pathos exam

telehealth

"Emerging model of health care delivery . . . which involves health care services, health information, and health education" and "a mechanism to provide services at a location that is physically distant from the client, thereby allowing for services to occur where the client lives, works, and plays

telerehabilitation

•Term used to identify the use of ICTs for the delivery of rehabilitative and rehabilitative services (ATA, 2010).

•Preferred term is telehealth

synchronous telehealth delivery

•Real-time delivery

•Example: Occupational profile performed through telehealth

•Client education

•Example exercise program or techniques.

asynchronous delivery

•Not in real time

•Example: Video recording of a walkthrough of the client's home that is uploaded for the therapist

•The therapist can then make recommendations for the client to make.

•The therapist may send documents for the client and caregiver to review at their earliest convenience.

telehealth is a

delivery method

NOT A DISTINCT SERVICE

COPD encompassess

emphysema and chronic bronchitis

Stage 1 COPD

mild

80% lung function

Stage 2 COPD

moderate

50-80% of lung function

Stage 3 COPD

severe

30-50% of lung function

Stage 4 COPD

very severe

less than 30% of lung function

hypercapnia

excessive carbon dioxide in the blood

emphysema

•The walls of the alveoli are destroyed

•Causing lungs to lose some of its elasticity

•Causes air trapping

•Reduces ability for the lungs to shrink during exhalation

•The lung then inhales less air on the next breath.

chronic bronchitis

•Excessive sputum production and cough lasting at least 3 months occurring 2 years in a row.

•Decreased oxygen to the brain caused by decreased oxygen in the blood (hypoxemia)

•Impaired judgment, confusion, and motor incoordination

•Buildup of carbon dioxide (hypercapnia) due to inadequate gas exchange in the lungs

•Drowsiness and/or apathy

diaphragmatic breathing

•Sit in a relaxed position preferably with feet elevated

•Place your hand on your abdomen

•As you inhale through your nose, try to feel your stomach push out as your lungs fill with oxygen

•Next, fill your stomach go down as you exhale with pursed lips

•Continue until you feel comfortable doing this

•Stop if you get light headed or fatigued.

asthma

•Asthma is a lung disease that makes it harder to move air in and out of your lungs.

•Airways in your lungs are often swollen or inflamed which makes them extra sensitive to things in the environment like cold weather, dust, smoke, chemicals, pet dander, etc.

•When you breathe in a "trigger" the airways become even more swollen.

•Most triggers cause an allergic reaction.

status asthmaticus

a prolonged, exacerbated, extremely severe, life-threatening asthma attack

Basal Metabolic Equivalent (MET) levels

cardiac

input valves

bicuspid, tricuspid

DIASTOLIC

output valves

aortic and pulmonary

SYSTOLIC

electrical conduction pattern of the heart

sinoatrial (SA) node in right atrium

atrioventricular (AV) node

bundle of His

L & R bundle branches

Purkinje fibers

SA node function

responds to vagal and sympathetic nervous system input

Ischemic heart disease

occurs when part of the heart is temporarily deprived of O2

coronary artery disease

atherosclerosis (build up of plaque) of the coronary arteries

narrowed blood vessels lead to reduced blood flow and O2 and nutrients

precursor to all cardiac events

can lead to CHF and MI

STEMI MI

involves all 3 layers of the heart-transmural

ST segment of ekg is elevated

classic heart attack

moderate to large MI= poor prognosis

anterior STEMI

most serious because of large muscle mass that is lost in the heart

Q wave indicates

size of MI

Non-STEMI MI

when thrombus in the coronary artery is incomplete, less damage

better prognosis but there is a higher risk for death or other cardiac events, due to hx of previous cardiac events

valvular disease

volume and pressure overload

volume overload

valve fails to close properly, blood backflows

increases risk for AFIB

aortic stenosis

pressure overload

Fromingham heart study identified...

risk factors for heart disease

cardiac ablation

destroy small areas that emit dangerous signals

Cardiac Rehab Phase 1

monitored low-level ax, 24-48hrs for medical status

self care

energy conservation

graded ax, monitor vitals

NSTEMI hospital stay

1 day

STEMI hospital stay

2-3 days

CABG hospital stay

3-7 days

Cardiac Rehab Phase 2

outpatient

cardiac rehabilitation is education about proper exercise procedures, and about how to self-monitor heart rate and exertion levels during exercise. This phase centers around your safe return to functional mobility while monitoring your heart rate.

•Begins upon discharge from hospital

•~3 days a week for 4-8 weeks (everyone is not the same)

•Around 5.0 - 6.0 METS for exercise goal if they have good heart function and physical condition

•Elderly patient that have low functional capacity may have a lower MET goal based on what level they begin at.

•Continuous versus discontinuous exercise

MAHR (maximum age adjusted heart rate)

•take 220, subtract pt's age

The difference is the pt's max age-adjusted heart rate

•To get the range of 50-70%, multiply that number by .50 and .70.

Cardiac Rehab Phase 3

Phase three of cardiac rehabilitation involves more independent and group exercise. You should be able to monitor your own heart rate, your symptomatic response to exercise, and your rating of perceived exertion (RPE).

community-based

not covered by insurance

•Trained personnel will monitor BP response and assist patients with monitoring their heart rate

•Goal setting for risk management continues

•Patients gain support form people who have a common goal of reducing their incidence of heart disease

shock related respiratory failure

pulmonary edema, sepsis, cardiac events lead to difficulty keeping O2 in blood

hypoxemic respiratory failure

too little O2

hypercapnic respiratory failure

too much CO2 in blood

acute on chronic respiratory failure

longstanding lung conditions that worsens