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2) Cardiopulm > 8) Cardiac Exam > Flashcards

8) Cardiac Exam Flashcards

1
Q

What are the things to look at when doing a chart review?

A
  • Md’s orders
  • MHx
  • Consultations
  • MD’s notes
  • Nursing notes
  • Other HCP notes
  • Labs
  • Graphics
  • D/c plans
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2
Q

What is a normal HR?

A

60-90bpm

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3
Q

Sinus Tachycardia

A

HR>100bpm

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4
Q

Sx’s of sinus tachycardia

A
  • Anxiety
  • Anemia
  • Fever
  • Hypoxia
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5
Q

Sinus Bradycardia

A

HR <60bpm

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6
Q

Who might normally have sinus bradycardia?

A

Athletes & pt’s on beta-blockers

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7
Q

What does a pulse deficit mean?

A

Heart beats aren’t pumping enough blood

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8
Q

W/what conditions is a pulse deficit common?

A

A-fib & dysrhythmia

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9
Q

Pulse Scale

A 
4+=Bounding
3+=Incr
2+=Brisk &amp; expected
1+=Diminished &amp; weaker than expected
0=Absent &amp; unable to palpate
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10
Q

What BP is considered pre-hypertensive?

A

120/80mmHg

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11
Q

True or False: BP should be similar bilaterally.

A

True

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12
Q

What does a BP discrepancy mean?

A

The side w/the lower pressure has arterial compression or obstruction

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13
Q

What does a BP fall of 10mmHg indicate?

A

Orthostatic hypotension

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14
Q

What indicates orthostatic hypotension?

A

A BP fall of 10mmHg or more

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15
Q

What BP indicates a medical emergency?

A

200/110 or really low/no BP w/lack of normal mentation

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16
Q

What is the lowest the MAP should be?

A

65mmHg

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17
Q

Based on BP, when is activity contraindicated?

A
  • SBP >200 or <80

* DBP >100

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18
Q

When should you terminate exercise?

A

SBP >250 & DBP >110

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19
Q

How do you calculate pulse pressure?

A

SBP-DBP

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20
Q

What is the normal range for pulse pressure?

A

30-50mmHg

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21
Q

What happens to the pulse pressure as a person ages?

A

It incr

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22
Q

What does a low pulse pressure indicate?

A

Vascular wall stiffness & predicts CV events

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23
Q

W/what conditions is a low pulse pressure common?

A
  • Aortic valve disorders
  • Severe anemia
  • Overactive thyroid
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24
Q

How should breath rate be measured?

A

W/the pt seated comfortably

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25
Q

What is a normal breath rate?

A

12-16/min

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26
Q

Tachypnea

A

> 20 breaths/min

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27
Q

Bradypnea

A

<10 breaths/min

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28
Q

Dyspnea

A

Pt’s subjective report of discomfort; SOB

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29
Q

Dyspnea Scale

A

1=Light, barely noticeable
2=Moderate, bothersome
3=Moderately severe; Very uncomfortable
4=Severe difficulty; Pt can’t continue

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30
Q

Sequelae of ventilatory issues

A
  • Orthopnea
  • Hyperventilation
  • Hypoventilation
  • Abdominal paradox
  • Rib Retractions
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31
Q

What should you not forget to look at?

A

Pt’s hands

32
Q

What will be frequently seen in pt’s using high-dose bronchodilators?

33
Q

What do warm & sweaty hands w/an irregular flapping tremor indicate?

A

Acute CO2 retention

34
Q

What is weakness & wasting of hand muscles an early sign of?

A

Pancoast Tumor

35
Q

What is weakness & wasting of hand muscles an early sign of?

A

Pancoast Tumor

36
Q

What is palmar erythema a sign of?

37
Q

What is clubbing a sign of?

38
Q

What can BMI predict?

39
Q

Non-modifiable risk factors for BMI

A
  • Age
  • Sex
  • FHx
  • Genetics
40
Q

Modifiable risk factors for BMI

A
  • Smoking
  • Diet
  • Alcohol intake
  • Dyslipidemia
  • HTN
  • Obesity
  • DM
  • Metabolic syndromes
41
Q

Emerging risk factors for BMI

A
  • hsCRP
  • CAC
  • Fibrinogin
  • Homocysteine
  • Lipoprotein
42
Q

What can facial characteristics indicate?

A

Pt’s ability to breath

43
Q

Adventitious Lung Sounds

A

Rales & Rhonchi

44
Q

Rales

A

Fluid in alveoli or closed alveoli opening

45
Q

What condition are rales common?

46
Q

Rhonchi

A

Associated w/AW obstruction, constriction, or mucous; Generally heard on exhalation

47
Q

What do you need to know about a pt’s cough?

A

If its productive & effective

48
Q

What does red sputum mean?

49
Q

What does rust color sputum mean?

50
Q

What does purple sputum mean?

51
Q

What does yellow/green sputum mean?

52
Q

What does pink sputum mean?

A

Pulmonary Edema

53
Q

What do you need to know about a pt’s sputum?

A
  • Color
  • Consistency
  • Smell
  • Amount
  • Frequency
54
Q

Edema Scale

A

1+=Barely perceptible depression
2+=Easily ID’ed depression (EID); Skin rebounds in 15sec
3+=EID; Skin rebounds in 15-30sec
4+=EID; Skin rebounds in >30sec

55
Q

What will be tight after heart surgery?

A

Anterior chest & hip flexors

56
Q

What posture would you expect a pt to have after heart surgery?

A

Forward head & rounded shoulders

57
Q

What will help protect a sternal incision?

A

Good posture

58
Q

What needs to be done for an incision?

A
  • Protect it–>Don’t move the bandage!
  • Check for infection
  • Be mindful of tenderness
  • Consider location
  • Consider possible graft location
59
Q

How much should the diaphragm move w/deep inspiration?

60
Q

Apnea

A

Cessation of breathing after expiration; Interrupted by eventual inspiration or the pt dies

61
Q

Cheyne-Stokes

A

Cyclic waxing & waning of depth of breathing w/periods of apnea?

62
Q

What does cheyne-stokes indicate?

A

Severe CNS lesion

63
Q

Biot’s Breathing

A

Irregular breathing w/slow, shallow breaths & periods of apnea

64
Q

What does Biot’s breathing indicate?

A

Meningitis

65
Q

Cluster Breathing

A

Clusters of normal breaths separated by irregular pauses

66
Q

What does cluster breathing indicate?

A

Medullary or low pontine lesion

67
Q

Kussmaul Breathing

A

Marked continuous hyperventilation w/incr rate & depth of breathing to eliminate excess CO2

68
Q

What does Kussmaul breathing indicate?

A

Diabetic Ketoacidosis

69
Q

Which way will the trachea deviate towards when there’s a unilateral loss of lung volume?

A

Towards the side w/the lesion

70
Q

What conditions will cause the trachea to deviate towards the side of injury?

A

Unilateral Loss of Lung Vol

  • Atelectasis
  • Fibrosis
  • Surgical excision
71
Q

When there’s an incr lung volume, which side with the trachea deviate towards?

A

Towards the healthy side

72
Q

What conditions will the trachea deviate towards the healthy side?

A

Incr Lung Vol

  • Pneumothorax
  • Pleural effusion
  • Abdominal viscera herniation
73
Q

What is exercise tolerance indicative of?

A

Fxnl status

74
Q

What does BADCAT stand for?

A 
Breathing that is audible
Active accessory muscle use
Dyspnea
Cyanosis &amp; clubbing
AP diameter >1
Tracheal deviation away from midline
75
Q

Clinical Manifestations of Respiratory Muscle Fatigue

A
  • Rapid shallow breathing
  • Paradoxical breathing
  • Incr accessory muscle activity
  • Dyspnea
  • Hypoxemia
  • Hypercapnia
76
Q

NYHA Fxnl Classification of Heart Disease

A

1=Pt w/cardiac disease but has no PA limitations; 6-10METS

2=Slight limitations; PA results in fatigue, dyspnea, palpitations, or angina; 4-6METS

3=Marked limitations of PA-Low inetnsity PA causes sx’s; 2-3METS

4=Unable to do PA w/out discomfort; <2METS

2) Cardiopulm (16 decks)

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