Conditions in Occupational Therapy

COPD AKA

Chronic Obstructive Pulmonary Disease (COPD)

COPD - Define

damage to the alveolar walls and inflammation of the conducting airways resulting in constriction and inflammation of the airways and more mucus production than usual.

COPD onset

gradual with dyspnea on exertion progressing to dyspnea at rest

Leading cause of COPD

cigarette smoking

Signs and Symptoms of COPD

1. dyspnea

2. fatigue

3. chronic cough

4. chest tightness

5. sputum production

Ways to measure lung function?

Pulse Oximeter and Spirometer

Pulse Oximeter define

place on fingertip and will report amount of oxygen in blood. needs to be greater than 90%

Spirometer define

breath into the device very slowly and exhale normally for 10 repetitions. A patient should have 1000 ml volume for reasonable amount of air inhaled.

Pneumonia define

inflammation of the lungs

Main types of Pneumonia

1. bacterial

2. viral

3. mycoplasmal

4. aspiration pneumonia

Bacterial Pneumonia define

most often streptococcus bacteria

Viral Pneumonia define

virus

Mycoplasmal Pneumonia define

same as bacterial but a specific and unique species of bacteria

Aspiration Pneumonia define

when client inhales food or liquid and it goes into the lungs and becomes infected. often in stroke clients

Methods of transmission of Pneumonia

1.Inhalation

2.Direct contact- secretions

3.Indirect contact with articles

Signs and Symptoms of Pneumonia

1.chills

2.chest pain

3. cough with rust or green colored mucus

4.fever 105 deg.

5. confused

6.increased breathing

7.lips and nail beds look blue

OT treatment of Pneumonia

1. graded activities to improve endurance and strength

2. functional activities- ADLs/IADLs , gradually increase level of activity.

3. patient education in energy conservation and simplification techniques.

Tuberculosis define

infectious chronic disease caused by M. tuberculosis.

Methods of spreading TB

inhalation-coughing, sneezing, or talking.

Signs and Symptoms of TB

1. cough

2. hemoptysis (coughing up blood)

3.fever

4.weight loss

3 types of TB

1.Latent

2.Active

3.Extrapulmonary

Latent define

90-95% of the population have a latent infection, where the bacteria remains dormant and the person does not develop symptoms.

Active

5-10 % of the population move into the symptoms and the active stage, where the symptoms and the ability to spread the disease occur

Extrapulmonary

TB that settles in the bone or organ in the body

Treatment of TB

medication consists of chemotherapeutic agents, which are administered daily and then three times a week. under direct observation for 6 months.

TB skin test

1. test to verify previous exposure

2. health-care workers must have the test once a year.

3.antigen injected under skin

4.if no raised area, test is negative

5.if raised area, sent to dr. for chest x-ray to verify if your infected.

6. Further test include mucus, bone, and tissue

Protect yourself by using

personal protective equipment (PPE)

OT treatment of TB

1.graded activities to improve endurance and strength

2. functional activities such as ADLs and IADLs by gradually increasing level of activity

3. Patient education in energy conservation and simplification techniques

Coronary Artery disease (CAD) define

condition in which plaque builds up inside the coronary arteries. these arteries supply your heart muscle with oxygen-rich blood.

What is plaque in CAD

plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.

When plaque builds up in the arteries the condition is called

atherosclerosis

Plaque causes problems

plaque narrows the arteries and reduces blood flow to your heart muscle. It also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow.

What does Angina or heart attack/ myocardial infraction MI may cause

when your coronary arteries are narrowed or blocked, oxygen-rich blood cant reach your heart muscle.

Angina define

chest pain or discomfort that occurs when not enough oxygen-rich blood is flowing to an area of your heart muscle.

Angina may feel like

pressure or squeezing in your chest. the pain also may occur in your shoulders, arms, neck, jaw, or back.

Angina tends to get worse and better when

this pain gets worse with activity and goes away when you rest. emotional stress also can trigger the pain.

Other names for Coronary Artery disease

1.atherosclerosis

2.coronary heart disease

3.hardening of the arteries

4.heart disease

5.ischemic heart disease

6.narrowing of the arteries

What causes Coronary artery disease?

research suggest that coronary artery disease (CAD) starts when certain factors damage the inner layers of the coronary arteries.

Coronary artery disease factors are

1.smoking

2.high amounts of fats and cholesterol in the blood

3.high blood pressure

4.high amounts of sugar in the blood due to insulin resistance or diabetes

The most common type of heart disease is

Coronary artery disease (CAD)

The leading cause of death in the U.S. for both men and women is what

Coronary artery disease (CAD)

Help prevent/ treat CAD by

1.life style changes

2.medicine

3.medical procedures

Arrhythmia define

problems with the speed or rhythm of your heartbeat.

Over time, CAD can weaken the heart muscle and lead to

congestive heart failure and arrhythmias

Heart failure is when

your heart cant pump enough blood throughout your body

You may notice with an arrhythmia that

your heart is skipping beats or beating too fast.

A fluttering feeling is called

palpitations

Arrhythmia may also cause

your to heart to suddenly stop beating

Sudden Cardiac Arrest (SCA) define

The heart stops beating. It can make you faint and cause death if not treated right away.

Heart attack or a myocardial infraction (MI) define

when an area of plaque in a coronary artery breaks apart, causing a blood clot to form. The blood clot cuts off most or all blood to the part of the heart muscle thats fed by the artery. Cells in the heart muscle die b/c they dont receive enough oxygen-rich blood. This can cause lasting damage to your heart.

Symptoms of a Heart attack

intense radiating chest pain or discomfort.

Chest pain- comes and goes in the center of chest.

Discomfort- pressure, squeezing, fullness, or pain.

Heart attack symptoms may also feel like

indigestion or heartburn

Other symptoms of a heart attack or cardiac distress are

1. UE discomfort in one or both arms, back, neck, jaw, or stomach.

2.Dyspnea, fatigue- may occur with or before

3.Nausea

4. lightheadedness

5.diaphoresis- cold sweat

6.cynanosis- turning blue

7.unable to conversate

8.heart palpitations

9.if blood pressure falls >20 mm Hg or HR >20bpm over resting rate or Orthostatic Hypotension

Orthostatic Hypotension define

falling blood pressure

Heart attack treatment/surgery

Angioplasty

or

Coronary Artery Bypass Graft (CABG)

Angioplasty define

balloon catheter guided through artery pushing plaque against the arterial wall to open blockage. to keep artery open, a wire mesh tube or a stent is implanted.

Coronary Artery Bypass Graft (CABG) define

Surgeon opens chest through sternum with saw and spreads ribs to get to heart. Diseased sections of the coronary arteries are bypassed with healthy blood vessels from veins in the legs.

Sternal Precautions

No lifting, pushing, or pulling <10 lbs

Do not use arms to sit down, stand up, or push up from side lying to sit

Use legs only to move wheel chair

Hold pillow to chest

Avoid activities that reach over head

Diuretics define

to reduce edema. cardiac medication

Vasodilators define

open arteries. cardiac medication

Anticoagulants define

thins blood to reduce clots. cardiac med.

Antiarrhythmics define

keep heart beating regularly. cardiac med.

Beta Blockers and calcium channel blockers define

lowers bp, manages angina, and controls CHF. cardiac med.

Nitrates define

relaxes blood vessels, increases blood flow. cardiac med.

Cholesterol lowering drugs define

lowers LDL (bad cholestrol) such as Statins. cardiac med.

What OTA should know about cardiac meds

calcium channel blockers, nitrate, and diuretics can cause client to have orthostatic hypertension. OTA should watch closely with supine to sit and transfer or any activities that require sudden postural changes.

Anticoagulants- coumadin or heparin can cause the client to bleed easily. Dont let client cut themselves.

Side effects to report to nurse when treating patient on meds

nausea, palpitations, vomiting, abdominal cramps, arrhythmia. DOCUMENT

Cardiac rehab Acute phase define

1 to 3 days- stabilization of patients condition

Cardiac rehab phase 1 define

acute but stable- this includes:

vital signs after activity,

performing activities that decrease effects of prolonged inactivity,

monitored low lvl physical activity and seflcare (MET lvl),

reinforce safety precautions,

graded activity,

teach energy conservation,

guildlines for activity lvls at discharge

Cardiac rehab phase 2 define

outpatient (about 12wks) cont. everything in phase 1. monitored HR and BP while increasing exercise

Cardiac rehab phase 3 define

community based exercise- cont. endurance training and safety precautions and modifications. prepare to return to work.

Cardiac rehab rates and tables to use are

Borg Rate of Perceived Exertion (RPE)- for client to monitor self.

and

Metabolic Equivalent Table (MET)- for client to slowly increase activity.