PT Implications for Cardiovascular and Thoracic Interventions

Question 1

What PT interventions must be done for thoracotomies?

Answer 1

after a lateral thoracotomy, need to do segmental breathing to minimize atelectasis, side bending, lateral chest wall stretching

Question 2

What is segmental breathing?

Answer 2

when lung areas are targeted to help pt breathe more into those areas

Question 3

What are PT interventions for thoracoabdominal incisions?

Answer 3

implement breathing exercises early
implement mobilization early
avoid forward flexed postures

Question 4

What are the traditional sternal precautions (5)?

Answer 4

No shoulder flexion or ABD above 90 degrees
No lifting more than 5 lbs
No pushing or pulling with UEs
No sitting in a car behind an airbag
Perform only pain free bilateral arm movements

Question 5

How long do traditional sternal precautions tend to last?

Answer 5

6-8 weeks

Question 6

What is an alternate approach to sternal precautions that some hospitals are starting to implement?

Answer 6

keep your move in the tube

Question 7

What are PT interventions for a CABG (6)?

Answer 7

mobilization of LE’s
sit at EOB
deep breathing exercises
incentive spirometry
coughing exercises
progressive mobility

Question 8

What does an incentive spirometer teach a pt how to do?

Answer 8

teaches them how to take a slow deep breath

Question 9

How often should incentive spirometers be used?

Answer 9

used every 1-2 hours and perform 10 reps each time (do not have to be continuous reps)

Question 10

t/f, you can use diathermy or e-stim on a pt who has just had a pacemaker implanted

Answer 10

false, should not be used

Question 11

What are common recommendations for someone who has just had a pacemaker installed?

Answer 11

no exercise in involved shoulder for 4-6 weeks
limit shld flex to 90 degrees for 4-6 weeks then use functionally as tolerated
can wb minimally in involved side to use AD
no lifting more than 5 lbs
no driving until cleared

Question 12

What are some precautions to be aware of if a pt has a chest tube, and what PT interventions?

Answer 12

the chest tube must stay upright and kept in a gravity dependent position,
wall suction may be used to create a closed system but ask nursing for help
airway clearance
shoulder ROM exercises to patient’s tolerance- assist in pulmonary ventilation
once removed-MD needs to clear out pneumothorax before resuming PT