•Note IV’s, Foley Catheters and other medical lines
•Pain-BP goes up
OT initial assessment
Previous level of function - 4 areas to consider
•Functional Activity Endurance
What precautions do you have to be aware of for open heart surgery patients?
•Sometimes referred to as “acute confusional
•Occurs in about 21% of post cardiac surgery patients with a mean duration of 2.5 days
What are the 3 types of delirium?
Hyperactive- agitation, restlessness,
attempts to remove catheter, tubes, hitting, biting, emotional lability
Hypoactive- withdrawal, flat affect,
apathy, lethargy, decreased responsiveness
Mixed- concurrent or sequential
appearance of some features of both hyperactive and hypoactive
What area of the brain is very sensitive to
Is cognitive impairment common after a CABG?
Yes, at d/c from hospital 53% have cognitive impairment
How long does post cardiac surgery leg edema last?
About 6 months
Are compression stockings always appropriate for edema?
No, compression is NOT indicated for
How long does healing of heart muscle take?
About 4-8 weeks
who have had a MI are taught to gradually progress from light to moderate ADL
and IADL activities. Keeping activity level between ___ and ___ METS until
they are assessed at cardiac rehab and given
2 to 4 METS
What do OTs educate on in Acute Care? (4)
•Heart Health and Activity Risk Factors
•Physical Precautions and their functional implications
•Energy Conservation & Activity Modification
What are the cardiac activity risk factors? (10)
•Extreme temp, or wind
•A recent large meal
•Tobacco, or street drugs
•Fumes or dust
•Feeling tired or unwell
•Stooping, bending or working overhead
What are symptoms of overdoing it? (5)
What are some energy conserving tips? (3)
•Most patients have more energy in the
•Adequate rest break between activities or
•Take med effects into account
What are the 6 P's of energy conservation?
4. Posture (body mechanics)
5. Physical activities
6. Practicing the P's
Education re: Shortness of Breath (SOB) (2)
Pursed Lip Breathing
Positioning - support and relax the arms
Key for stress management?
Stress management education (7)
•Physical/Behavioral Coping Skills
•Yoga and Slow Stretching
•Incorporating good sleeping habits into lifestyle
•Relaxation Exercises (ex. Deep breathing, imagery, progressive muscle relaxation)
•Cognitive/Mental Coping Strategies (ex. Problem solving, reappraisal, meditation)
•Personal/Social Coping Skills (ex. Integration of leisure time in lifestyle, explore spirituality, develop hobbies and interests, give to others, implement vacation and rest)
When going up stairs should you put your stronger or weaker leg first?
strong leg first
Going down step with weaker leg
OT Role in outpatient cardiac rehab
•Activity guidelines for functional activity/work/play
•Facilitating independence or return to
productive role: ADL equipment, community supports, family education
•Address changes in cognitive function
•Self management skill building: stress
•Post op complication management
To assess the physiological response of
people with no known cardiovascular disease
Exercise stress testing
When is the exercise stress test stopped?
•When target HR has been reached
•Pt. develops symptoms (angina, dizziness,
dyspnea, leg claudication, marked tiredness (19 on Borg scale)
•Specific ECG changes (Ex. Arrhythmias)
What work conditions are not ideal for people
who have HF?