Week 6 - OT Treatment for Cardiac Conditions Flashcards
Name the 3 types of post-operative precautions for pts. who underwent cardiovascular surgery.
- sternal
- abdominal
- pacemaker
what is the surgical technique associated with STERNAL precautions?
median sternotomy
what is the purpose of sternal precautions?
to protect sternum as bone regenerates
how long are sternal precautions in place?
6-8 weeks
name 4 cardiac treatments that will have sternal precautions.
- heart transplants
- valve repairs/replacements
- CABGs
- TAAA repairs
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
vertical incision along the lateral aspect of the trunk
AAA repair precautions - surgical technique
what is the purpose of AAA repair precautions?
protect the skin and muscle as skin and abdominal muscle incision heal.
what is the duration of AAA repair precautions?
4-6 weeks
name 2 cardiac treatments associated with AAA repair precautions.
- AAA repairs
- some TAAA repairs
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
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
what is the purpose of PPM and ICD precautions?
prevent displacement of device
what is the duration of PPM and ICD precautions?
6 weeks
what are the cardiac conditions associated with PPM precautions?
rate-related problems
what are the cardiac conditions associated with ICD precautions?
dysrhythmias including atrial fibrillation and ventricular tachycardia
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
used to monitor activity tolerance during cardiac rehabilitation.
metabolic equivalent table (MET)
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
