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Cardiopulmonary
Coronary Artery Disease (CAD) - a condition affecting arteries of the heart that reduces the flow of blood and the delivery of oxygen and nutrients to the myocardium; most often caused by atherosclerosis Signs + Symptoms of Cardiac Distress - -dyspnea -angina -orthopnea -nausea/vomiting -cold/clammy (diaphoresis) -fatigue -orthostatic vitals Hypotension - lower than normal blood pressure CAD Risk Factors - -age -family history -smoking -high BP -elevated cholesterol levels -stress -obesity -diabetes -sedentary lifestyle Anticoagulants: Adverse Effects - Bleeding Bruising or cuts GI upset Hepatic dysfunction Alopecia, dermatitis, bone marrow suppression, prolonged, and painful erection
NYHA Heart Failure Class 1 - -diagnosed w/HF but no limitation of physical activity NYHA Heart Failure Class 2 - -slight limitation of physical activity -comfortable at rest NYHA Heart Failure Class 3 - -marked limitation of physical activity -comfortable at rest NYHA Heart Failure Class 4 - -inability to carry on any physical activity without discomfort -symptoms of HF may be present at rest -discomfort increases w/any physical activity Sternal Precautions - -do not lift more than 8 pounds -do not push or pull with arms when getting into and out of bed or up from a chair -do not bring elbows above shoulders -avoid twisting and deep bending -hug a pillow when coughing or sneezing -do not drive until cleared by surgeon -report clicking or popping noises to your surgeon Atherosclerosis - condition in which fatty deposits called plaque build up on the inner walls of the arteries Myocardial Infarction (MI) - heart attack; death of myocardial tissue (infarction) caused by ischemia (loss of blood flow) as a result of an occlusion (plugging) of a coronary artery usually caused by atherosclerosis
ex: Metoprolol, Atenolol Nitrates/Vasodilators - relax blood vessels, increase blood flow and O2 to the heart, reduce cardiac workload, ease angina ex: isordil, nitroglycerin ACE Inhibitors - decrease preload through peripheral vasodilation, reduce myocardial O2 demand, improve blood flow, antihypertensive ex: Monopril Calcium Channel Blockers - inhibit flow of calcium ions decrease HR, angina control arrhythmias dilate coronary arteries ex: Procardia, Cardizem, Norvasc Diuretics - decrease myocardial work antihypertensive ex: Lasix, Esidrix
Anti-platlet agents - prevent platelets from forming clots usually prescribed for unstable angina, after MI Coronary Artery Bypass Grafting (CABG) - procedure in which a blood vessel from another part of the body is surgically attached to a coronary artery to bypass an area of blockage -used to treat CAD COPD (chronic obstructive pulmonary disease) - A group of lung diseases that block airflow and make it difficult to breathe. -includes emphysema and chronic bronchitis Emphysema - permanent, abnormal enlargement and deconstruction of air spaces s/s of dyspnea upon exertion, diminished breath sounds, chronic cough, wheezing interventions include smoking cessation, corticosteroids, O2 therapy, surgery Chronic Bronchitis - inflammation of bronchi persisting over a long time; type of chronic obstructive pulmonary disease (COPD) -chronic cough and sputum production, with dyspnea -A client with chronic bronchitis has poor oxygenation, resulting in a bluish tinge to skin and lips (cyanosis), along with edema. OT Eval for Respiratory Conditions - - ADL assessment, noting ROM, muscle strength, sensation, cognition, and psychosocial status
Contraindications for Cardiac Rehabilitation - -acute MI (within 2 days) -unstable angina -uncontrolled cardiac arrhythmias -acute PE or pulmonary infarction -acute myocarditis or pericarditis -acute aortic dissection Current CPR Guidelines - -100 compressions/minute -30:2 compression to breath ratio -Push at least 2 inches deep (no interruptions) Cystic Fibrosis (CF) - hereditary disorder of the exocrine glands characterized by excess mucus production in the respiratory tract, pancreatic deficiency, and other symptoms can effect function including exercise intolerance, poor nutrition, developmental delays Respiratory Distress Syndrome (RDS) - A respiratory disorder that affects premature infants born without enough surfactant in the lungs It is treated with respiratory support (O2, CPAP, intubation if severe) and surfactant administration Wound Vac - A medical device that applies negative pressure to a wound to promote healing and prevent infections. The wound VAC should not be turned off without the nurse's knowledge because it can only be turned off for 2 hours within a 24-hour period. Postprandial orthostatic hypotension - occurs when a person goes from supine to standing shortly after eating a meal.
Peripheral Artery Disease - A form of peripheral vascular disease in which there is partial or total blockage of an artery, usually one leading to a leg or arm. -be aware of c/o leg pain/cramping when walking as this can be a sign of decreased blood flow Ambulation post DVT Anti-coagulation administration - ambulation may be permitted as soon as an effective anticoagulation level has been reached. early ambulation is not associated with increased risk of adverse events or mortality for patients with DVT. Pacemaker Implantation Precautions - no shoulder flexion or abduction greater than 90° on the side on which the pacemaker was implanted for the first 4 weeks. Best sleep position for client w/obesity + sleep apnea - side lying Typical cause of pulmonary embolism - DVT in the lower extremities Symptoms of Right Sided Heart Failure - cyanotic nail beds, jaundice, and lower-extremity edema Symptoms of Left Sided Heart Failure - wheezing, dyspnea, orthopnea, dry cough, anxiety, and cerebral hypoxia. Asthma - A chronic allergic disorder characterized by episodes of severe breathing difficulty, coughing, and wheezing. Barrel Chest - happens when the lungs become overfilled (hyper-inflated) with air — like a balloon — as they work harder. In children, asthma is the most common cause of barrel chest
