Pulmonary system, vital signs, eval and cardiopulmonary rehab Flashcards
pneumonia
- bacterial: acute disease, intra-aveolar infection
- viral
- aspiration
Tuberculosis
airborne infection from a bacteria
s/s: bad cough, chest pain, blood sputum, weakness/fatigue, weight loss, chills/fever
tx: drug therapy (prolonged)
possible outcomes with TB
- compromised spinal integrity
- spinal lesions –> motor and sensory impairments
- brain lesions –> stroke like symptoms
COPD
- poor expiratory flow rates
1. peripheral airway disease: smoking
2. chronic bronchitis
3. emphysema (enlargement and destruction of air spaces)
s/s: dyspnea, wheezing, cough and sputum
interventions: bronchodilators, steroids for anti inflammatory effects, preventative vaccination, O2 therapy
OTs do not change their O2
other chronic obstructive diseases
asthma
cystic fibrosis
hyaline membrane disease
chronic restrictive diseases
difficulty expanding lungs
can be from bony/muscular/organ changes: bony thorax, ankylosing spondylitis, scoliosis, pectus excavatum, burns, muscular degeneration, SCI, etc
pulmonary edema
seepage of fluid from vascular system in interstitial space
pulmonary emboli
thrombus from vein becomes embolic and lodges in pulmonary circulation, can cause infarction
pleural effusion
excessive fluid between the pleura from inflammatory conditions
atelectasis
collapsed or airless alveolar unit
claudication, angina, and dyspnea scales
0 - no pain
1 - light/mild
2 - moderate/bothersome
3 - moderate/severe
4 - severe/most pain
vital signs
measured before, during, and after activity
note side effects from medications may impact vital signs
HR for infants/adults
infant: 120 bpm
adult: 60-100 bpm
BP for infants/adults
infant: 75/50 mm Hg
adult: <120/80 mm Hg
RR for infants/adults
infant: 40 br/min
adult: 12-20 br/min
diaphoresis
excessive sweating with decreased cardiac output
pulses
decreased or absent associated with PVD
skin color and vascular status
cyanosis: bluish color
pallor: turning white (limited blood flow)
rubor: redness (PVD)
temp
skin pale, shiny dry, ulcers, gangrene
claudication: pain/cramping/fatigue typically in calves
edema
Phase 1 of cardiopulmonary rehab
hospitalization (acute)/inpatient rehab
- usually 24 hours after being stable for 24 hours
- bedside eval, MET level 1-2
- educate on energy conservation, cardiac precautions, BREATHING exercises
- monitor vital signs always
- can go to phase 2 when they are at 3.5 mets
cardiac precautions
- no holding breath/straining
- no overhead exercises
- no lateral arm movements/stretch the chest
absolute contraindications to go to cardiac rehab (inpatient and outpatient)
acute MI (within 2 days)
unstable angina
uncontrolled cardiac arrhythmias
acute PE or pulmonary infection
acute myocarditis or pericarditis or aortic dissection
Phase 2
outpatient rehab (subacute)
start at 3.5 METs
- as early as 24 hrs after d/c from hospital
- build up activity tolerance
- ADLs, IADLs, work activities
- lifestyle change support
sex 5-6 mets
Phase 3
maintenance/training
community exercise programs
gym programs (weight and cardiovascular training)
cystic fibrosis
pediatric pulmonary disorder
- genetically inherited (both parents are carriers)
- production of abnormal mucous
- chronic, progressive
- exercise intolerance
- poor nutrition, developmental delays
respiratory distress syndrome (RDS)
pediatric pulmonary disorder - premature birth
- insufficient production of surfactant (coating on the lungs to keep alveoli open)
- lung collapses after each breath
- supplemental O2 with CPAP, intubation with PEEP
- mother is treated with steroid meds 24-36 hours proper to premature delivery to stimulate surfactant production
- baby at risk for hemorrhage, dysplasia, developmental delay
bronco pulmonary dysplasia (BPD)
- result of barotrauma (from ventilation, high inflating pressures, infection, aspiration, asphyxia - deprived of O2)
- prematurity
- lung walls thicken, making O2 exchange difficult
- oxygen therapy, ventilation, bronchodialtors
- risk for hypotonia, gross motor delays, feeding problems, CNS problems
when are vital signs monitored during acute phase
prior to activity, at the peak, immediately upon cessation, and 4-5 min after activity
internal bleeding s/s
ecchymosis (black and blue)
swollen, tender, firm (abdomen especially)
different skin color/temp
increased breathing and pulse
low BP
nausea/vom
restlessness/anxiety
minor: RICE
major: alert medical personnel
shock s/s
pale gray or blue cool skin
increased, weak pulse
increased RR
decreased BP
irritability
diminishing level of consciousness
nausea or vommitting
- capillary refill test
- elevate legs
- no food/drink
