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PT Hustle > Cardiopulmonary > Flashcards

Cardiopulmonary Flashcards

1
Q

If a patient is diagnosed with broca’s aphasia, which artery is likely to be effected

A

MCA

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2
Q

Where is broca’s aphasia located in the brain

A

premotor area of the left frontal lobe

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3
Q

Broca’s/Wernicke’s aphasia is described as slowed and hesitant speech pattern, where the pt’s vocabulary is limited. The pt might have trouble properly arranging words in well formed sentences.

A

Broca’s

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4
Q

What does the saying “BEN has Broca’s” mean

A

BEN is the acronym to help remember the other names of broca’s aphasia
Broca’s
Expressive
Non-fluent

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5
Q

If a patient is diagnosed with Wernicke’s aphasia, which artery is likely to be effected

A

MCA

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6
Q

Where is Wernicke’s aphasia located in the brain

A

auditory associated cortex in the left lateral temporal lobe

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7
Q

Broca’s/Wernicke’s aphasia is described as speech that flows smoothly with a preserved melody, however the speech makes no sense or is incoherent

A

Wernicke’s

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8
Q

True or False

if a pt has receptive aphasia, they may ot be able to comprehend written words as well as spoken words.

A

true - this pt will have trouble following commands.
spoken words are difficult to comprehend because the auditory comprehension is impaired

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9
Q

What is Wernicke’s aphasia also known as?

A

receptive, sensory, or fluent aphasia

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10
Q

If a patient is diagnosed with Global aphasia, which artery is likely to be effected

A

MCA

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11
Q

Where is global aphasia located in the brain

A

in the third frontal convolution and th eposterior aspect of the superior temporal gyrus

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12
Q

Will a patient with global aphasia has a better or poorer prognosis compared to the other forms of aphasia

A

significantly poorer prognosis with global aphasia

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13
Q

What intervention would be useful when practicing PACE - promoting aphasic’s communication effectiveness

A

playing charades to improve the patients conversational skills.

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14
Q

What is VAT or visual action therapy and what patient population is it used for

A

The pt begins by tracing objects followed by matching object to the tracing. Then the patient will use gestures to identify visible objects in the room, then use gestures to identify objects not in room.
-
used for pt’s with global aphasia

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15
Q

What is the most common type of SCI and its MOI

A

central cord syndrome, due to hyperextension of the cervical spine,
or it can be caused by stenosis which can create a hemorrhaging in the centermost aspect of the spinal cord

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16
Q

True or False

There is significant bowel and bladder impairments with central cord SCI

A

false, minimal to none

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17
Q

A patient with central cord syndrome asks if she is likely to walk again, what is her prognosis

A

it is common for patients to regain the ability to ambulate due to the UE being more impaired than the LE.

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18
Q

what does the 6MWT test for

A

functional endurance and aerobic capacity

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19
Q

How is the 6MWT performed

A

an open area at least 100ft long and markers every 3 meters.
pt walks for 6 minutes and the distance traveled is recorded.

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20
Q

According to Kyle Rice, what are some NPTE curveballs related to the 6MWT

A

The pt can use an AD but it should be the least restrictive without decreasing safety
The pt should be alerted how much time is left after every minute
Non-standardized encouragement is prohibited. You can say you are doing well or keep up the good work
The PT should walk half a step behind the pt and not beside or in front to avoid setting the pace

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21
Q

High altitude has a significant effect on the cardiopulmonary system, what height is considered to be high altitude

A

1500+ meters or 4900+ feet

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22
Q

At high altitudes, the atmospheric pressure is (low/high) and the partial pressure of (oxygen/carbon dioxide) is low.

A

low, PaO2

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23
Q

State a person’s acute reaction to high altitude in regards to heart rate, cardiac output, blood pressure, ventilation, exercise performance, stroke volume, PaCO2

A

Heart rate increasing
cardiac output increasing
blood pressure increase
ventilation increase
exercise performance decrease
stroke volume decrease
PaCO2 decreased

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24
Q

What are common signs and symptoms of altitude sickness

A

headache, nausea/vomiting, edema, dizziness, lethargy, dyspnea, epitaxis, insomnia

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25
Why should patients with dyspnea avoid being submerged in water above the xiphoid process?
hydrostatic pressure increases the difficulty of breathing with will increased their respiratory rate
26
What are the benefits of using warm water during aquatic therapy
it increases vasodilation and reduces fatigue by increasing relaxation. it will increase heart rate and decrease blood pressure
27
What are the benefits of using cold water during aquatic therapy
it can be stimulating and invigorating it will increase blood pressure and decrease heart rate
28
Your patient with MS is interested in going to a spa and using the hot tub over the weekend. Is this a good idea or not
No because those with MS should avoid water temp above 84 degrees
29
What is the most effective intervention to try FIRST in regards to smoking cessation
smoking cessation education followed b exercise and weight control
30
What is the interpretation of an ABI of greater than 1.2
diabetes, arterial disease
31
What is the interpretation of an ABI of 1.19-0.95
normal
32
What is the interpretation of an ABI of 0.94-0.75
intermittent claudication, mild arterial disease
33
What is the interpretation of an ABI of 0.74-0.50
rest pain, moderate arterial disease
34
What is the interpretation of an ABI of less than .50
severe arterial disease
35
Use the mnemonic PALLOR to remember the signs and symptoms of arterial insufficiency.
Pale Abnormal nail growth Little leg hair Lateral malleolus wounds Overly dry skin Rest pain
36
What mnemonic will you use to help remember signs and symptoms of respiratory acidosis
CARBS Confusion, agitation, restlessness, blurred vision, seizures
37
What mnemonic will you use to help remember signs and symptoms of respiratory alkidocis
NO CARDS Numbness/tingling Orthostatic hypotension Confusion Anxiety Rapid breathing Dizziness Seizures
38
What mnemonic will you use to help remember signs and symptoms of metabolic acidosis
Stupor Hyperkalemia Arrythmias Muscles twitching Emesis Decreased cardiac output
39
What mnemonic will you use to help remember signs and symptoms of metabolic alkalosis
4-T'S Tetany, tachycardia, tremors, tingling
40
What does an elevated ST segment mean
myocardial infarction especially if the elevation is greater than 1mm
41
What does an depressed ST segment mean
myocardial infarction or lack of blood flow to heart, greater depression than 2mm means the person should stop exercising due to MI
42
Systolic blood pressure is the pressure on the arterial walls during ventricular (contraction/relaxation)
contraction
43
Diastolic blood pressure is the pressure on the arterial walls during ventricular (contraction/relaxation)
relaxation
44
Does the UE or LE demand less O2 during exercise
UE uses less O2 than LE
45
What is a hypotensive response to exercise
a decrease in SBP/DBP greater than 10 with increasing workload
46
A blunted response to exercise is when the SBP fails to increase with workload or increases less than 8 mmHg. Why would a pt have a blunted response
use of beta blockers
47
What is a hypertensive response to exercise
DBP greater than 110 or an increase greater than 10 SBP greater than 260
48
What are the classifications of blood pressure
normal - less than 120 AND less than 80 elevated - 120-129 AND less than 80 Hypertension stage 1 - 130-139 OR 80-89 Stage 2 - 140+ OR 90+ Hypertensive crisis - 180+ and/or 120+
49
How is the S1 heart sound created, what does it sound like, and where can it be heard best
S1 is created when tricuspid and mitral valves close Low pitched Best heard over the apex of the heart
50
How is the S2 heart sound created, what does it sound like, and where can it be heard best
S2 is created by the aortic and semilunar valves closing No description Best heard over the base of the heart
51
How is the S2 heart sound created, what does it sound like, and where can it be heard best
S3 is created when a large amount of blood strike a weakened tissue as the mitral valve open Heard right after S2 Best heard over the apex of the heart
52
How is the S3 heart sound created, what does it sound like, and where can it be heard best
This is abnormal and occurs just before S1 when the atria contract. This is always abnormal and is a sign of heart failure or MI
53
S3 heart sound is called ventricular gallop. This is an abnormal sound, however can be normal is what patient populations
well trained athletes, children, and pregnant women
54
You listen to your patient's heart sounds and determine she has a pericardial friction rub. What would this sound like and what underlying condition will also be present
pericardial friction rub has a scratchy, leather-like sound and is caused exclusively by pericarditis on the NPTE
55
If you suspect your patient has a pericardial friction rub caused by pericarditis, where would you auscultate to hear the heart sound
over the left sternal border
56
Where are the auscultation sites to listen to heart sounds HINT; use the pneumonic all people enjoy time magazine
Aortic valve - right 2nd intercostal at sternal border Pulmonic valve - left 2nd intercostal at sternal border Erb's point - 3rd ICS of left sternal border Tricuspid valve - 4th intercostal space at left sternal border Mitral/bicuspid - 5th ICS at midclavicular line on left side
57
If a patient has chronic ESRD, or end stage renal disease, what other common conditions do you expect to see due to inadequate filtration of toxins within the kidneys.
hypercalcemia, hyperkalemia, diabetic ketoacidosis, metabolic acidosi
58
True or False: Exercise is best performed on dialysis days.
false, on non-dialysis days and NEVER immediately post hemodialysis
59
What is the normal lab value range of glucose
100-250mg/dL
60
What are contraindications to exercise in regards to glucose levels
Do not exercise if 100 or lower with symptoms, but Exercise with caution if 70-100 and no symptoms. Do not exercise if 250-300 and call EMS if there is presence of ketones, but exercise with caution without presence of ketones. Call EMS if greater than 300
61
What is the normal lab value range of hemoglobin for males and female
Male is 14-17 g/dL Female is 12-16 g/dL
62
What are the exercise guidelines in regards to hemoglobin lab values
No exercise is less than 8 Light exercise except avoid aerobic activity if 8-10 Low intensity, resistance training allowed if 10-12
63
What is the normal lab value range of Hematocrit for male and female
male is 42%-52% female is 37%-47%
64
What are the exercise guidelines in regards to hematocrit lab values
Do not exercise if less than 25 percent Avoid resistive exercise is greater than 25 percent Gradually progress to resistive exercise if 30 percent or greater
65
What is the normal lab value range of Internatioanl Normalized Ratio - INR
0.9-1.1
66
What are the exercises guidelines in regards to INR lab values
>2.5: Use extreme caution and guard against falls >3.0: Risk for hemarthosis >4.0: Progression of exercise contraindicated; discuss with physician
67
What is the normal lab value range of platelets
150,000-450,000
68
What is the normal lab value range of white blood cells
5.0-10.0 x 10^9 L
69
When does the protein, troponin, enter the body and what does its lab values indicate?
Troponin enters the bloodstream after a myocardial infarction. Increased levels of .1 or greater indicate MI
70
What are normal levels of troponin
zero to 0.03 0.10 indicates MI
71
When does brain natriuretic peptide or BNP released into the body and what do its lab values indicate?
BNP is released during volume expansion and stress on the walls of the heart. Higher levels of BNP indicate heart failure
72
What are normal lab values for BNP
less than 100
73
When does the body release C-reactive protein or CRP into the body and what do these lab values indicate?
CRP is released into the body during an inflammatory condition such as arthritis, RA, meningitis. Lab value greater than 3 indicates elevated CRP
74
What is ESR or erythrocyte sedimentation rate, and what does elevated levels indicate?
ESR is the measurement of how fast RBC's fall in a sample of anticoagulated blood. The rate is increased in the presence of rheumatic conditions, HIV, systemic infections, and collagen vascular diseases
75
What are normal ESR ranges for males and females
males 0-15 females 0-20
75
Alanine amino transferase or ALT is an enzyme that is found within liver cells and is released into the bloodstream in alcoholism, celiac disease, cirrhosis, and liver cancer. What are normal ranges of ALT
7-55
76
When is creatine kinase released into the bloodstream and what are its normal lab values
CK is released in the heart, brain, and skeletal tissue when muscle is damages extensively. Normal ranges are 22-198 and elevated.
77
_____ is an inflammatory reaction of the distal airways from inhalation of bacteria, viruses, microorganisms, foreign substances, gastric contents, dust, or chemicals/radiation therapy.
pneumonia
78
what are the four types of pnuemonia
bacterial viral fungal aspiration
79
What will the clinical presentation of pneumonia look like in regards to observation, palpation, auscultation, and cough
observation- tachypnea, fever, fatigue, chest discomfort palpation- tachycardia, decreased chest wall expansion auscultation- crackles, rhonchi cough- sputum, dry to productive cough
80
What would treatment look like for pnuemonia
education, incentive spirometer, early mobilization, hygiene
81
Why would a patient have an arterial line
to measure arterial blood pressure in real time and to obtain samples for blood gas analysis
82
True or False: Arterial lines are typically used to administer medications
false, the use of a venous catheter would be used to administer medications.
83
Where is a peripherally inserted central catheter or PICC line inserted at and what is its purpose
the PICC line is inserted into a peripheral vein and advanced into the superior vena cava. used to administer chemotherapy, parenteral nutrition, administer drugs/antibiotic therapy
84
What is another name for the central venous catheter and where does it insert at
the CVC or hickman's catheter is inserted into the jugular vein or other large vein and advanced into the superior vena cava
85
What is the function of a hickman catheter
deliver chemotherapy, withdrawal blood, monitor central venous pressure
86
True or false Hickman catheters or central venous lines are utilized when the pt will be in long term care
true
87
What is another name for the swan ganz catheter and where is it inserted at
the swans ganz or pulmonary artery catheter/PAC is inserted into the right side of the heart to monitor pulmonary artery pressure, effectiveness of cardiovascular medications, dx right heart failure
88
What drug class does albuterol belong to and what is the action of the drug
albuterol is a bronchodilator that stimulates adrenergic receptors to relax smooth muscle tissue
89
What drug class does Ipratropium belong to and what is the action of the drug
this is a bronchodilator and inhibits vagally mediated reflexes by blocking acetylcholine in turn relaxing smooth muscle
90
What drug class does aminophylline or theophylline belong to and what is the action of the drug
this is a bronchodilator used to treat wheezing, sob, and difficulty breathing by obstructive conditions.
91
What are common side effects of bronchodilators
dizziness, tremors, flu like symptoms
92
What is diaphragmatic breathing and when is it indicated
this is a deep inhalation technique to breath more with the belly than the chest. This is used to improve O2 stats, atelectasis, anxiety, or mobilize secretions
93
What is pursed lip breathing and when is it indicated
inhaling through the nose and exhaling through pursed lips indicated for relieving dyspnea, activity tolerance, and reduce wheezing
94
Asthma, bronchitis, cystic fibrosis, and emphysema are all (obstructive/restrictive) conditions.
obstructive
95
Sarcoidosis, pulmonary fibrosis, acute respiratory distress, pneumonia are all (obstructive/restrictive) conditions.
restrictive
96
What is cheyne-stokes breathing pattern and when is it seen
deep and faster breathing that has a temporary stop in breathing called apnea that last thirty seconds to two minutes at a time. This is seen is end of life, stroke, TBI, CHF, and drug use
97
What is apneustic breathing
slow, deep gasping inspiration with apnea at full inspiration and insufficient expiration due to damage of the pons/upper medulla
98
What is paradoxical breathing pattern
a reversal of normal breathing where the chest contracts during inspiration and expands during expiration. This is normal in some infants but is pathological in adults and is a serious medical condition.
99
Gerdy is being treated for chronic emphysema in the outpatient clinic. After a trial of sit to stand transfers, the patient is seen hyperventilating. Which of the following breathing techniques is most recommended. A. Pursed lip breathing B. Diaphragmatic breathing C. Active cycle of breathing D. Postural draining
A. pursed lip breathing - this is utilized in obstructive conditions like emphysema. diaphragmatic breathing is for restrictive conditions active cycle of breathing is used when there is secretion issues such as bronchitis

PT Hustle (6 decks)

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