cardio Flashcards
Ms Smith is admitted to the trauma ward due to sustaining a pneumothorax after being assaulted at work. The trauma surgeon inserted an intercostal drain (ICD) at her right chest wall, prescribed analgesia and referred her for physiotherapy.
- Define a pneumothorax. (1)
is a complete of partial collapse of a lung, which is due to air leaking into the pleural space , the increased intra-thoracic volume due to air occupying the pleural space leads to lung collapse and compression of underlying lung
Ms Smith is admitted to the trauma ward due to sustaining a pneumothorax after being assaulted at work. The trauma surgeon inserted an intercostal drain (ICD) at her right chest wall, prescribed analgesia and referred her for physiotherapy.
2. Document the CXR features that you would anticipate to see with a pneumothorax. (4)
- mediastinal shift away from pneuomothorax
- Black lung fields with NO lung markings
- hyperinflated lung
- edge of lung pulled away from rib cage resulting in lung collapse
Ms Smith is admitted to the trauma ward due to sustaining a pneumothorax after being assaulted at work. The trauma surgeon inserted an intercostal drain (ICD) at her right chest wall, prescribed analgesia and referred her for physiotherapy.
3. Explain the ICD activity that you would observe in the ICD bottle of Ms Smith. (2)
- swing/ oscillation which refelects the changes in pleural pressure on breathing
- bubbling- reflects the amount of air draining out of the pleural space
Ms Smith is admitted to the trauma ward due to sustaining a pneumothorax after being assaulted at work. The trauma surgeon inserted an intercostal drain (ICD) at her right chest wall, prescribed analgesia and referred her for physiotherapy.
4. Explain four impairments that Ms Smith may present with due to her pathology. (8)
- sputum retention- due to inability to effectively cough
- dyspnoea- due to decreased lung volumes
- fatigue- due to reduction v/q mismatch
- tachypnoea- due to the decrease in ventilation capacity, body will compensate by increasing RR
Mr Solomon complains of class four breathlessness and is admitted to a medical ward with a diagnosis of pneumocystis jiroveci pneumonia. During your assessment the following is found:
Vital signs: heart rate 115 bpm, respiratory rate 28 breaths/ minute, Sp02 92%.
Apical breathing pattern with increased use of accessory respiratory muscles.
Arterial blood gas (ABG) on FiO2 0.4: pH = 7.33, PaCO2 = 48 mmHg, HCO3 = 24 mmol/l, BE 1.5, PaO2 = 95 mmHg.
Auscultation of his chest wall reveals no added abnormal lung sounds but slight diminished breath sounds bilateral basally (all segments).
2.1 Explain class four breathlessness. (1)
symtoms of breathlessnes at rest
Mr Solomon complains of class four breathlessness and is admitted to a medical ward with a diagnosis of pneumocystis jiroveci pneumonia. During your assessment the following is found:
Vital signs: heart rate 115 bpm, respiratory rate 28 breaths/ minute, Sp02 92%.
Apical breathing pattern with increased use of accessory respiratory muscles.
Arterial blood gas (ABG) on FiO2 0.4: pH = 7.33, PaCO2 = 48 mmHg, HCO3 = 24 mmol/l, BE 1.5, PaO2 = 95 mmHg.
Auscultation of his chest wall reveals no added abnormal lung sounds but slight diminished breath sounds bilateral basally (all segments).
2.2 Analyse and interpret the ABG. (4)
PH =7.33 (normal 7.35-7.45) therefore acidotic Hco3 = 24 (normal 22-26) normal paco2 48 (normal 35-45) high therefore respritory acidosis
2.4 Discuss how you will manage Mr Solomon’s breathlessness during your first treatment. (5)
Acbt
neb with mucolitic
active coughing
manual chest therapy
2.5 Name an outcome measure that can be used to assess Mr Solomon’s functional status. (1)
FSS-ICU
Mrs Viljoen is 70 years old and was admitted to the medical ward due to a complaint of breathlessness and fatigue when performing mild daily activities. Her symptoms have progressively worsened and for the last month she has also started experiencing a chronic non-productive cough and orthopnoea. Her past medical history reveals a history of hypertension and type two diabetes. The medical team ordered a chest X-ray and noted she has cardiomegaly with small bilateral pleural effusions and Kerley B-lines basally.
3.1 State the precautions that you will following when treating Mrs Viljoen considering her pathology. (4)
monitor vitals before and after
regulary palpate pule during treatment
monitor intensity level of breathlessness
observe patient closely eg coulor and signs of cyanosis
monitor secretions
Mrs Viljoen is 70 years old and was admitted to the medical ward due to a complaint of breathlessness and fatigue when performing mild daily activities. Her symptoms have progressively worsened and for the last month she has also started experiencing a chronic non-productive cough and orthopnoea. Her past medical history reveals a history of hypertension and type two diabetes. The medical team ordered a chest X-ray and noted she has cardiomegaly with small bilateral pleural effusions and Kerley B-lines basally.
3.2 Document four foot care advice tips that you will explain to Mrs Viljoen as a means of preventing diabetic foot ulcers in the long term. (4)
- wash feet daily in lukewarm water and soap
- dry feet effectively
- wear clean socks daily
- apply hand cream to feet esp dry areas
Question 3
Mrs Viljoen was admitted to the medical ward due to a complaint of breathlessness and fatigue when performing mild daily activities. Her symptoms has progressively worsened and for the last month she has also started experiencing a chronic non-productive cough and orthopnoea. The medical team diagnosed her with left ventricular heart failure.
3.1 Define orthopnoea. (2)
orthopnea is the sessation of breathlessness in the recumbent position, which is releaved by sitting or standing
Question 3
Mrs Viljoen was admitted to the medical ward due to a complaint of breathlessness and fatigue when performing mild daily activities. Her symptoms has progressively worsened and for the last month she has also started experiencing a chronic non-productive cough and orthopnoea. The medical team diagnosed her with left ventricular heart failure.
3.2 Name the classification system that is used to classify heart failure according to functional limitations and justify Mrs Viljoen’s classification. (2)
class 4 on the NYHA funtional classfication of hf since she complains of breathlessness on mild activities ie less then ordinary activities, she is not comftobale at rest and the activty casues fatigue and breathlessness
Ms Smith is admitted to the trauma ward due to sustaining a haemothorax after being assaulted at work. The trauma surgeon inserted an intercostal drain (ICD) at her right chest wall, prescribed analgesia and referred her for physiotherapy.
- Define a haemothorax. (2)
blood accumulating in the pleural space
Ms Smith is admitted to the trauma ward due to sustaining a haemothorax after being assaulted at work. The trauma surgeon inserted an intercostal drain (ICD) at her right chest wall, prescribed analgesia and referred her for physiotherapy.
2. Document the chest x-ray features you expect to find with a haemothorax. (4)
grey discoloration over lungs in supine
white density over mid-lower lung regions with meniscus sign in sitting
possible mediastinal shift away from haemothorax
- Explain the ICD activity that you would observe in the ICD bottle of Ms Smith. (4)
swinging where gentle movement of fluid back and forth within the collection tube
drainage of blood
- Document the precautions regarding the ICD that you will teach Ms Smith that she should following during treatment and physical activity. (5)
Cough with ICD support
• ICD should always be below insertion site.
infection control near insertion site
make sure drain is upright
drains should be on the floor on their stand fro gravity drainage
Mr Solomon complains of breathlessness and is admitted to a medical ward with a diagnosis of pneumocystis jiroveci pneumonia. During your assessment the following is found:
Vital signs: heart rate 115 bpm, respiratory rate 28 breaths/ minute, Sp02 88%.
Apical breathing pattern with increased use of accessory respiratory muscles.
Arterial blood gas (ABG) on room air: pH = 7.33, PaCO2 = 48 mmHg, HCO3 = 24 mmol/l, BE 1.5, PaO2 = 55 mmHg.
Auscultation of his chest wall reveals no added abnormal lung sounds but slight diminished breath sounds bilateral basally (all segments).
2.1 Name an outcome measure that can be used to quantify Mr Solomon’s breathlessness during functional activities. (1)
new york heart association classfircation of breathlessness
Mr Solomon complains of breathlessness and is admitted to a medical ward with a diagnosis of pneumocystis jiroveci pneumonia. During your assessment the following is found:
Vital signs: heart rate 115 bpm, respiratory rate 28 breaths/ minute, Sp02 88%.
Apical breathing pattern with increased use of accessory respiratory muscles.
Arterial blood gas (ABG) on room air: pH = 7.33, PaCO2 = 48 mmHg, HCO3 = 24 mmol/l, BE 1.5, PaO2 = 55 mmHg.
Auscultation of his chest wall reveals no added abnormal lung sounds but slight diminished breath sounds bilateral basally (all segments). 2.2 Analyse and interpret the ABG. (4)
PH =7.33 (normal 7.35-7.45) therefore acidotic Hco3 = 24 (normal 22-26) normal paco2 48 (normal 35-45) high therefore respritory acidosis
Mr Solomon complains of breathlessness and is admitted to a medical ward with a diagnosis of pneumocystis jiroveci pneumonia. During your assessment the following is found:
Vital signs: heart rate 115 bpm, respiratory rate 28 breaths/ minute, Sp02 88%.
Apical breathing pattern with increased use of accessory respiratory muscles.
Arterial blood gas (ABG) on room air: pH = 7.33, PaCO2 = 48 mmHg, HCO3 = 24 mmol/l, BE 1.5, PaO2 = 55 mmHg.
Auscultation of his chest wall reveals no added abnormal lung sounds but slight diminished breath sounds bilateral basally (all segments). 2.3 Justify whether oxygen therapy is required when managing Mr Solomon. (4)
yes the pt has severe hyoxmia pao2 below 60 and spo2 88
Mr Solomon complains of breathlessness and is admitted to a medical ward with a diagnosis of pneumocystis jiroveci pneumonia. During your assessment the following is found:
Vital signs: heart rate 115 bpm, respiratory rate 28 breaths/ minute, Sp02 88%.
Apical breathing pattern with increased use of accessory respiratory muscles.
Arterial blood gas (ABG) on room air: pH = 7.33, PaCO2 = 48 mmHg, HCO3 = 24 mmol/l, BE 1.5, PaO2 = 55 mmHg.
Auscultation of his chest wall reveals no added abnormal lung sounds but slight diminished breath sounds bilateral basally (all segments). 2.4 Document the physiotherapy aims for the treatment of Mr Solomon. (6)
prevent secondary complications reduce breathlessness encourage effective ventilation increase lung volumes effective cough increase exercise tolerance
Mr Solomon complains of breathlessness and is admitted to a medical ward with a diagnosis of pneumocystis jiroveci pneumonia. During your assessment the following is found:
Vital signs: heart rate 115 bpm, respiratory rate 28 breaths/ minute, Sp02 88%.
Apical breathing pattern with increased use of accessory respiratory muscles.
Arterial blood gas (ABG) on room air: pH = 7.33, PaCO2 = 48 mmHg, HCO3 = 24 mmol/l, BE 1.5, PaO2 = 55 mmHg.
Auscultation of his chest wall reveals no added abnormal lung sounds but slight diminished breath sounds bilateral basally (all segments). 2.5 Explain how you will perform sputum induction with Mr Solomon. (6)
hypertonic saline, ultrasonic neb, nil by night, brushing of teeth, ifenction control, 20 min, acbt,in sterile jar
Question 1
Mrs Khan was admitted to the medical ward due to a complaint of breathlessness and fatigue when performing mild daily activities. She is a known hypertensive patient and was diagnosed with heart failure with reduced ejection fraction (HFrEF).
1.1 Document three chest X-ray features of HFrEF. (3)
kerely b lines fluid fills and distends the interlobular septa
kerelly b lines (septal lines) visible in costophrenic angles (horizontal lines)
enlarged heart
billateral pleural effusion
interstitialpulmary oedema
as the left atrial pressure rises blood is shunted to the upper zones
Mrs Khan was admitted to the medical ward due to a complaint of breathlessness and fatigue when performing mild daily activities. She is a known hypertensive patient and was diagnosed with heart failure with reduced ejection fraction (HFrEF).
1.2 Define her breathlessness according to the New York Heart Association Scale. (1)
class 3
1.3 Define orthopnoea. (2)
deacresed breathlesness sensation in the recumbent postion and is relieved with sitting up or standing
