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Boards: PEAT Review > Cardiopulmoary and Lymphatic > Flashcards

Cardiopulmoary and Lymphatic Flashcards

1
Q

PVC: Bigeminy

A

occurs when every other beat is a PVC

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2
Q

PVC: Couplets

A

When 2 PVC are together with no normal heartbeat between them
Can be caused by ischemia, hypokalemia, CHF or drug toxicity

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3
Q

PVC: Multifocal

A

when more than one PVCs occur, and they do not appear to have similar configurations

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4
Q

Ventricular Tachycardia

A

> 3 PVCs, if observed during exercise STOP and report

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5
Q

Ventricular Fibrillation

A

No organized electrical activity or effective pumping

Requires IMMEDIATE cardioversion

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6
Q

Myocardial Oxygen Demand Calculation

A

“Double Product” = HR x SBP

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7
Q

Circulatory Reflex

A

Response of baroreceptors to changes in blood pressure
Inc-BP = bradycardia, peripheral dilation, parasymp stimulation, decreased rate and F cardiac contraction, symp inhibition, decreased peripheral resistance
Dec BP = tachycardia, sympathetic stimulation, increased HR and BP with vasoconstriction of peripheral blood vessels

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8
Q

Airway Clearance: Abdominal Thrusts

A

primarily used in pts w. low neuromuscular tone or flaccid abdominal ms

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9
Q

Airway Clearance: Postural Drainage

A

faciliates drainage of secretions to the level of the segmental bronchus only. requires additional cough to clear secretions

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10
Q

Airway Clearance: Huffing

A

Helps to stabilize collapsible airways present w. COPD (weak, wet cough)

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11
Q

Airway Clearance: Percussions

A

help mobilize secretions from the periphery of the lungs, however, do not assist in improving the strength of the patient’s cough

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12
Q

Most useful measurements for determining the progression of obstructive pulmonary disease (staging)

A

FEV1 and FEV1/FVC

FEV1 is significantly reduced, FVC reduced, while other measurements may increase

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13
Q

Most useful measurements for determining restrictive pulmonary disease

A

Normal FEV1 while all other measurements decrease

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14
Q

Cardiac Sounds: Aortic Valve/Stenosis

A

R 2nd intercostal space, sternal border

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15
Q

Cardiac Sounds: Pulmonic Valve

A

L 2nd Intercostal Space, sternal border

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16
Q

Cardiac Sounds: Tricuspid Valve

A

L 4th intercostal space, sternal border

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17
Q

Cardiac Sounds: Mitral Valve

A

L 5th intercostal space, mid-clavicular line

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18
Q

Absolute contraindications to exercise

A
  • acute infections
  • acute PE or Pulm infarct
  • unstable angina or arrhythmia
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19
Q

Relative contraindications to exercise

A

-chronic infections

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20
Q

Reduction in exercise/activity with:

A
  • acute illness: fever, flue
  • acute injury or ortho complications
  • progression of cardiac dx, edema, weight gain or unstable angina
  • overindulgence; food, caffeine, alcohol
  • environmental extremes
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21
Q

Absolute indications to terminate exercise

A

-drop SBP > 10 mmHg
-mod-severe angina
-increased nervous system: ataxia, dizziness, near syncope
-signs of poor perfusion
-technical difficulties with monitoring ECG or BP
subjects desire to stop
sustained VT
ST elevation > 1mm (2)

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22
Q

Relative Indications to terminate Exercise

A
  • ST or QRS changes
  • arrhythmias other than VT
  • fatigue, SOB, wheezing, leg cramps, claudication
  • development of bundle branch block
  • increasing chest pain
  • HTN response SBP>250 or DBP >115
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23
Q

Metabolic Acidosis: Causes

A 
pH & HCO3 decrease, PaCO2 = WNL
a depletion of bases or an accumulation of acids, blood pH falls below 7.35
diabetes
renal insufficiency
diarrhea
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24
Q

Metabolic Acidosis: Signs/Symptoms

A 
hyperventilation (compensatory)
deep respirations
weakness
muscular twitching
malaise
nausea
vomiting and diarrhea
headache
dry skin and mucous membranes
poor skin turgor
*May lead to stupor or coma*
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25
Metabolic Alkalosis: Causes
``` an increase in bases or blood pH > 7.45 excess vomiting excess diuretics hypokalemia peptic ulcer excessive intake of antacids ```
26
Metabolic Alkalosis: Signs/Symptoms
``` hypoventilation (compensatory) depressed respirations dysrhythmias prolonged vommiting diarrhea weakness muscle twitching irritability agitation convulsion and coma (death) ```
27
Respiratory Acidosis: Causes
``` pH decrease, HCO3 WNL, PaCO2 increase CO2 retention, impaired alveolar ventilation hypoventilation drugs/oversedation chronic pulmonary dx hyper metabolism (burns, sepsis) ```
28
Respiratory Acidosis: Signs/Symptoms
``` dyspnea hyperventilation cyanosis restlessness headache may lead to disorientation, stupor and coma, death ```
29
Respiratory Alkalosis: Causes
``` pH increase, HCO3 WNL, PaCO2 decreases diminished CO2, alveolar hyperventilation anxiety attack w/ hyperventilation hypoxia (emphysema, pneumonia) impaired lung expansion CHF PE diffuse liver or CNS disease salicylate poisoning extreme stress ```
30
Respiratory Alkalosis: Signs/Symptoms
``` tachypnea dizziness anxiety difficulty concentrating numbness and tingling blurred vision diaphoresis muscle cramps twitching and tetany weakness arrhythmias convulsion ```
31
Arterial Ulcers
``` Etiology: atherosclerosis or atheroembolism Appearance: irregular, smooth edges, min granulation, usually deep Location: distal lower leg LATERAL malleolus, anterior tibial area Pedal Pulses: decreased or absent Pain: very, p! inc w/ legs raised Drainage: not present Assoc Gangrene: maybe Assoc Signs: trophic changes pallor w/ foot elevation dusky rubor on dependency ```
32
Venous Ulcers
Etiology: valvular incompetance, venous HTN Appearance: irregular, dark pigmentation, sometimes fibrotic, good granulation, shallow Location: distal lower leg, MEDIAL malleolus Pedal Pulses: present Pain: little p! comfortable w/ legs elevated Drainage: moderate to large exudate Assoc Gangrene: absent Assoc Signs: edema, stasis dermatitis possible cyanosis on dependency
33
Postural Drainage: Upper Lobes - Apical Segments
Bed or drainage table flat Pt leans back on pillow @ 30 deg angle against therapist PT claps between clavicle and top of scapula on each side
34
Postural Drainage: Upper Lobes - Posterior Segments
Bed or drainage table flat Pt leans forward over folded pillow @ 30 deg angle PT stands behind and claps over upper back on both sides
35
Postural Drainage: Upper Lobes - Anterior Segments
Bed or drainage table flat Pt lies on back w/ pillow under knees PT claps between clavicle and nipple on each side
36
Postural Drainage: Right Middle Lobe
Foot of table elevated 16 inches Pt lies on L side and rotates 1/4 turn backward, knees flex PT claps over R nipple area
37
Postural Drainage: Left Upper Lobe - Lingular Segments
Foot of table elevated 16 inches Pt lies on R side and rotates 1/4 turn backward, knees flex PT claps over R nipple area
38
Postural Drainage: Lower Lobe - Anterior Basal Segments
Foot of table elevated 20 inches Pt lies on side, pillow under knees (left or right basilar) PT claps over lower ribs
39
Postural Drainage: Lower Lobe - Lateral Basal Segments
Foot of table elevated 20 inches Pt lies on abdomen, then rotates 1/4 turn upward, upper leg fixed over pillow for support PT claps over uppermost portion of lower ribs
40
Postural Drainage: Lower Lobe - Posterior Basal Segments
Foot of table elevated 20 inches Pt lies on abdomen, head down, w/ pillow under hips PT claps over lower ribs to spine on each side
41
Postural Drainage: Lower Lobe - Superior Segments
Bed or table flat Pt lies on abdomen w/ two pillow under hips PT claps over middle of back at tip of scapula on either side of spine
42
Signs/Symptoms of Myocardial Infarction
- ST segment elevation or depression - altered CPK or Troponin Levels - Chest p! not alleviated by nitroglycerin - Referred p! to neck, jaw, L arm, or upper back
43
Presentation of Angina/CVD in Women
-Midthoracic, and upper extremity p! | undue fatigue, nausea and weakness
44
Side Effects of ACE Inhibitors
-hypotension
45
Ankle Brachial Index Values
``` >1.4 = noncompliant arteries 1.0-1.4 = Normal .91-.99 = borderline <.50 = severe arterial disease, risk for critical limb ischemia, may have p! at rest. ```
46
Components of APGAR assessment
- Heart Rate - Color - Respiration - Muscle tone - Reflex irritability
47
Reasoning for Tripod position w/ pulmonary disease
This position increases the effectiveness of the pectoralis and serratus anterior muscles to act as accessory muscles of inspiration by reverse action, thereby improving breathing and minimizing fatigue.
48
Heart Sounds: S1
"lub"; normal closure of mitral and tricuspid valves; marks begining of systole - decreased with 1° of AV Block
49
Heart Sounds: S2
"dub"; normal closure of aortic and pulmonary valves; marks end of systole - decreased in aortic stenosis
50
Heart Sounds: S3
This heart sound is associated with ventricular filling, occurs soon after S2 - In older individuals may be indicative of CHF (LV)
51
Heart Sounds: S4
This heart sound is associated with ventricular filling and atrial contraction; occurs just before S1 - Associated with pathology: CAD, MI, Aortic stenosis or Chronic hypertension
52
Heart Sounds: Gallop
An abnormal heart rhythm with three sounds in each cycle; resembles the gallop of a horse. (i.e., either S1,S2,S3 or S4,S1,S2 is heard during auscultation)
53
Heart Sounds: Bruit
This is an adventitious sound or murmur (blowing sound) of arterial or venous origin; common in carotid or femoral arteries - indicative of atherosclerosis
54
Heart Sounds: Thrill
An abnormal tremor accompanying a vascular or cardiac murmur; felt on palpation
55
Heart Sounds: Systolic Murmur
With regards to murmur or extra sounds, this one falls between S1 and S2. May indicate valvular disease (e.g., mitral valve prolapse or may normal
56
Heart Sounds: Diastolic Murmur
With regards to murmurs or extra sounds, this one falls between S2 and S1. Usually indicates valvular disease
57
Effects of Prolonged Bed Rest
- Resting and submaximal heart rates begin to increase = lowered cardiac efficiency - Resting SBP declines due to decreases in blood volume from profound diuresis - Blood volume declines from profound diuresis - Cardiac output declines from decreases in blood volume and decreases in stroke volume
58
Signs of Venous Insufficiency
-Edema
59
Signs of Arterial Insufficiency
- pallor - absent pulses - decreased temp
60
Pharmacological Management of HTN
beta blockers, alpha blockers, angiotensin-converting enzyme (ACE) inhibitors, diuretics, vasodilators, or calcium channel blockers.

Boards: PEAT Review (6 decks)

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