Cardiopulmonary System Flashcards
standard vital signs
hear rate
respiratory rate
blood pressure
temperature
normal range of heart rate
60-100 bpm
normal range of respiratory rate
12-20 breaths per min
normal blood pressure
systemic <120
diastolic <80
take observations of these before vital signs
signs of distress seated posture overall nutritional status skin color - cyanosis (blue) - jaundice (yellow) - bruising - petechia (purple marks) diaphoresis (excessive sweating) peripheral observation of extremities - edema - clubbing of digits
clinical indicators that warrant VS testing
dyspnea- difficulty breathing
fatigue
chest pain/discomfort
irregular heart beat- palpitations
cyanosis- blue fingertips or lips
intermittent claudication- leg pain with activity or rest
pedal edema- swelling of feet and lower legs
pulse
wave of blood in artery created by contraction of left ventricle during ventricular systole
three aspects of HR
rates, rhythm, quality
rate of HR
normal range= 60-100 bpm
bradycardia= < 60 bpm
tachycardia= >100 bpm
palpitation
sensation of one or more irregular heart beats- feels like heart skips a beat or flutters
rhythm of HR
arrhythmia or dysrhythmia= irregular rhythm
- premature or mission beats
- typically caused by conduction abnormalities
HR quality
related to blood volume
- larger volume= stronger pulse
- smaller volume= weaker pulse
weak or “thready”= difficult to detect and easy to eliminate
strong or “bounding”= difficult to eliminate
factors affecting HR
age/gender fitness level emotional status exercise medications temperature (external and internal)
methods of assessing HR
arterial palpation
auscultation of heart apex
electrocardiogram (EKG or ECG)
electronic devices
palpation points
temporal external carotid brachial radial femoral popliteal (behind knee) dorsal peds
diaphragm innervation
C3,4,5
supper respiratory tract
noce, mouth, pharynx, larynx
conducting zone
trachea, primary bronchus, bronchioles, terminal bronchioles
respiratory zone
respiratory bronchioles, alveolar duct, alveolar sac
ventilation
mechanical process of breathing
can have voluntary control but usually involuntary
respiration
gas exchange in alveolar sacs to bloodstream
involuntary
inspiration/inhalation
diaphragm, intercostal muscles, accessory muscles (scalenes, SCM)
expiration/exhalation
passive elastic recoil of diaphragm and lung parenchyma abdominals
regulatory mechanisms
respiratory center (pon, medulla) control rate and depth of breath central and peripheral chemoreceptors monitor PaCO2/pH, PaO2
factors affecting RR
metabolic rate/demand age (higher in kids) body size body position (lower laying) environment emotion/stres medications disease
RR parameters
12-20 br/min ("eupnea")
tachypnea (>24 br/min)
bradypnea (<10 br/min)
apnea= absence of breathing
normal tidal volume= 0.5L/brsounds of RR
normally smooth and soft usually requires stethoscope wheezing= narrow airway stridor= upper airway obstruction crackles= secretions in air passages
ventilation is controlled voluntarily by
cortex
ventilation is controlled involuntarily by
pons and medulla
blood pressure definition
force exerted agains arterial walls, measure in mmHG (millimeters of mercury)
BP= cardiac output x total peripheral resistance
systolic BP
highest pressure exerted on arteries during cardiac systole
diastolic BP
lowest pressure recorded within arteries during cardiac diastole
modifiable risk factors or hypertension
current cigarette smoking diabetes mellitus dyslipidemia/hypercholesterolemia overweight/obesity physical inactivity/low fitness unhealthy diet
factors that affect BP
blood volume elasticity of arteries exercise valsalva maneuver body position arm position
arm position affect
1-2 mm Hg for every 2.5 cm above or below level of the heart
above- BP reading is too low
below- BP reading too high
orthostatis hypotension
precipitous drop in BP of more tan 20 mmHg (systolic) when moving from supine/seated to standing
can lead to loss of consciousness
gradual acclimatization can restore baroreceptor reflex function
- compression stockings, tolt tables, repetition
elevated BP
120-129/ <80
stage 1 hypertension
130-139/ 80-89
stage 2 hypertension
> 140/>90
temperature regulation center
hypothalamus
fever vs. hyperthermia
fever
- never exceed 104*F
- associated with change to hypothalamic set point
- respond to medication
- some diurnal variation
hyperthermia
- exceeds 104*F
- does not respond to medication, needs whole body cooling
- no diurnal variation
- extremely dangerous an requires intensive care
signs and symptoms of hyperthermia
mental statu change strong rapid pulse lack of sweating dry flushed skin faintness staggering coma
health related factors of hyperthermia
dehydration impaired blood circulation inefficient sweat glands hear, lung, kidney diseases high BP reduced sweating from diuretic medication, sedatives, tranquilizers, heart or BP medication being substantially over or underweight drinking alcohol
hypothermia
drop in core body temperature below 95F (35C)
stages of hypothermia
- shivering
- slow, weak pulse, slow breathing, lack of coordination, irritability, confusion, sleepiness
- slow, weak, or absent respiration and pulse, loss of consciousness
factors raising core body temperature
later in the day (4-8pm_ children exercise menstrual cycle pregnancy environment ingestion of hot things
factors lowering core body temperature
mornings (4-6am)
elderly people
environment
ingestion of cold things
signs nd symptoms of infectious disease
chills vomiting sweating fatigue nausea change in blood composition enlarged lymph nodes inc. HR inc. RR loss of appetite dec. urine output
common causes of fever
blood infection UTI lung infection gastrointestinal infection skin infection
cause of LE edema
excessive buildup of fluid in tissues
- prolonged standing/sitting
- pregnancy
- injury/trauma/infection/surgery in LE
- venous insufficiency
- heart, kidney, liver failure
edema grade
- mild, moderate, sever
- pitting edema scale
- 0+ no pitting edema
- 1+ mild pitting, barely perceptible depression
- 2+ moderate pitting, easily identifies depression (skin rebound within 15 seconds)
- 3+ moderately severe pitting edema, easily identifies depression (skin rebound in 15-30 seconds)
- 4+ severe pitting edema, easily identifies depression (skin rebounds >30 seconds)
