down equipment; avoiding unwell populations; be aware of psychological considerations

50
Q

4 long term PT goals post organ transplant ?

A
  1. aerobic conditioning
  2. prevent steroid induced mm atrophy
  3. optimize secretion clearance and breathing
  4. lessen OP effects secondary to diuretics and steroids

PHTH 564 - ICU (15 decks)

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