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Ortho Eval > Week 6 - OT Treatment for Cardiac Conditions > Flashcards

Week 6 - OT Treatment for Cardiac Conditions Flashcards

1
Q

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

A
  • sternal
  • abdominal
  • pacemaker
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2
Q

what is the surgical technique associated with STERNAL precautions?

A

median sternotomy

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3
Q

what is the purpose of sternal precautions?

A

to protect sternum as bone regenerates

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4
Q

how long are sternal precautions in place?

A

6-8 weeks

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5
Q

name 4 cardiac treatments that will have sternal precautions.

A
  • heart transplants
  • valve repairs/replacements
  • CABGs
  • TAAA repairs
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6
Q

name 8 sternal precautions.

A
  • 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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7
Q

vertical incision along the lateral aspect of the trunk

A

AAA repair precautions - surgical technique

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8
Q

what is the purpose of AAA repair precautions?

A

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

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9
Q

what is the duration of AAA repair precautions?

A

4-6 weeks

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10
Q

name 2 cardiac treatments associated with AAA repair precautions.

A
  • AAA repairs

- some TAAA repairs

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11
Q

name 6 abdominal precautions.

A
  • 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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12
Q

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).

A

pacemaker and implanted cardiac defibrillator precautions - surgical technique

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13
Q

what is the purpose of PPM and ICD precautions?

A

prevent displacement of device

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14
Q

what is the duration of PPM and ICD precautions?

A

6 weeks

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15
Q

what are the cardiac conditions associated with PPM precautions?

A

rate-related problems

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16
Q

what are the cardiac conditions associated with ICD precautions?

A

dysrhythmias including atrial fibrillation and ventricular tachycardia

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17
Q

name 5 post-operative precautions.

A
  • 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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18
Q

used to monitor activity tolerance during cardiac rehabilitation.

A

metabolic equivalent table (MET)

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19
Q

how many levels does the MET scale include?

A

12 levels

20
Q

how much energy does 1 met use?

A

3.5 mL oxygen per kilogram of body weight per minute

21
Q
  • seated activities with arms supported

- grooming, typing, eating

A

1-2 METs

22
Q
  • sustained UE tasks (2-30 mins)

- full sponge bath, transfers

A

2-3 METs

23
Q
  • walking 3 mph

- standing-level full shower, hand-washing laundry

A

3-4 METs

24
Q
  • walking 3.5 mph
  • having a bowel movement
  • light carpentry, raking
A

4-5 METs

25
Q
  • walking 4 mph
  • having sexual intercourse
  • climbing 2 flights of stairs
A

5-6 METs

26
Q
  • walking 5 mph

- pushing a lawnmower, square dancing

A

6-7 METs

27
Q
  • jogging 5 mph

- digging ditches, hand sawing wood

A

7-8 METs

28
Q
  • running 5.5 mph

- playing social handball and squash games

A

8-9 METs

29
Q
  • running 6 mph
  • playing competitive handball and squash games
  • shoveling x 10 minutes with 35 lb loads
A

10+ METs

30
Q

name the 4 phases of cardiac rehabilitation.

A
  • phase 1 - acute care
  • phase 2 - home OT
  • phase 3 - outpatient therapy
  • phase 4 - community setting
31
Q

name 5 OT considerations.

A
  • vital signs monitoring
  • MET education
  • home safety
  • energy conservation
  • post-operative precautions
32
Q

describe bed mobility regarding line management safety.

A

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

33
Q

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

A

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

34
Q

describe walking to bathroom regarding line management safety.

A
  • 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
35
Q

describe dressing regarding line management safety.

A

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

36
Q

name 3 UE dressing considerations.

A
  • consider UE movement precautions.
  • front-fastening shirts
  • supportive, comfortable bra
37
Q

describe 2 LE dressing considerations.

A
  • excessive trunk flexion restrictions

- consider adaptive equipment to avoid strain.

38
Q

name 1 shaving consideration.

A

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

39
Q

name 1 hair care consideration.

A

avoid simultaneous shoulder flexion >90 degrees.

40
Q

name 3 bathing considerations.

A
  • showers better than baths
  • surgical incision care
  • seated to conserve energy
41
Q

how many METs is a bowel movement?

A

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

42
Q

name 3 eating considerations.

A
  • post surgical chewing/swallowing -intubation effects
  • adequate nutrition
  • avoid fluid overload (ice chips)
43
Q

what is normal BP?

A

systolic - 110-120

diastolic - 80

44
Q

<60 beats per minute

A

bradycardia

45
Q

> 100 bpm

A

tachycardia

46
Q

what is normal respiratory rate?

A

12-20 breaths per min

47
Q

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

A

keloid

Ortho Eval (24 decks)

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