Treatment/Interventions for Cardiopulm Pathologies Flashcards
Cardiac Rehab (3 phases)
Phase I = inpatient phase: simple household tasks only
Phase 2 = outpatient: monitor exercise and risk factor reduction; multi-dimensional approach
Phase 3 = maintenance: home or gym based exercise w/ goal of continuing what was learned in phase 2 on their own w/o being monitored
Diaphragmatic Breathing Technique
indicated for difficult or labored breathing (dyspnea) due to abdominal ascities/peripheral edema b/c it will limit diaphragm descent
Goal is to increase depth and time of the breath/inhalation
Pursed Lips breathing technique
indicated for difficult or labored breathing (dyspnea) due to pulmonary edema/congestion b/c it decreases gas exchange
Goal is to create a back pressure to open up the alveoli during expiration and allow for greater gas exchange/transport
Beta Blockers
- primary action
- result
- prescribed for
- interaction w/ exercise
“-olol”
Primary action: block beta 1 receptor found in heart, decreasing the action of the SNS on the heart
Result = decreased HR and conduction –> prolonged diastole –> greater blood flow to myocardium
Prescribed for mild/modHTN
- Age predicted MHR may not be accurate, blunted HR/BP response to exercise
- Improved exercise tolerance, allowing for a longer period until discomfort
Alpha blockers
- primary action
- result
- prescribed for
Alpha receptors are responsible for eliciting a PNS response or blocking a SNS response, and are mainly found in SMOOTH MUSCULATURE (vessels)
Primary action: block alpha receptors to halt vasoconstriction in the periphery (decrease afterload)
Result = vaso-flexibility, decreased peripheral pressure
Prescribed for severe HTN
Ca Channel blockers
- primary action
- 4 types
- interaction w/ exercise
Ca is important for myocardial contractility, vasomotor tone and cardiac electrical activity
Primary action: block Ca from entering cell to halt vasoconstriction (decreasing afterload), and decrease HR and contractility
4 types: 1 & 2 most common
- decreases myocardial O2 demand and improves myocardial blood supply
- improves exercise tolerance
Avoid if on digoxin or CHF
Diuretics
- primary action
- prescribed for
- interaction w/ exercise
Primary action: reduce total fluid volume by increasing Na and water excretion, which will decrease afterload (and BP)
Prescribed for HTN, CHF
- decreases BP at rest and w/ exercise
- increase PVC’s w/ exercise
- avoid prolonged exercise in heat due to loss of electrolytes
ACE Inhibitors
- primary action
- prescribed for
- interaction w/ exercise
prevent conversion of angiotension I to II by blocking ACE converter, which will halt vasoconstriction
Primary action: halt vasoconstriction and Na/water retention to decrease BP and improve hemodynamics
Prescribed for HTN
- increased Q w/ exercise
- improve exercise performance in long-term
Anti-Arrhythmic Drugs
- Goals of drugs (3)
- Class 1-4
- interaction w/ exercise
Goal of drugs is to decrease membrane automaticity (decreased ease of AP’s), slow impulse conduction, and prolong the refractory period
Class 1 - 4
May actually enduce arrhythmias w/ exercise
Digitalis
- primary action
- prescribed for
- interaction w/ exercise
one of most common medications in US
Primary mode: block Na/K pump, activates Na-Ca exchanger driving more Ca INTO the cell, which will increase contractility (and Q), also increase renal perfusion, decrease SNS activity on the heart
Prescribed for CHF
- improve LV function, improve EF, and improve exercise tolerance
Nitrates
- Primary action
- prescribed for
- interaction w/ exercise
restore and maintain balance between myocardial O2 demand and supply
Primary action: produces NO which will cause vasodilation (decreased preload and afterload) which will ameliorate ischemia
Prescribed for angina, MI’s
- if taken prior to exercise it can decrease cardiac workload and improve tolerance before onset of angina
