Cardiopulmonary Conditions

Question 1

Most common cause for pulmonary embolism

Answer 1

Deep Vein Thrombosis (DVT); more than 90% of pulmonary emboli are the result of clots in legs and pelvis as a result of DVT
-emboli occur in 30% of cases of untreated DVT

Question 2

Best course of action when patient is lightheaded and blood pressure drops

Answer 2

Lay patient down and elevate the lower extremities to return blood to head

Question 3

Syncope

Answer 3

Fainting caused by fall in blood pressure, not enough O2

Question 4

Averages RR, BP, and HR

Answer 4

• Respiratory rate: 12-20 breaths per minute
• Heart rate: 60-100 beats per minute
• Blood pressure: 120/80

Question 5

Cardiac conditions and terms

Answer 5

• Arrhythmia- irregular heart beat
• Cardiac arrest- heart stops
• Congenital heart defects- born with this disease
• Congestive heart failure (CHF)- heart not functioning correctly; chronic
• Coronary heart disease or coronary artery disease (CAD)- due to structural issues caused by things like smoking or high blood pressure
• Myocardial infarction (MI)- heart attack

Question 6

Signs and symptoms of cardiac disease

Answer 6

• Angina; chest pain
• Change in heart sounds
• Confusion or other behavioral changes
• Dizziness
• Dyspnea (SOB)
• Edema
• Fainting
• Heart palpitations
• Pale, cool, moist skin
• Poor exercise tolerance
• Sweating
• Tachycardia

Question 7

Metabolic Equivalent Rate (MET)

Answer 7

METs show the amount of energy burned, or oxygen needed during exercises and various physical activities.
-One MET is equal to the energy consumed when a pt is at rest in semi-reclined, which is 3.5 ml of O2 per minute per kg of body weight.

Question 8

MET examples

Answer 8

METs measured from 1 to 10:

• 1.3 would be sitting watching TV
• 4 would be pushing a child in a stroller
• 9.8 would be running or heavy exercise
• **Dressing self requires 2 METs

Question 9

MET restrictions following heart attack

Answer 9

• Directly following heart attack, limit to 1-2 METs.

- As rehabilitating pt progresses (over 4-8 weeks), limit activities to 2-4 METs.

Question 10

Ventricular tachycardia

Answer 10

More than 100 beats per minute, which can cause sudden death.
-Symptoms include: SOB, syncope (dizziness), palpitations, increased pulse rate or chest pain

Question 11

Ventricular tachycardia during therapy

Answer 11

If therapist suspects ventricular tachycardia they should stop therapy immediately due to life threatening nature of condition, deferring pt until stable (monitor and report).

Question 12

Postprandial orthostatic hypotension

Answer 12

OH which occurs when a person goes from supine to standing shorty after meal.
-Generally affects older adults, people with hypertension and people with Parkinson’s disease.

Question 13

Best sleeping position for morbidly obese pt

Answer 13

Side lying with head of bed elevate; main goal to elevate entire upper trunk instead of just head.

Question 14

Heart failure symptoms on each side of heart

Answer 14

• Right side: blood flows back into venous system, causing cyanotic nail beds (blue nails), jaundice, and lower extremity edema.
• Left-side: Coughing/wheezing, fatigue, SOB, sudden weight gain/edema, and nausea

Question 15

What is “barrel chest” a sign of?

Answer 15

Barrel chest is an appearance related to emphysema; pts with emphysema have hyperinflated lungs, which partially expand the ribcage causing barrel-like appearance of chest.

Question 16

Best sitting position for client with dyspnea (SOB)

Answer 16

Avoid forward trunk bending; rest arms on thighs (releases diaphragm).
-pursed lib breathing can slow breathing and reduce anxiety

Question 17

Raynaud’s syndrome

Answer 17

Disrupts blood flow to the digits in vasospastic attacks. Pt should be educated in wearing gloves when exposing hands to the cold, such as reaching into the freezer.

Question 18

Pacemaker precautions: UE positioning

Answer 18

No shoulder flexion or abduction greater than 90 deg on side of pacemaker implant for 4 weeks.