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Sharlene and MB's PT party > Cardiovascular- Diagnostic tests, labs, and lab values > Flashcards

Cardiovascular- Diagnostic tests, labs, and lab values Flashcards

1
Q

Diagnostic Tests: why do a chest x-ray

A

will reveal abnormalities of lung fluids, overall heart shape and size (cardiomegaly), aneurysm

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2
Q

Diagnostic Tests: myocardial perfusion imaging

A
  • used to diagnose and evaluate ischemic heart disease, myocardial infarction
  • thallium-201 scan is where thallium is injected into blood via IV; radioisotopes concentrate in normal tissue but not in ischemic or infarcted tissues (cold spots)
    used to identify myocardial blood flow, areas of stress-induced ischemia (exercise test, old infarcts
    -thallium stress test is used with exercise test; injected at peak exercise
  • Positron emission tomography (PET) uses radioactive marker 18-F-fluorodeoxyglucose (FDG)
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3
Q

Diagnostic Tests: echocardiogram

A

noninvasive test that uses US to assess internal structures- size of chambers, wall thickness, ejection fraction (EF), movement of valves, septum, abnormal wall movement

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4
Q

Diagnostic Tests: cardiac catherization

A
  • passage of tiny tube via brachial or femoral artery through aorta into blood vessels; uses contrast medium and x-ray to see whats happening in coronary vessels
  • gives info about anatomy of heart, vessels, valves, and any abnormalities
  • can also check EF
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5
Q

Diagnostic Tests: Central line (Swan-Ganz catheter)

A
  • catheter is inserted through vessels into right side of heart
  • measures central venous pressure (CVP), pulmonary artery pressure (PA), pulmonary capillary wedge pressures (PCWP)
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6
Q

Diagnostic Tests: why select an MRI

A

creates a 3D image of heart to investigate coronary arteries, aorta, pericardium, and myocardium

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7
Q

Lab Tests: Why check changes in the enzyme troponin

A

rise and fall > 99th percentile is the primary measure of detecting MI

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8
Q

Lab Tests: What must accompany troponin value to diagnose MI

A

Any one of the following:

  • symptoms of ischemia
  • new or presumed new ST changes on ECG
  • development of pathological Q waves on ECG
  • new loss of viable myocardium and/or new wall motion abnormality on imaging
  • evidence of intracoronary thrombus via catherization or autopsy
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9
Q

Lab Tests: what other enzyme level could you check

A

elevation of CP or CPK (serum creatine kinase or creatine phosphokinase) with concomitant elevation of CK-MB (serum creatine kinase MB) can also be assessed, but peaks between 12-24 hours

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10
Q

Lab Tests: purpose of serum lipid panels

A

used to determine coronary risk

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11
Q

Lab Values: Arterial Blood Gases- SpO2

A
  • Norm 98%-100%

- SaO2 below 88%-90% usually requires supplemental O2

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12
Q

Lab Values: Arterial Blood Gases- PaO2

A
  • Norm 90-100 mm Hg
  • increased level = hyperoxygenation
  • decreased level = cardiac decompensation, COPD, and some neuromuscular disorder
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13
Q

Lab Values: Arterial Blood Gases- PaCO2

A
  • Norm 35-45 mm Hg
  • increase = COPD, hypoventilation
  • decrease = hyperventilation, pregnancy, PE, and anxiety
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14
Q

Lab Values: Arterial Blood Gases- pH, whole blood

A
  • Norm 7.35-7.45
  • increase = resp alkalosis (>7.45) = hyperventilation, sepsis, liver disease, fever
  • increase = metabolic alkalosis (>7.45) = vomiting, potassium depletion, diuretics, volume depletion
  • decrease = resp acidosis = hypoventilation, COPD, resp depressants, myasthenia (weakness)
  • decrease = metabolic acidosis = increased acids (diabetes, alcohol, starvation); renal failure, increased acid intake, and loss of alkaline body fluids
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15
Q

Lab Values: Hemostasis (clotting time)- Prothrombin time

A
  • Norm 11-15 sec

- increase detects factor X deficiency, hemorrhhagic disease, cirrhosis, hepatitis drugs (warfarin)

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16
Q

Lab Values: Hemostasis (clotting time)- Partial Prothrombin Time

A
  • Norm 25-40 sec

- increase implicates factor 8, 9, and 10 deficiency

17
Q

Lab Values: Hemostasis (clotting time)- International Normalized Ratio (INR)

A
  • Reference range 0.9- 1.1
  • Pts. with DVT, PE, mechanical valves, Afib, on coagulation will have target INRs of 2-3. These pts.
    and those with clotting disorders may have orders for target INR 3.5
  • Look for active signs of beleeding when treating these patients and use compensatory strategies to reduce risk of falling
18
Q

Lab Values: Hemostasis (clotting time)- Bleeding time & C-reactive protein (CRP)

A
  • Bleeding time norm 2-10 min
  • CRP norm <10 mg/L
  • increase values implicate platelet disorders, thrombocytopenia
  • increased levels associated with increased risk of atherosclerosis
  • > 100 mg/L associated with inflammation and infection
19
Q

WBC

A
  • Norm 4300-10,800 cells/mm3
  • indicative of status of immune system
  • over 10,800 = infection (bacterial or viral), inflammation, hematologic malignancy, leukemia, lymphoma, drug use (corticosteroids)
  • under 4300 = aplastic anemia, B12 or folate deficiency
  • with immunosuppression there is increased risk of infection
20
Q

Lab Values: CBC- physical therapy considerations for abnormal WBC values

A

consider metabolic demands in presence of fever and use of mask when WBCs < 1000 - 2000 or Absolute Neutrophil Count (ANC) <500 - 1000

21
Q

Lab Values: CBC- RBC

A
  • norm males 4.6 - 6.2
  • norm females 4.2 - 5.9
  • above norm = polycythemia
  • below norm = anemia
22
Q

Lab Values: CBC- Erythrocyte Sedimentation Rate (ESR)

A
  • norm male <15 mm/hr
  • norm female <20 mm/hr
  • above norm = infection and inflammation: rheumatic or pelvic inflammatory disease, osteomyelitis used to monitor effects of treatment eg. RA, SLE, Hodgkin’s disease
23
Q

Lab Values: CBC- Hct

A
  • hematocrit percentage of the whole blood
  • norm males 45-52%
  • norm females 37- 48%
  • norms are age dependent
  • above norm = erythrocytosis, dehydration, shock
  • below norm = sever anemia, acute hemorrhage
24
Q

Lab Values: CBC- PT considerations for abnormal Hct

A

can cause decrease in exercise tolerance, increase fatigue, and tachycardia

25
Q

Lab Values: CBC- Hgb

A
  • norm male 13-18 g/dL
  • norm female 12-16 g/dL
  • norms are age dependent
  • above norm = polycythemia, dehydration, shock
  • below norm = anemias, prolonged hemorrhage, RBS destruction (cancer, sickle cell disease)
26
Q

Lab Values: CBC- PT considerations for abnormal Hgb

A

can cause decrease in exercise tolerance, increase fatigue, and tachycardia

27
Q

Lab Values: CBC- Platelet count

A
  • norm 150,00- 450,000 cells/mm3
  • above norm = chronic leukemia, hemoconcentration
  • below norm = thrombocytopenia, acute leukemia, aplastic anemia, cancer chemotherapy
28
Q

Lab Values: CBC- PT considerations for abnormal Platelet count

A
  • increased risk of bleeding with low levels so monitor for hematuria, petechiae, and other signs of active bleeding
  • <20,000 AROM, ADLs only
  • 20,000 - 30,000 light exercise only
  • 30,000 - 50,000 moderate exercise

Sharlene and MB's PT party (35 decks)

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