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PTRS 826 > Test 3 > Flashcards

Test 3 Flashcards

1
Q

risk factors for cardiovascular and pulmonary disease

A

hypertension

smoking

family history of disease

older age

obesity

diabetes

sedentary lifestyle

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2
Q

family’s ability to supply care and it’s financial resources. improves patient ability to respond to disease

A

support system

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3
Q

cardiac enzymes

A

creatine phosphokinase

lactate dehydrogenase

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4
Q

blood lipids

A

cholesterol

triglycerides

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5
Q

Complete blood count

A

Hb

hematocrit

WBC

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6
Q

ABG’s: low oxygen but not below _____ on room air: supplemental O2 with exercise

A

60 mmHg

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7
Q

resting pO2 _______ or saturation _____ supplemental O2

A
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8
Q

bronchodilator meds for patients with

A

decrease flow rates or volumes

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9
Q

Inspection components

A

general appearance

facial expression

effort of breathing

neck

chest

phonation/cough/sputum production

posture

positioning

extremities

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10
Q

general appearance

A

level of consciousness

body type

body posture

body position

skin tone

presence of all equipment

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11
Q

level of consiousness

A

can patient understand the treatment plan

alert

agitate

confused

semi comatose

comatose

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12
Q

Indirect measure of nutrition and indication of level of exercise tolerance

A

Body type

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13
Q

body type

A

obese: decrease tolerance and increased WOB

cachectic

normal

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14
Q

weakness from wasting muscles

A

cachectic

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15
Q

body position

A

tripod position (increased WOB)

supine

use of pillows

semi fowlers

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16
Q

skin tone

A

cyanotic look - may need oxygen supplement

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17
Q

indicate a need for change in the treatment

A

facial expression

distress/fatigue

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18
Q

signs of distress

A

nasal flaring

sweating

paleness

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19
Q

use of face and neck muscles and movement of lips to breath

need to teach them

A

effort of breathing

pursed lip breathing

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20
Q

evaluation of neck

A

sternocleidomastoid

jugular venous distention

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21
Q

shortening- due to chronic forward bent posture of head and trunk hypertrophy- when used extensively

A

sternocleidomastoid

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22
Q

indication of increased volume in the venous system, early sign of right sided heart failure

A

jugular venous distention

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23
Q

jugular venous distention patient sitting or recumbent in bed - head elevated at least ______ if veins distend above______

A

45 deg the level of the clavicle

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24
Q

congenital chest defects

A

pectus excavatum

pectus carinatum

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25
Q

results of chronic hyperinflation seen in evaluation of hest

A

rib angle

increase intercostal spaces broader anteriorly

diaphragm is stretched, flatter and less active

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26
Q

accessory muscles that hypertrophy and seen in the evaluation of the chest

A

scalenes

trapezius

intercostals

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27
Q

temporary cessation of breathing, especially during sleep

A

apnea

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28
Q

normal, good, unlabored ventilation

A

eupnea

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29
Q

refers to an abnormally slow breathing rate

A

bradypnea

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30
Q

abnormally rapid breathing

A

tachypnea

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31
Q

increased depth of breathing when required to meet metabolic demand of body tissues

A

hyperpnea

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32
Q

COPD 1:4 vs normal 1:2

A

prolonged expiration

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33
Q

is shortness of breath (dyspnea) that occurs when lying flat

A

orthopnea

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34
Q

Hyperventilation is rapid or deep breathing that can occur with anxiety or panic

A

hyperventilation

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35
Q

an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea. The pattern repeats, with each cycle usually taking 30 seconds to 2 minutes

A

cheyne-stokes

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36
Q

factors to look at for cough

A

strength

depth

length of cough

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37
Q

long spasmodic cough

A

bronchospasm

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38
Q

ICD is beneficial for individuals with

A

LVEF <30%

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39
Q

frothy sputum

A

dyspnea - heart failure

pulmonary edema

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40
Q

productive cough fro more than 3 months consecutively and for at least 2 years

A

chronic bronchitis

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41
Q

digital clubbing

A

tissue hypoxia

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42
Q

decreased circulation due to cold, vasospasm, peripheral vascular disease, reduced cardiac output

A

cyanosis

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43
Q

calves: blue/purple

A

peripheral vascular disease

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44
Q

irreversible renal function systemic disease psychosocial or cognitive instability absence of support active infection history of non compliance active substance use morbid obesity lack of adequate financial coverage

A

contraindications for heart and lung transplantation

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45
Q

decreased sound transmission with auscultation of lungs

A

air trapped

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46
Q

used to listen to high pitched sound

A

diaphragm

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47
Q

used to listen to accentuated low frequency sounds, filters high pitched, place lightly on the skin

A

bell

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48
Q

mediate percussion sounds

A

resonance - normal dull - liver, other dense tissues, consolidation, tumors hyperresonant - empty stomach and hyperinflation (air trapping)

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49
Q

rapid rise in HR means

A

sever deconditioning

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50
Q

normal oxygen saturation response to activity

A

to remain in normal range

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51
Q

patient with chronic pulmonary dysfunction of congestive heart failure ________ with activity

A

desaturate their oxygen from hemoglobin

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52
Q

no exercise is sat drops to

A

86 or below

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53
Q

patient need a longer warm up and cool down period monitor exercise tolerance using vitals and RPE scale

A

post op treatment considerations

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54
Q

diaphragm ascends into chest by _____ with anesthesia _______ is significantly reduced

A

2cm TLC

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55
Q

during surgery _________ occurs when lung tissue and surrounding structures are being physically manipulated

A

compression atelectasis

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56
Q

during surgery airway resistance is increased with

A

breathing circuits

valves

tracheal tubes

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57
Q

during surgery airways can become obstructed with

A

blood

fluid

bronchospasm d/t irritation of airways

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58
Q

diaphragmatic procedures performed through _____

A

lateral or thoracoabdominal incision

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59
Q

operative side elevated (1/4 turn from prone) uppermost arm elevated forward and flexed at elbow and behind head incision downward between 4th thoracic vertebrae and the scapula

A

posterolateral thoracotomy

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60
Q

muscle considerations for posterolateral thoracotomy

A

serratus anterior divided close to origin to preserve function avoid long thoracic nerve

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61
Q

operative side elevated (1/4 turn from supine) uppermost arm elevated forward and place beneath the back

A

anterolateral thoracotomy

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62
Q

muscle considerations for anterolateral thoracotomy

A

retracts the latisissmus dorsi

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63
Q

sidelying, operative side up arm abducted, flexed at elbow and rotated

A

lateral thoracotomy

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64
Q

muscle considerations for lateral thoracotomy

A

latissiumus dorsi is not incised but moved either anteriorly / posteriorly and fibers of serratus anterior incised careful preservation of long thoracic nerve

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65
Q

frequently used incision for cardiothoracic surgery pt is supine extends below xiphoid process sternum is divided along its midline sternal retractor holds incision open sternum closed with stainless steel sutures

A

Median Sternotomy

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66
Q

why ventilate

A

impending or established respiratory failure inadequate ventilation and or oxygenation

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67
Q

use an inflatable device to increase lumen size use a peripheral access site into coronary arteries to site of lesion contrast dye to assess blood flow risk associated with these procedures short length of stay

A

coronary artery revascular procedures

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68
Q

used when lesion does not completely occlude lumen on coronary artery lesion penetrated, balloon placed at distal aspect of catheter and inflated presses central portion of lesion outward against wall of artery if needed, can start with smaller catheters and progress to larger ones to increase lumen size

A

percutaneous transluminal coronary angioplasty (PTCA)

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69
Q

tiny spring like devices placed into stenotic lesion once positioned, inflated and remain in place increase luminal diameter to restore blood flow

A

endoluminal stents

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70
Q

artery becomes completely occluded venous grafts come from either or both saphenous veins median sternotomy performed, pt on heart/lung machine graft placed above and below lesion site chest wall closed and recovery process begins

A

coronary arty bypass graft (CABG)

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71
Q

the need to deliver positive pressure ventilation protection of the respiratory tract from aspiration of gastric contents almost all situations involving neuromuscular parlysis surgical procedures involving the cranium, thorax or abdomen

A

indications for intubation

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72
Q

electronic pulse generator creates an artificial action potential electrical voltage difference between the two electrodes controls some arrhythmias (2nd or 3rd degree blocks, tachycardia, bradycardia) used to eliminate hemodynamic compromised d/t inadequate cardiac outbut

A

cardiac pacemaker

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73
Q

similar to pacemaker but designed to correct life-threatening arrhythmias detects and corrects all tachycardias, bradycardias and ventricular fibrillation Implanted into the pt and a seperate programmer used to change the function

A

Implantable cardioverter defibrillator

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74
Q

ICD is beneficial for individuals with

A

LVEF

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75
Q

prevent stroke caused by atherosclerotic plaques surgical incision along anterior border of SCM pt left with incision scar on lateral aspect of neck

A

carotid endarterectomy

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76
Q

candidates for carotid endarterectomy

A

symptomatic pt with carotid stenosis > or equal to 70%

symptomatic pt with stenosis of 50-69% of carotid artery (modest benefit)

asymptomatic pt with stenosis of 60% or greater

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77
Q

low flow oxygen delivery

A

nasal cannula reduces hypoxemia and intrapulmonary shunting

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78
Q

high flow oxygen delivery

A

oxygen masks

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79
Q

systematic sequence for mobilization in post operative period

A

supine to turning in bed

sitting over the bed

standing

sitting in chair

walking

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80
Q

irreversible renal function systemic disease psychosocial or cognitive instability absence of support active infection history of non compliance active substance use morbid obesity lack of adequate financial coverage

A

contraindications for heart and lung transplantation

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81
Q

criteria for heart transplant, recommended:

A

coronary artery disease

cardiomyopathy

heart valve disease with congestive heart failure

severe congenital heart disease

poor quality of life: intractable angina and life threatening arrhythmias

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82
Q

criteria for lung transplant, recommended:

A

COPD/emphysema

idiopathic pulmonary fibrosis

cystic fibrosis

other (idiopathic pulmonary hypertension, sarcoidosis)

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83
Q

PT eval: cardiopulmonary assessment

A

breathing and ventilatory function airway clearance ascultations

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84
Q

PT eval exercise tolerance

A

max stress test submax treadmill or cycle 6 min walk test oxygen saturation/gas exchange

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85
Q

ABO blood compatible histocompatability brain death age less than 35-40 relatively healthy weight and thoracic dimensions match

A

donor selection

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86
Q

based on disease level, need for mechanical support and medicaiton determines how quickly patient gets transplant

A

recipient classification

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87
Q

types of surgical procedures for the heart

A

orthotopic heart transplant heterotopic heart transplant (old heart stays)

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88
Q

pulmonary hygiene and shest wall mechanics strength and ROM exercises: ADLs, MET levels 1-3, breathing education on precautions

A

postoperative treatment: acute inpatient

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89
Q

patient need a longer warm up and cool down period monitor exercise tolerance using vitals and RPE scale

A

post op treatment considerations

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90
Q

from hospital discharge up to 8-12 weeks post similar to phase 2 cardiac rehabilitation goals: strength aerobic conditioning independence with home exercise program education and self monitoring muscculoskeletal problem solving

A

post operative treatment: outpatient

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91
Q

heart transplant signs of rejection

A

flu like symptoms fever muscle aches dysarrhythmias

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92
Q

lung transplant signs of rejection

A

shortness of breath desaturation

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93
Q

device that receives blood from left ventricle and delivers to aorta. assists to pump blood through the body implanted below the heart, attaches at apex used to treat heart failure

A

left ventricular assist device (LVAD)

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94
Q

always record

A

exercise induced changes

95
Q

how long can LVAD extend life

A

5-10 years

96
Q

LVAD precautions

A

sternal (post implantation for 6 weeks or longer) no chest compressions gait belt placement fall risk with increased risk of breathing (Elevated INR 1.5-2.5)

97
Q

alternatives to transplantation: lung

A

lung volume reduction surgery (LVRS) pressure release ventilation or biphasic positive airway pressure (BiPAP)

98
Q

sphygmomanometer pressure transducer pressure transmitter monitor or recorder

A

hemodynamic monitoring and life-support continuous monitoring of blood pressure

99
Q

systolic BP range

A

90-140

100
Q

diastolic BP range

A

60-80

101
Q

rapidly shuttles helium gas in and out of the ballon which is located in the descending aorta. the balloon is inflated at the onset of cardiac diastole and deflated at the onset of systole

A

pulmonary artery catheter and intra-aortic balloon counter pulsation (IABC)

102
Q

why ventilate

A

impending or established respiratory failure inadequate ventilation and or oxygenation

103
Q

intermittent manditroy ventilation (IMV) or synchronized intermittent mandatory ventilation (SIMV) pressure support ventilation (PSV) inspiratory hold positive end expiratory pressure constant positive airway pressure

A

modes of positive pressure ventilation

104
Q

artificial opening into the trachea, through which a tube can be inserted

A

tracheostomy

105
Q

“maintenance” long term outpatient cardiac rehab

A

phase 3 cardiac rehab

106
Q

temporarily during some operations to protect the airway from inspiration and swelling permanently after laryngectomy provide airway access for some patients on ventilators after facial trauma

A

indications for tracheostomy

107
Q

the need to deliver positive pressure ventilation protection of the respiratory tract from aspiration of gastric contents almost all situations involving neuromuscular parlysis surgical procedures involving the cranium, thorax or abdomen

A

indications for intubation

108
Q

disease or “state” in which pt’s oxygen transport system fails increased secretions hypoxia altered mental state: unconsciousness changes in cardiac function pneumonia

A

acute cardiopulmonary dysfunction

109
Q

when should you perform postural drainage

A

before exercise

110
Q

increased basal heart rate decreased maximal heart rate and o2 consumption orthostatic hypotension increased venous thrombosis risk decreased total blood volume decreased hemoglobin concentration decreased blood flow

A

effects of acute cardiopulmonary dysfunction (hospitalization) on cardiovascular system

111
Q

decreased vital capacity and residual volume decreased paO2 impaired ability to clear secretions increased ventilation-perfusion mismatch

A

effects of hospitalization on respiratory system

112
Q

decreased muscle strength and girth decreased efficiency of contraction joint contractures decubitus ulcers

A

effects of hospitalization on musculoskeletal system

113
Q

emotional issues behavioral disturbances cognitive function altered sensation joint position sense

A

effects of hospitalization on CNS

114
Q

stages of a cough

A

inspirations greater than tidal volume closure of the glottis abdominal and intercostal muscles contract (+ intrathoracic pressure) sudden opening of glottis and air foreced out

115
Q

post operative cough technique

A

series of coughs to reduce fatigue associated with maximal cough small breath small cough medium breath medium cough large breath large cough

116
Q

active cycle of breathing technique

A
  1. breathing control 2. thoracic expansion exercises 3. repeat breathing control followed by thoracic expansion exs, followed by breathing control 4. forced expiratory technique 5 follow with breathing control
117
Q

goal of active cycle of breathing thechique

A

to be independent with secretions

118
Q

breathing control for active cycle of breathing technique

A

diaphragmatic breathing at a normal tidal volume for 5.10 seconds

119
Q

thoracic expansion exercises for active cycle of breathing technique

A

pt in postural drainage position, deep inhalation with relaxed exhalation at vital capacity range. can be coupled with percussion/vibration during exhalation

120
Q

fetal heart sounds can be detected by

A

8-10 weeks gestation

121
Q

maximize airway clearance

A

position for success maximize inhalation first ask for breath hold encourage maximal intrathoracic and intraabdominal pressures instruct in appropriate timing and trunk movements for expulsion make the procedure as active as possible for pt

122
Q

manually assisted coughing techniques

A

costophrenic assist counter rotation assist

123
Q

self assisted coughing techniques

A

prone on elbows, head flexion long sitting short sitting

124
Q

overuse of accessory muscles (difficulty getting air out) treatment should consist of energy conservation, relaxations and pacing activity with breath control exercise is impt part of pulmonary rehab

A

control of breathing with primary lung disease such as asthma, bronchitis (increased work of breathing)

125
Q

decreased inspiratory time and cough upper chest collapses but can use accessory muscles to balance upper/lower chest (increased vital capacity)

A

conrol of breathing for SCI (restrictive) - trouble getting air in

126
Q

dyspnea scale

A

0- no dyspnea 1 - mild, noticable 2 - mild, some difficulty 3 - moderate difficulty, but can continue 4 - severe difficulty, cannot continue

127
Q

angina scale

A

1+ - light, barely noticable 2+ - moderate bothersome 3+ - severe, very uncomfortable 4+ - most severe pain experienced, unbearable

128
Q

can progress to hall walk if pt can tolerate

A

about 4 min of marching

129
Q

always monitor recover time for

A

about 5 min after session to assess complications which may occur

130
Q

always record

A

exercise induced changes

131
Q

to restore and maintain and individual’s optimal physiological, psychological, social and vocational status

A

mission of cardiac rehab

132
Q

a comprehensive long term program involving medical evaluation, prescribed monitored exercise, and risk factor modification

A

cardiac rehabilitation

133
Q

affects excretory glands of the body (lungs, pancreas, GI/digestive system, reproductive organs, sinuses and sweat glands) secretions are thicker/more viscous and can obstruct systems of the body dysfunction of pulmonary system most common cause of morbidity and mortality life expectancy 37.4

A

cystic fibrosis

134
Q

fatty substance found in the human body and in foods that come from animals

A

cholesterol

135
Q

defined as an excessive accumulation of fat on the body creates problems with respiration and circulation added strain to the heart (increased work, blocked arteries)

A

obesity

136
Q

associated risk factors for obesity

A

hypertension hyperlipidemia increased blood glucose levels patterns of sedentary lifestyle

137
Q

interferes with the body’s ability to produce adequate amounts of insulin needed for your body to use sugars and carbs are at higher risk for CAD

A

Diabetes

138
Q

decreases HDL levels and collateral circulation and vessel size increases total cholesterol levels, glucose intolerance, body weight, blood pressure

A

physical inactivity

139
Q

“inpatient” cardiac rehab

A

phase 1 of cardiac rehab

140
Q

monitored “outpatient” cardiac rehab usually initiated 1-3 weeks after even usually lasts 3-4 mo

A

phase 2 cardiac rehab

141
Q

“maintenance” long term outpatient cardiac rehab

A

phase 3 cardiac rehab

142
Q

what do you monitor in cardiac rehab

A

ECG HR BP signs and symptoms

143
Q

a type of chest pain, pressure or discomfort heart is not receiving enough oxygen due to narrowed coronary artery

A

angina

144
Q

pathological limitations of airflow in the lungs generally is not reversible not only a fatal condition but is chronic in nature, making breathing difficult

A

pulmonary disease

145
Q

for many people SOB affects

A

every aspect of daily living become fearful of physical activity and become less active with increased SOB

146
Q

supervised progressive exercise/activity functionala and activities of daily living training energy conservation breathing retraining stress management medication education

A

components of pulmonary rehab

147
Q

what diagnoses are covered for pulmonary rehab

A

COPD chronic bronchitis asthma emphysema

148
Q

FITT

A

frequency intensity time (duration) type (mode)

149
Q

considerations for exercise with angina

A

prolonged warm up and cool down ROM stretching low level aerobic activites upper body exercise may precipitate angina more readily

150
Q

considerations for exercise with MI

A

warm up should last 5-10 min (stretching, light aerobic activity) aerobic activity should last 20-30 min (discontinue with S&S) cool down should last as long as it takes for HR to reach resting level

151
Q

considerations for exercise with percutaneous cardiac intervention

A

exercise training can begin almost immediately progress more rapidly if no myocardial damage watch closely for potential reoccurrence manifested by S&S of ischemia

152
Q

considerations for exercise with surgical CABG and Valve intervention

A

start lower level and progress at slower rate be cautious of sternal precautions, no upperbody exercises for 6-8 weeks post surgery

153
Q

considerations for exercise with pulmonary diagnoses

A

be very aware of oxygen sat levels throughout intermittent bouts are generally used, anywhere 5-10 min with a 2-3 min rest upper body exercises are found to be more beneficial due to specificity

154
Q

one of first functional organs within the growing fetus

A

cardiac system

155
Q

contractions of the heart begin at

A

17 days gestation

156
Q

fetal heart sounds can be detected by

A

8-10 weeks gestation

157
Q

what percentage of blood flow in a fetus follows the pathway of adult circulation

A

12

158
Q

fetal circulation has alternative pathway due to

A

fluid filled lungs

159
Q

one way door in atrial septum closes withing first few hours of life

A

foramen ovale

160
Q

vascular link outside the heart between PA and aorta allowing blood exit the PA and directly into the aorta for systemic circulation closes within first few weeks of life

A

ductus arteriosus

161
Q

respiratory system begins to develop at

A

22-26 days of gestation

162
Q

production of surfactant at about

A

20 weeks of gestation amount increases as gestational age progresses

163
Q

adequate levels of surfactant are reached at

A

2 weeks before birth

164
Q

newborns chest wall is primarily

A

cartilaginous increased compliance of rigcage muscles are primary stabilizers

165
Q

helps with typical development of ribcage structure and function

A

upright antigravity head, nech and trunk control

166
Q

conditions that impair ventilation in infants

A

asthma cystic fibrosis infant respriatory distress syndrome bronchopulmonary dysplasia

167
Q

obstructive pulmonary disease characterized by episodic periods of reversible airway narrowing cause by airway inflammation, increased secretions and smooth muscle bronchoconstriction

A

asthma

168
Q

shortness of breath, wheezing, cough, shest tightness induced by exercise no chronic inflammation may have without diagnosis of asthma

A

exercise induced bronchospasm

169
Q

affects excretory glands of the body (lungs, pancreas, GI/digestive system, reproductive organs, sinuses and sweat glands) secretions are thicker/more viscous and can obstruct systems of the body dysfunction of pulmonary system most common cause of morbidity and mortality life expectancy 37.4

A

cystic fibrosis

170
Q

sustain greater ventilatory work less respiratory fatigue ability to affect work capacity not yet determined int eh literature

A

Resistive breathing device

171
Q

low blood oxygen

A

hypoxemia

172
Q

decreased oxygen supply to tissue

A

hypoxia

173
Q

obstructive pulmonary disease (thought to occur as a result of RDS) need for ventilatory assistance at least 3 days and the need for supplemental oxygen at 28 days of life need for supplemental oxygen at 36 weeks gestational age radiographic abnomalities and chronic ventilation beyond initial period of RDS

A

Bronchopulmonary dysplasia (BPD)

174
Q

alteration in chest wall mobility, lung compliance, muscle strength, ROM or skeletal formation can impact muscle alignment and restrict ribcage movement

A

musculoskeletal system impariments

175
Q

opening in ventricular septum which allows blood to flow from LV to RV (left to right shunt) already oxygenated blood flows back from LV to RV to pulmonary arteries and back into the lungs, bypassing systemic system

A

ventricular septal defect (VSD)

176
Q

opening in atrial septum oxygenated blood flows from LA to RA,, pulmonary artery and back to the lungs (Left to right shunts) less symptomatic than VSD

A

atrial septal defect (ASD)

177
Q

ductus arteriosus does not close (alternative routine the fetus) blood flows from aorta to pulmonary artery, or from left to right causing oxygenated blood to return to the lungs

A

patent ductus arteriosus

178
Q

murmur on cardiac auscultation poor feeders fatigue diaphoresis (excessive sweating) tachypnea (rapid breathing) decreased systemic blood flow

A

left to right shunts symptoms

179
Q

HR in children

A

infant 100-140 child 80-120 adult 60-100

180
Q

BP in children

A

infant 80/40 child 100/60 adult 120/80

181
Q

RR in childen

A

infant 30-40 child 25-30 adult 12-18

182
Q

non-invasive, creates a _______ pressure gradient around the patients body during inspiration; provided using a chest shell, poncho/wrap or tank

A

negative pressure ventilator negative

183
Q

apnea weakening ventilatory effort decreased breath sounds asystole severe brady or tachycardia coma, nonresponsiveness limpness, no ability to cry

A

clinical selection criteria for mechanical ventilation

184
Q

PaCO2 selection criteria for mechanical ventilation

A

newborn: >60-65 mmHg child: >55-60 mmHg rapidly rising >5 mmHg

185
Q

PaO2 selection criteria for mechinical ventilation

A

newborn

186
Q

normal PaO2 newborn/infant

A

60-90 mmHg 80-100 mmHg

187
Q

how fast air or fluid if removed

A

flow rate

188
Q

diabetes family hx HTN obesity sedentary lifestyle smoking impariments; functional work capacity, aerobic capacity, dyspnea

A

pattern 6A

189
Q

POC: ther Ex, risk management, diability mgmt, WOB mgmt past and current PT involvement in health and wellness, risk management/prevention

A

Pattern 6A

190
Q

Impaired aerobic capacity/endurance with deconditioning

A

Pattern 6B

191
Q

Diabetes, ischemic heart disease HIV, cardiomyopathy Cancer, CHF Parkinson’s disease, PVD MS, pneumonia ALS, emphysema bronchitis, dyspnea and respiratory abnormalities diseases of the mitral and aortic valve

A

Pattern 6B

192
Q

POC Ther Ex, risk management, disability mgmt, WOB mgmt/breathing strategies, balance, postural control, ADL training, devices/adapted equipment, work Outcomes: Aerobic capacity, Mm strength and endurance, Pain management, Balance and gait/assistive device, Impact on functional limitations (job, school, leisure activities, ADL surveys) physiologic response to increased O2 demand improved

A

Pattern 6B

193
Q

Impaired Ventilation, Respiration/Gas Exchange and Aerobic Capacity Associated with Airway Clearance Dysfunction

A

6C

194
Q

Cystic fibrosis, pneumonia, COPD, pneumoconiosis, pulmonary congestion, pulmonary fibrosis, injury to heart and lung,

A

6C

195
Q

POC Ther Ex, disability mgmt, WOB mgmt/breathing strategies, relaxation techniques, flexibility ex’s, balance, postural control, ADL training, functional training programs (task adaptation) and manual/mechanical techniques and positioning Outcomes: Aerobic capacity, Mm strength and endurance, assistive device, impact on functional limitations, Supervision of activities/tasks/ADL’s, Independence of pt with postural drainage techniques, edema measures, Gait w/o negative physiologic response, Lung sounds, O2 sats, O2 use, QOL

A

6C

196
Q

Impaired Aerobic Capacity/Endurance Associated with Cardiovascular Pump Dysfunction or Failure

A

6D

197
Q

Diseases of valves, HTN heart disease, MI, pericarditits, cardiomyopathy, conduction disorders, cardiac dysrhythmias, heart failure, aortic aneurysm

A

6D

198
Q

POC Ther Ex, disability mgmt, balance/neuro re-ed, task specific performance training, relaxation flexibility ex’s, balance, postural control, ADL training, functional training programs (task adaptation) and return to work, movement efficiency and energy conservation Outcomes Aerobic capacity, Mm strength and endurance, Assistive device, impact on functional limitations, supervision of activities/tasks/ADL’s, Edema measures, Gait w/o negative physiologic response, QOL

A

6D

199
Q

minimize risk, maximize benefit

A

risk screening

200
Q

FITT

A

specificity of training

201
Q

most beneficial for secondary prevention of CHD

A

cardiorespiratory fitness

202
Q

Most challenging task in designing the exercise program: Requires individualization, Monitoring/supervision Expressed as a percent of functional capacity: VO2 max, Age adjusted maximum heart rate (AAMHR)

A

exercise Intensity for Cardiorespiratory (CR) Fitness

203
Q

exercise prescription for intensity for CR fitness start at

A

40-50% THRR

204
Q

high intensity aerobic exercise promotes

A

respiratory muscle strength older adult with lung disease are unlikely to sustain these intensities

205
Q

sustain greater ventilatory work less respiratory fatigue ability to affect work capacity not yet determined int eh literature

A

Resistive breathing device

206
Q

sound made by the closure of the AV valves

A

S1

207
Q

sound made by teh closure of the aortic and pulmonic vlaves

A

S2

208
Q

low frequency abnormal diastolic sounds that occur when there is rapid ventricular filling

A

S3 and 4

209
Q

occurs early in diastole

A

S3

210
Q

occursas as the atria contract (late in diastole ) during the atrial kick

A

S4

211
Q

perform therapuetic percussion for how long

A

2-3 min in each position

212
Q

how many times should you perform vibration

A

2-3 times

213
Q

with CPT always re auscultate after

A

anything comes up

214
Q

sitting is the best position for

A

volitional cough

215
Q

contraindications for postural drainage

A

look at sheet

216
Q

location of apex of lungs

A

sternal portion of 1st rib

217
Q

location of diaphragm

A

7th and 8th rib

218
Q

location of R and L upper lobes

A

between ribs 2 and 4

219
Q

location of lower lobes

A

8th rib

220
Q

location of R middle lobe

A

T2-T4 around 5th and 6th rib

221
Q

enclosed, empty space; negative pressure

A

vacuum

222
Q

application of negative pressure

A

suction

223
Q

how fast air or fluid if removed

A

flow rate

224
Q

3 major factors affect flow rate

A

amount of negative pressure (set on regulator) resistance of the suction system viscosity of the material being suctioned

225
Q

to achieve maximum flow with suction

A

increase negative pressure use short lengths of large bore tuping suction watery fluids

226
Q

suctioning the airway pressure preterm infants infants children adults

A

40-60 mmHg 60-100 mmHg 60-100 mmHg 80-120 mmHg

227
Q

indication; pts are unable to clear their own secretions non sterile procedure ok to delegate to unlicensed staff or assistive personnel

A

oropharyngeal suction

228
Q

indication: pts are unable to clear their own secretions suction catheter with thumb control is passed through the nare to the back of the throat may involve a nasal airway nonsterile procedure may delegate to unlicensed staff or assistive personnel

A

nasopharyngeal suction

229
Q

Indication: unable to clear secretions and oropharyngeal suction ineffective, suspected aspiration assessment of need: auscultate chest, monitor heart rate and respiratory rate, heart rhythm, oxygen sat, skin color/perfusion, assess effectiveness of cough

A

tracheal suction

230
Q

indications of tracheostomy

A

upper airway obstruction long term airway management helps ventilator weaning

231
Q

to facilitate/improve speech allows increased volumes of air to be forced up through the larynx during exhalation to improve swallow function - restoring more normal airflow restores some of the protective mechanisms of normal swallow

A

fenestrated “talking trach”

232
Q

suction technique involves single use suction catheters

A

open

233
Q

techique utilizes a catheter in sleeve device that is incorporated into the ventilator tubing

A

closed

PTRS 826 (3 decks)

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