Week 6 - OT Treatment for Cardiac Conditions Flashcards by Rebecca M

Name the 3 types of post-operative precautions for pts. who underwent cardiovascular surgery.

sternal
abdominal
pacemaker

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what is the surgical technique associated with STERNAL precautions?

median sternotomy

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what is the purpose of sternal precautions?

to protect sternum as bone regenerates

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how long are sternal precautions in place?

6-8 weeks

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name 4 cardiac treatments that will have sternal precautions.

heart transplants
valve repairs/replacements
CABGs
TAAA repairs

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name 8 sternal precautions.

no lifting greater than 5-10 lbs.
no pushing or pulling
no raising both arms overhead
no reaching behind with both arms
no excessive anterior trunk flexion
no lying in prone position
no driving
splinted cough

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vertical incision along the lateral aspect of the trunk

AAA repair precautions - surgical technique

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what is the purpose of AAA repair precautions?

protect the skin and muscle as skin and abdominal muscle incision heal.

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what is the duration of AAA repair precautions?

4-6 weeks

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name 2 cardiac treatments associated with AAA repair precautions.

AAA repairs

- some TAAA repairs

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name 6 abdominal precautions.

no lifting anything heavier than 5-10 lbs.
no trunk rotation
no excessive anterior trunk flexion
no pushing or pulling
no driving
splinted cough

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implantation of device in superior anterior chest area, with leads connecting to area of heart with pacemaker dysfunction (SA node, AV node of the Bundles of His).

pacemaker and implanted cardiac defibrillator precautions - surgical technique

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what is the purpose of PPM and ICD precautions?

prevent displacement of device

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what is the duration of PPM and ICD precautions?

6 weeks

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what are the cardiac conditions associated with PPM precautions?

rate-related problems

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what are the cardiac conditions associated with ICD precautions?

dysrhythmias including atrial fibrillation and ventricular tachycardia

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name 5 post-operative precautions.

sling for the first 24 hours
no lifting anything heavier than 5-10 lbs
no pushing or pulling with left arm
no driving
no left shoulder flexion and abduction beyond 90 degrees

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used to monitor activity tolerance during cardiac rehabilitation.

metabolic equivalent table (MET)

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how many levels does the MET scale include?

12 levels

how much energy does 1 met use?

3.5 mL oxygen per kilogram of body weight per minute

seated activities with arms supported

- grooming, typing, eating

1-2 METs

sustained UE tasks (2-30 mins)

- full sponge bath, transfers

2-3 METs

walking 3 mph

- standing-level full shower, hand-washing laundry

3-4 METs

walking 3.5 mph
having a bowel movement
light carpentry, raking

4-5 METs

- walking 4 mph - having sexual intercourse - climbing 2 flights of stairs

5-6 METs

- walking 5 mph | - pushing a lawnmower, square dancing

6-7 METs

- jogging 5 mph | - digging ditches, hand sawing wood

7-8 METs

- running 5.5 mph | - playing social handball and squash games

8-9 METs

- running 6 mph - playing competitive handball and squash games - shoveling x 10 minutes with 35 lb loads

10+ METs

name the 4 phases of cardiac rehabilitation.

- phase 1 - acute care - phase 2 - home OT - phase 3 - outpatient therapy - phase 4 - community setting

name 5 OT considerations.

- vital signs monitoring - MET education - home safety - energy conservation - post-operative precautions

describe bed mobility regarding line management safety.

log roll onto the side where there is no chest tube (usually right side)

describe sit-to-stand transfers regarding line management safety.

don't step onto any lines bc you can restrict flow or dislodge

describe walking to bathroom regarding line management safety.

- often need 2 staff (one assisting pt., another carrying chest tube box and pushing IV pole. - one chest tube is removed and pt is deemed stable on their are feet they are usually permitted to walk themselves into the bathroom pushing the IV pole

describe dressing regarding line management safety.

-hospital gown has snaps at sleeves and open back to dress around lines.

name 3 UE dressing considerations.

- consider UE movement precautions. - front-fastening shirts - supportive, comfortable bra

describe 2 LE dressing considerations.

- excessive trunk flexion restrictions | - consider adaptive equipment to avoid strain.

name 1 shaving consideration.

electric razor to minimize blood loss with risks if taking anticoagulant meds.

name 1 hair care consideration.

avoid simultaneous shoulder flexion >90 degrees.

name 3 bathing considerations.

- showers better than baths - surgical incision care - seated to conserve energy

how many METs is a bowel movement?

4-5 (pt may take laxative to avoid strain at first)

name 3 eating considerations.

- post surgical chewing/swallowing -intubation effects - adequate nutrition - avoid fluid overload (ice chips)

what is normal BP?

systolic - 110-120 | diastolic - 80

<60 beats per minute

bradycardia

>100 bpm

tachycardia

what is normal respiratory rate?

12-20 breaths per min

when scar tissue exceeds the borders of the original surgical incision. can resist ROM

keloid