cardiac evaluation Flashcards
Med record/chart review
- extract pertinent info to develop database on pt
- helps drive physical assessment
anginal equivalents
signs/symptoms that can indicate cardiac ischemia that aren’t traditional signs
Ex: fear of impending doom
T/F: anginal equivalents are more common in males than females
False
more common in females
Data Acquisition:
Med list
what meds and why?
- in the outpatient setting patients should always be asked to bring list of OTC meds and herbal supplements or the actual containers
- review for duplicates
- consider AE
- are drugs working
On an XR what strucures are lighter in color
The denser the material, the lighter it appears
air will be black
muscle, fat, and fluid will apear in shades of gray
Data Acquisition:
O2 recruitment
- does pt use supplemental O2
- can PT change flow rate?
- does order for O2 prescribe the flow rate?
When should a patient be considered for supplemental O2?
- resting PO2 < 60mmHG on room air or O2 % sat < 90%
When would a patient possibly require supplemental O2 w/exercise?
low PO2 but not below 60mmHg on room air or low PO2 on oxygen
T/F: minimally invasive surgery is dependent on which valve needs replacing and doesn’t requires sternal precautions
True
What to keep in mind regarding surgical complications
did they occur during the procedure or immediately afterwards?
Normal PaO2 on room air
80-100 mmHg
mildly hypoxemic PaO2
60-80 mmHg
moderately hypoxemic
40-60 mmHg
Severely hypoxemic
<40 mmHg
What to look for with a pacemaker range
- note the low and high values
- If high value is reached, will shock (defibrillation) to reset heart
- stop PT if getting too close to high range.
why does a defibrillator reset the heart when the high pacemaker value is reached?
prevent VFIB
what to keep in mind when reviewing vital signs
- how have they changed?
- assess if not recent and/or if needed
what to keep in mind when reviewing the hospital course of a patient
- what has been the patient’s clinical course since admission?
- complications increase risk for serious complications or death
physical exam:
general appearance
- body posture and position that may affect respiration
- skin tone may indicate general O2 level and peripheral perfusion
semi fowler position
decreases overload of fluid in system
position is 30 deg elevation of head of bed
professorial position
stabilizes upper ribs to allow full lung expansion
where is cyanosis most noticable?
at lips and fingernail beds
central cyanosis
caused by diseases of the heart or lungs, or abnormal hemoglobin
discoloration is systemic
peripheral cyanosis
caused by decreased local circulation and increased extraction of O2 in peripheral tissues
discoloration regional
