8976 Study Guide - Midterm Guide: Pulmonary Compliance, Bronchospasm, Hernia
2 Jul 2018
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CARDIOTHORACIC INTERVENTIONS PRAC EXAM NOTES
MOBILISATION
Evidence (3)
1. Mckay and Ellis (2005) found that adding Deep Breathing and Coughing
to mobilization added no more improvement than mobilization by itself
after Open Abdominal Surgery
2. Haines et. Al (2013) 3 times more likely to develop PPC for every day a
patient does not mobilise away from the bed
3. Orfanos et al (1999) found that upright posture increased Thoracic
Volume and Respiratory Rate
Precautions (8)
1. PaO2/FiO2 less than 300 (they require high O2 during exercise)
2. Cardiovascular status (Heart Rate and BP)
3. Weight Bearing Status (do they usually use a walking aid)
4. Nausea and Vomiting
5. Level of Cooperation from Patient
6. Environmental Risks (prepare environment, TED stockings, chair)
7. Attachments
8. Prepare for emergency
9. Skin Graft
10. DVT without anticoagulant therapy
Contraindications (6)
1. Severe pain
2. Decreased Cognition
3. Inability to Weight Bear
4. Unstable Cardiovascular Status
5. Un-drained Pneumothorax
6. Require Continuous UWSD suction (for away from bed)
What Is the Benefit (7)
1. Upright posture increases Ventilation – Perfusion matching
2. Increased FRC and lung volumes with upright posture
3. Increased Thoracic Volume + increased flow rate means more chance to
open collapsed airways and shear out sputum
4. Increased lymphatic flow
5. Increased Respiration Rate and Depth
6. Increased surfactant (helps keep alveoli by increasing surface tension)
7. Maintain Functionality for ADLs
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Document Summary
Evidence (3: mckay and ellis (2005) found that adding deep breathing and coughing to mobilization added no more improvement than mobilization by itself after open abdominal surgery, haines et. Al (2013) 3 times more likely to develop ppc for every day a patient does not mobilise away from the bed: orfanos et al (1999) found that upright posture increased thoracic. Inability to weight bear: severe pain, decreased cognition. 3: unstable cardiovascular status, un-drained pneumothorax, require continuous uwsd suction (for away from bed) What is the benefit (7: upright posture increases ventilation perfusion matching. Increased frc and lung volumes with upright posture. Increased thoracic volume + increased flow rate means more chance to open collapsed airways and shear out sputum. Increased surfactant (helps keep alveoli by increasing surface tension) Evidence: neilson et al (2003) a systematic review found upright positioning improved frc, sao2 and pao2/paco2, orfanos et al (1999) found that upright posture increased thoracic.
