Cardiac eval Flashcards
Angina rating scale (ACSM)
0-no pain
1-mild, barely noticeable
2-mod, bothersome
3-mod severe, very uncomfy
4-most severe or intense pain ever experienced
Labs specific to pt with cardiopulmonary dysfunc
-blood lipids
-CBC
-BUN, creatine, arterial blood gases
-coagulation studies (ability blood to clot)
-electrolyte screening panels
-glucose tolerance tests (sensitivity to insulin)
Radiologic tips
-denser material, lighter it appears on xray
-dense (bone) will appear white
-air is black, and muscle, fat, fluid is gray
Medicare guideline O2
Resting PO2 of <55 mmHg on room air or O2 % saturation of <88% should be considered for supplemental O2
if pt has low PO2 but NOT <55 on room air OR low PO2 on O2, pt may need supplemental O2
Arterial blood gases (PaO2)
norm: 80-100 on room air
mildly hypoxemic: 60-80
mod hypoxemic: 40-60
Severe hypoxemic: <40
blood draw to determine total dissolved O2
General appearance
Body posture and position may affect respiration
Kyphosis and scoliosis [limit vital capacity and hence exercise capacity]
Assuming the professorial position
Often unable to lie in a flat, supine position
Typically assume a semi-Fowler’s position
-skin tone can indicate level of O2 and perfusion of periphery
-cyanosis of skin is due to lack of O2 in blood (mostly in lips and fingernail beds)
Central cyanosis
caused by diseases of heart or lungs or abnormal hemoglobin
discoloration systemic (they will be totally blue)
Peripheral cyanosis
caused by decreased local circulation and increased extraction of O2 in peripheral tissues
discoloration regional
First heart sound/S1
-lub
-associated w/ closure of mitral and tricuspid valves
-corresponds w/ onset of ventricular systole
-results from reverberation within blood associated w/ sudden block of flow reversal by valves
second heart sound/S2
-dub
-closure of aortic and pulm valves
-corresponds with the start of ventricular diastole
-results from reverberation within blood associated w/ sudden block of flow reversal
Third sound /S3
-lub dub dub
-occurs in early diastole while ventricle is rapidly filling
-norm in healthy children or young adults
-older people- indicates loss of ventricular compliance
-called ventricular gallop
Fourth sound/S4
-la-lub-dub
-occurs late in diastole before S1
-atrial gallop
-associated with increased resistance to ventricular filling
-hypertensive cardiac disease, CAD, pulmonary disease
Murmurs
-results from vibrations from turbulent blood flow
stenosis: aortic or pulmonary valve cant fully open
regurg: mitral/tricuspid valve cant fully close
mitral valve prolapse/regug is most common valvular condition
Pitting edema scale
0-no depression
1+ : barely detectable depression
2+ : slight indentation. <15 secs rebound
3+ : deeper indentation. 15-30 secs rebound
4+ : >30 secs to rebound
Activity eval
-mode of activity (walk, cycle, etc)
-intensity, work level, rate of activity (mph, % grade, etc)
-duration of activity at each intensity level
*Eval terminated if and when an abnormal response identified
