CardioPulm

Question 1

Both of these signs are normal responses to the stress test.

Answer 1

P wave increases in height, and the S-T segment upslopes

Question 2

Beta blockers work on the beta-adrenergic receptors to decrease

Answer 2

sympathetic responses to stress, primarily the heart rate.

Question 3

Create back-pressure in the airways to ease airflow via what technique

Answer 3

pursed lip breathing

Question 4

A Swan-Ganz catheter is a diagnostic tool used to

Answer 4

detect blood pressure in the right side of the heart.

Question 5

Changes after heart transplant?

Answer 5

no longer any sympathetic innervation to the heart, blunting the effect of exercise on heart rate. After several minutes of activity, the heart will then respond to circulating catecholamines and increase gradually.

Question 6

ABI values less than ? indicate PAD

Answer 6

0.90

Question 7

S??? is created from the closure of the mitral and tricuspid valves during ventricular systole.

Answer 7

1

Question 8

abdominal swelling and is a symptom of right-sided heart failure

Answer 8

Ascites

Question 9

generalized swelling and is a symptom of right-sided heart failure

Answer 9

Anasarca

Question 10

Hepatomegaly is a symptom of

Answer 10

R side heart failure

Question 11

? sided heart failure leads to swelling in the lungs as the blood backs up, causing Dyspnea

Answer 11

Left

Question 12

irregular ECG signals that are turbulent and asynchronous = ?

Answer 12

V fillibration (EMERGENCY)

Question 13

? are air pockets in the lung that form from tissue destruction as a result of cancer, COPD, emphysema, etc.

Answer 13

Bullae

removal =
Bullectomy

Question 14

procedure in which the involved lobe with part of the main stembronchus is removed; indicated for central tumors of the lung

Answer 14

Sleeve lobectomy

Question 15

surgical procedure to remove a lung

Answer 15

Pneumonectomy

Question 16

removal of a portion of diseased lung

Answer 16

lobectomy

Question 17

Have the patient inhale deeply, and then assist exhalation with firm pressure applied to the chest wall.

What type of tx?

Answer 17

Segmental breathing;

requires manual assistance from the therapist to facilitate full exhalation of the targeted segments.

Question 18

High x blood pressure does not allow the blood to be pumped efficiently out of the heart and subsequently reduces stroke volume.

Answer 18

diastolic

Question 19

define Preload

Answer 19

Preload is the end-diastolic pressure and drives blood into the atria.

Question 20

define Afterload

Answer 20

afterload is the amount of pressure that the heart needs to exert to eject the blood during ventricular contraction.

Question 21

A patient with congestive heart failure is having great difficulty with activities of daily living. Which cardiac factor is MOST likely the cause of such difficulty?

Answer 21

Afterload

Question 22

a high-pitched breath sound emanating from the patient’s upper bronchi during inspiration which can be a medical emergency and indicates obstruction of the upper airways.

Answer 22

Stridor

Question 23

Describe Rhonchi

Answer 23

continuous gurgling or bubbling sounds typically heard during both inhalation and exhalation. These sounds are caused by movement of fluid and secretions in larger airways (asthma, viral URI)

Question 24

short, explosive sounds. They can also sound like bubbling, rattling, or clicking. are generated by small airways snapping open on inspiration. predominantly inspiratory. Can be high or low pitched. Indicate…

Answer 24

Crackles aka Rales

Indicate pnumonia

Question 25

x refers to the high-pitched whistle-like sound heard during exhalation as air moves through a narrow or obstructed airway. may also be lower-pitched, having a snoring or moaning quality in which they are referred to as rhonchi.

Answer 25

Wheeze

Question 26

appropriate ratio of chest compressions to rescue breaths for infants

Answer 26

30:2 for 1 rescuer and 15:2 for 2 rescuers.

Question 27

Posterior segment R upper lobe percussion occurs in what position?

Answer 27

Question 28

What segment? | Pt turned 1/4 from prone on R with bed elevated 45 deg.

Answer 28

Post L upper lobe

Question 29

What lobe? 1/4 turn to R from supine, bed elevated 12 inches percussion on L below axilla

Answer 29

L lingula upper lobe

Question 30

Pt supine w bed flat, bil percussion below clavicle

Answer 30

anterior R/L upper lobes

Question 31

Foot of bed elevated 12 inches, 1/4 turn on L; percussion @ R axilla

Answer 31

R mid lobe

Question 32

Bed flat, pt prone; bil percussion @ inf border

Answer 32

Superior segment of lower lobes

Question 33

Patient is prone with foot of bed elevated 18 inches, bilateral percussion on lower ribs

Answer 33

Posterior basal segments of lower lobes

Question 34

Patient is supine with the foot of the bed elevated 18 inches, bilateral percussion over anterior lower ribs

Answer 34

Anterior basal segments of lower lobes

Question 35

For whom is diaphragmatic breathing contraindicated or precaution

Answer 35

Moderate to severe COPD Patients with paradoxical breathing

Question 36

What is a good cue to facilitate the diaphragm

Answer 36

Sniffing

Question 37

What are the expected outcomes of diaphragmatic breathing

Answer 37

Decreased respiration rate, decreased use of accessory muscles of inspiration, increased tidal volume, improvements of tolerance for activity

Question 38

what wave segment is "key" to screening for MI? what changes alert for MI?

Answer 38

S-T is key! Elevation OR depression, downslope greater than 1mm change from baseline

Question 39

is a very serious type of heart attack during which one of the heart's major arteries (one of the arteries that supplies oxygen and nutrient-rich blood to the heart muscle) is blocked

Answer 39

ST-Elevation Myocardial Infarction (STEMI)

Question 40

What ratio should q wave be to R wave?

Answer 40

Less than 1/3 of R wave

Question 41

what does it mean when P wave is absent? what results expected?

Answer 41

SA node inactive AV or HIS taking over = lower HR, progression of HF

Question 42

normal resting HR for adults

Answer 42

60-100 lower for athletes

Question 43

QT interval should be about what #

Answer 43

below 400 to 440 in men, up to 460 in women

Question 44

lower HR results in a longer ???

Answer 44

QT interval AKA the time it takes to fire an impulse through the ventricles and then recharge

Question 45

lower chamber of the heart beats too fast to pump well and the body doesn't receive enough oxygenated blood what is this arrythmia called?

Answer 45

V tach

Question 46

What produces sawtooth pattern on ECG? What risks increase? Causes?

Answer 46

Atrial flutter can lead to blood clots, over time weakens heart Binge drinking, being overweight, caffeine OD

Question 47

dif between a-fib and flutter?

Answer 47

In atrial fibrillation, the atria beat irregularly. In atrial flutter, the atria beat regularly, but faster than usual and more often than the ventricles, so you may have four atrial beats to every one ventricular beat.

Question 48

Normal time for P R interval?

Answer 48

.12-20 ms same for QRS wave

Question 49

To carry out the activities of daily living an exercise intensity of at least ? METs is required

Answer 49

5

Question 50

Contraind for ex testing

Answer 50

Acute myocardial infarction (within 4-6 days) Unstable angina= pain @ rest in previous 48 hours Uncontrolled heart failure Acute myocarditis or pericarditis Acute systemic infection Deep vein thrombosis Uncontrolled hypertension (systolic blood pressure >220 mm Hg, diastolic >120 mm Hg) Severe aortic stenosis Severe hypertrophic obstructive cardiomyopathy Untreated life threatening arrhythmia Dissecting aneurysm Recent aortic surgery

Question 51

expected outcome of exercise on BP

Answer 51

systolic blood pressure rises up to 225 mm Hg (more in athletes) Diastolic blood pressure tends to FALL slightly

Question 52

what is j point on ecg and what is expected in exercise

Answer 52

The J point (the point of inflection at the junction of the S wave and ST segment) becomes depressed during exercise, with maximum depression at peak exercise. Influences upslope of ST seg. j point marks the end of V depolarization and beginning of repolarization

Question 53

Uncontrolled hypertension = what levels

Answer 53

systolic blood pressure >220 mm Hg | diastolic >120 mm Hg

Question 54

normal ECG changes in exercise

Answer 54

P wave increases in height J point becomes depressed ST segment upslopes Q-T + PR interval shortens T wave + R wave DECREASE in height

Question 55

Hypotension during exercise, defined as a drop of more than ??? during exercise, may signify severe cardiac ischemia

Answer 55

10 mm Hg in the systolic blood pressure

Question 56

what change in diastolic blood pressure during the postexercise period is not unusual and is considered physiologic

Answer 56

A 10 mm Hg decrease

Question 57

What s/s considered abnormal on cardiac stress test

Answer 57

Exercise-induced hypotension Exercise-induced angina or anginal equivalents Appearance of an S3, S4 or heart murmur during exercise

Question 58

large (more than 2 to 3 mm) ST-segment depressions depression during exercise indicate what pathology?

Answer 58

Cardiac arterial disease

Question 59

The appearance during exercise of an S3, S4 or murmur indicates what

Answer 59

cardiac muscle dysfunction and therefore ischemia

Question 60

Nonsignificant Findings During Exercise Stress Testing

Answer 60

Fatigue, dyspnea, diaphoresis, flushing Incremental increase in blood pressure and heart rate Shortening of QT + P-R interval Functional J point depression ≤ 0.2 mV