cardio exam Flashcards
what can S3 heart sound indicate? what are a few potential signs and symptoms?
CHF, ventricular filling
u may see edema, cold hands and feet!
if someone has an active occluded artery, should you do any exercise?
NO ACTVITY because u don’t wanna increase BP
what is Heparin and what does it treat?
an anticoagulant used to treat DVT
For pleural pain, pain is alleviated by laying a what side?
lay on the affected side
reduced CO leading to a backup of fluid in the lungs producing SOB and coughing are signs of what?
CHF
S4 sound can incidate?
MI or HTN
ventricular filling and atrial contraction
differing BP reading in both arms, drop in diastolic BP, extremities are cold to touch, abdominal bulge are signs of what?
ruptured aneurysm
what does Digitalis treat and how does it work?
treats CHF, lowers HR and increases strength of contraction
what’s the normal respiratory rate?
12-20
how can I drain posterior segments of lower lobes?
pt lies on abdomen with pillows under hips and legs and the foot of bed is elevated to 18 inches. percussion is over the lower ribs close to the spine
during acute exercise, INITIAL increase in HR is d/t withdrawal of ____ and not stimulation of _____
PNS, SNS
the SNS causes RR to ______ d/t stimulation of beta 2 receptors
increase
dyspnea, cyanosis of lips, cramping of calf muscle are all signs of…
signs of respiratory distress
In COPD, PaCO2 is __________, PaO2 is _________, pH is ___________
increased, decreased, decreased
HR * SBP =
RPP (measures metabolic demand of the heart)
CO =
HR * SV
does MAP increase with exercise?
yes, linearly
does systolic BP increase with exercise? Does diastolic?
systolic increases, diastolic remains fairly constant
should you do a warm up for the 6MWT?
no
normal BP
less that 120/80
elevated BP is …
120-129 and diastolic less than 80
stage 1 HTN is
systolic 130-139 or diastolic 80-89
stage 2 HTN is…
systolic at least 140 or diastolic at least 90
what are the numbers for a hypertensive crisis?
180 systolic or above and/or diastolic of 120 or above
what is VO2 predictive of?
aerobic capacity
volume of oxygen
when VO2 reaches steady state during exercise, the ATP demand is _____ _________
met aerobically
in a high altitude environment, the body makes more _____s to account for the decreased level of oxygen
RBCs
if you go somewhere with high altitude, what happens to BP, CO, HR, and SV?
BP increases
CO increases
HR increases
SV remains unchanged
once acclimated, BP and CO will become normal, HR stays increased, SV decreases
will venous return increase or decrease with aquatic therapy?
increase, d/t hydrostatic pressure exerted by water
what happens to HR, BP, and VO2 during aquatic therapy?
all decrease
what happens to CO and SV during aquatic therapy?
they increase
what happens to work of breathing during aquatic therapy?
increases
what happens to vital capacity during aquatic therapy?
decreases
what do beta blockers do to HR and contractility? what conditions are they used for?
decrease them
pts with HTN and CAD
what scale do you use for exercise prescription for people on beta blockers d/t decreased HR?
RPE (scale is 6-20)
SHVEM:
13 - somewhat hard
15 - hard
17 - very hard
19 - extremely hard
20 - max exertion
the best way to measure change in fitness from pre and post training is to measure…
the time it takes for the HR to return to baseline, quicker it returns to baseline the more fit
what are the auscultation landmarks
A P
T M
Aortic: 2nd IC space, R sternal border
Pulmonic: 2nd IC space, left sternal border
Tricuspid: 4th IC space, left sternal border
Mitral: 5th IC space, midclavicular line
what heart sound is “lub” associated with?
S1, closure of mitral and tricuspid valves, onset of systole
what heart sound is “dub” associated with?
S2, closure of aortic and pulmonary valves, onset of diastole
which heart sound is the loudest at the base (top) of the heart?
S2
what heart sound is loudest at the apex (bottom) of the heart?
S1
what condition is an increase in both the RBCs and the hemoglobin, increased blood viscosity, resulting in HTN?
polycythemia
what can be used to determine myocardial O2 demand of a patient at the onset of chest pain symptoms?
rate product pressure (RPP)
at what point are S1 and S2 heard equally loud?
Erb’s point (in between base and apex)
what heart sound is associated with early systole?
S1 “lub”
what heard sound is associated with late diastole?
S4 (abnormal)
what heart sound is associated with early diastole?
S3 (abnormal)
what heart sound is associated with late systole?
S2 “dub”
the SA node initiates _____________
depolarization
the AV node passes ________ to ventricles
depolarization
the P wave on an ECG represents ______ __________
atrial depolarization
the QRS complex on an ECG represents
ventricular depolarization and atrial repolarization
the T wave on an ECG represents
ventricular repolarization
depolarization =
contraction
repolarization =
relaxation
how to find the HR on a 6 second ECG strip?
count the R waves
which AV heart block is there a delay in conduction?
1st degree (P-R interval is 1 large box)
which AV heart block is there a dropped QRS but it is expected (PR interval gets progressively longer)? What is the correct response?
2nd degree/Mobitz Type 1
lower intensity of exercises and monitor ECG
which AV heart block is there an intermittently dropped QRS and no pattern can be discerned? What is the correct response?
2nd degree/Mobitz type II
stop exercise!
which AV heart block is the atrial rate independent of the ventricular rate, and there is no relation at all of the P-R intervals? what should you do?
third degree AV block, call 911!
what are the main symptoms of L sided HF?
Lung problems, pulmonary edema
what are the main sx of R sided HF?
peripheral edema
what is cor pulmonale?
R ventricle failure
myocardial ________ is when there is a decrease in blood supply and a ST segment depression of 2mm and higher?
ischemia (loss of blood)
myocardial _________ is when there is a complete occlusion of blood supply and cell death, ST segment is elevated 1mm and higher?
infarction
which arrhythmia is the saw tooth pattern?
atrial flutter
which arrhythmia doesn’t let the T wave fully finish?
PAC
are the supra ventricular arrhythmias (PAC, atrial tach, atrial flutter, and Afib) 911 situations?
no
palpitations, SOB, and fatigue are sx of what?
afib
if exercising stop and report to physician
is ventricular tachycardia and emergency situation?
yes
PVCs that occur ___ or more in a row is called ventricular tachycardia
3
call 911
if you see a unifocal PVC while a pt is exercising, what should you do?
keep exercising at a lower intensity
consult with physician is not required here
