10401734
| Question | Answer |
| 3VCAD stands for | triple vessel CAD |
| Phase I cardiac rehab occurs in the hospital, after a _______ or other major heart problems, or _______. | Myocardial infarction Surgical procedures |
| What is the specific goal of physical therapy in Phase I cardiac rehab? | 1. Evaluation of physiologic responses to self-care and mobilization activities. 2. Monitoring ECG, lab values, to determine hemodynamic stability and assess wounds/incision. |
| Which medical test is the most common pre- and post-cardiac surgery? | 1. Echocardiogram 2. cardiac catheterization |
| Which medical test allows you to see the blood vessels of the heart? | Coronary angiogram |
| Which two vessels are the most common for CABG? | 1. saphenous veins 2. internal mammary artery |
| What do you expect in a post-op patient at POD #1? WBC count: RBC count: Hematocrit: lung volume: pulmonary edema: pleural effusions: EKG: | WBC count: higher (trending down) RBC count: lower (trending up) Hematocrit: lower (trending up) lung volume: low (atelectasis) pulmonary edema: some pulmonary edema pleural effusions: risk of pneumothorax EKG: may have post-op a-fib |
| K+ is usually (low/high) post surgery because __________, which may lead to ________. | Usually low. Due to fluid imbalance. May lead to ECG changes |
| Ca++ is usually _____ post-op, because ________, which may lead to _________. | Usually low. Due to renal insufficiency May lead to muscle weakness, fatigue, dysrhythmia |
| Intraoperative blood loss may cause low _____, _______ and _______. | Low RBC count, low hemoglobin, low hematocrit. |
| WBC is usually ______ post-op, due to _________. This may lead to ________. | Usually high. Due to infection/inflammation. May lead to fever/chills and decreased exercise tolerance. |
| Low RBC is also known as ________. | Anemia |
| Low hemoglobin count is known to cause ______, __________, ______ and _____. | Tachycardia. DOE. Poor cardiovascular reserve. Limited endurance. |
| Low hematocrit may cause ______, ________, ______ and ________. | Chest pain. Dizziness. DOE/ SOB. Muscle cramps. |
| Low platelet after surgery may be caused by __________ from the _________. It may result in _____. Caution during PT should be paid to avoid ________. | Caused by consumptive thrombocytopnea from the cardiopulmonary bypass circuitry. may result in slowed healing and risk of bleeding. PT caution: fall prevention, bruising. |
| Which movements should be promoted for a sternal precaution patient? | 1. shoulder, scapular full ROM 2. unilateral and bilateral movements of the arm 3. allow using UE for sit-to-stand 4. Log roll for bed mobility |
| What should the patient do when coughing? | splint the chest with pillow. |
| What is the weight lifting limit bilaterally and unilaterally? | Bilateral: 10lb Unilateral: < 5lb |
| What is a movement that should be avoided during sternal precaution? | Active curl-up from supine |
| Which risk factors can increase likelihood of sternal complication? | 1. smoking 2. DM 3. COPD 4. obesity/ high BMI 5. large breast size 6. increased time for cardiopulmonary bypass 7. increased time for mechanical ventilation 8. limited functional capacity |
| Which questions should you ask before proceeding to treatment? | 1. Are there any red flags present? 2. Is the patient medically stable? 3. Do the patient's symptoms fit the clinical referral? 4. Have I reviewed the most recent: CXR, lab values, ECG, and vitals? |
| Criteria for the patient to be considered medically stable? | 1. No new/recurrent episode of chest pain in past 8 hours 2. No new signs of uncompensated HF (no dyspnea at rest, no bilateral crackles >0.5 of lung, no hypotension) 3. No new significant, abnormal ECG during the past 8 hours 4. Troponin levels are decreasing 5. Patient is able to speak comfortably with a RR <30 breath/min 6. Cardiac index > 2L/min/m2 7. Central venous pressure > 12 mmHg |
| What is the difference between pneumothorax and atelectasis? | Partial lung collapse: atelectasis Entire lung collapse: pneumothorax |
| What are some common ECG changes in post-op patients? | 1. a-fib 2. atrial flutter 3 .PVC |
| Why is there increased tissue O2 extraction post-op? | 1. increased O2 consumption for healing 2. decreased O2 delivery due to recovering heart |
| What are some position-related symptoms of post-op patients? | Orthostatic hypotension |
| Atelectasis is caused by | Mucous plug in the bronchiole |
| What are some common pulmonary complications in post-op patients? | 1. atelectasis 2. pneumothorax 3. exacerbation of COPD 4. pulmonary edema 5. pleural effusions 6. infection 7. hypoxemia 8. respiratory failure due to prolonged ventilatory support |
| Can the patient exercise if he/she has stable angina? | Yes |
| Can the patient exercise if he/she has unstable angina? | No |
| Can the patient exercise if he/she has history of endocarditis? | Yes |
| Can the patient exercise if he/she has an active endocarditis? | NO |
| Can the patient exercise if he/she has sustained VT? | No |
| Can the patient exercise if he/she has 3rd degree AV block with pacemaker? | Yes. |
| Can the patient exercise if he/she has 3rd degree AV block without a pacemaker? | NO |
| Can the patient exercise if he/she has new onset of a-fib/ atrial flutter/ PAT? | NO |
| Can the patient exercise if he/she has a known bradycardia/ tachycardia without hemodynamic compromise? | Yes.Can the patient exercise if he/she has |
| Can the patient exercise if he/she has a new onset of brady/tachy with hemodynamic compromise? | NO |
| Which of the following conditions is NOT a contraindication for exercise? 1. severe symptomatic aortic stenosis 2. asymptomatic aortic stenosis 3. acute pulmonary embolus 4. compensated HF 5. decompensated HF | 2. asymptomatic aortic stenosis and 4. compensated HF |
| A drop in SBP for about ______ is a contraindication of exercise. | 10 mmHg |
| Which signs and symptoms suggests exercise intolerance? | 1. angina 2. marked dyspnea 3. pallor 4. cyanosis |
| Which of the following are only relative contraindications to exercise? 1. endocarditis 2. pericarditis 3. myocarditis | 2 and 3 |
| If the patient is experiencing atrial fibrillation with uncontrolled ventricular rate, the PT should | Obtain a medical report but it is ok to continue exercise as long as symtoms allow. |
| The relative contraindication to exercise is when the patient's BP is: | SBP > 200 mmHg or DBP > 110 mmHg |
| The RPE of exercise should be kept at about | 15/20 |
| Can the patient exercise with uncontrolled DM? (resting blood glucose is >400 mg/dL) | Relative. (depends on symptoms). |
| Average MET for toileting | 1-2 (5 - 15 beats increase) |
| Average MET for bathing | 2-3 (10 - 20 beats increase) |
| Average MET for walking | 2 - 3.3 (5 - 15 beats increase) |
| arm/trunk exercise is usually ______ MET, with ______ beats increase in HR. | 2 - 3METs 10 - 20 beats increase |
| Leg calistenics and stair climbing are usually about ______METs and _____ beats increase from RHR. | 2.5 - 4MET 10 -25 beats increase |
| POD 1, MET should be controlled at ____. | 1-2 |
| POD 2 and3, MET should be at | MET 2-3 Up to 2-3/day |
| When is the earliest time for patient to be OOB? | POD #1 (even if in ICU) |
| What is the intensity of warm-up? | 50% of stimulus intensity |
| HR should not increase for more than ____bpm | 20 -30 |
| BP should decrease for NO MORE THAN _______mmHg | 10 - 20 |
| Desired RPE is | 11-13 (light to somewhat hard) |
| Why should a cough be established after cardiopulmonary surgery? | 1. prevent aspiration and safety with eating 2. clear upper airways to increase ventilation |
| EF cut-off for low risk, moderate risk, and high risk of exercise. | low: >50%. (max. MET =/> 7) moderate: 40-49% (max MET =5.0-6.9) high: <40% (max MET = 5 or less) |
| SF-36 is an objective measure of | QOL |
| ABC scale is an objective measure of _____. | Balance efficacy |
| What are some objective outcomes for exercise tolerance? | 1. Borg RPE 2. Modified Borg 3. HR response 4. BP response 5. 6MWT |
| What are some functional assessments for patients? | 1. 5 times sit-to-stand 2. Berg balance test 3. TUG 4. Dynamic gait index 5. Functional gait assessment 6. Short physical performance battery (SPPB) 7. Gait speed |
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