CAT Topics 1 Flashcards
CHF: impairment in cardiac output causes the body to compensate and results in an increase in
- blood volume
- cardiac filling pressure
- heart rate
- cardiac muscle mass
A pt with CHF will initially show signs of _____
Tachycardia
Left sided heart failure is generally associated with signs of _________ venous congestion
Pulmonary
R sided heart failure is generally associated with signs of _______ venous congestion
Systemic
CHF: Over time, fluid accumulation spreads and you get
- ankle edema
- congestive hepatomegaly
- ascites
- pleural effusion
What medication issue do you have to watch out for with CHF?
Digitalis toxicity
Medical mgmt for CHF: types of drugs used
- diuretics
- nitrates
- analgesics
- ACE inhibitors
CHF: survival
3-5 years
How is cor pulmonale different from CHF?
Form of R sided heart failure, but is normally seen as a consequence of COPD
With CF, there is an underlying impermeability of epithelial cells to _______
Chloride
The most consistent symptom to confirm CF is
The finding of high concentrations of sodium and chloride in the sweat
Sodium and chloride amounts greater than ___ mEq/l is a positive dx for CF
60
Standard value is 40
CF is (obstructive/restrictive)
Obstructive
CF: Airway obstruction can lead to
- pulmonary HTN
- atelectasis
- pneumonia
- lung abscess
CF median age of death
35 years
Most common cause of death for CF pts
Respiratory failure
3 Classifications of emphysema
- centrilobular
- panlobular
- paraseptal
Emphysema results from non-reversible injury and destruction of this protein within the alveolar walls
Elastin
Pockets of air that form between alveolar spaces
Blebs
Pockets of air that form within the lung parenchyma
Bullae
Centrilobular emphysema destroys _______, but _____ remain intact
- bronchioles of upper lungs
- alveoli
Panlobular emphysema destroys _____ and is usually found here
- destroys air spaces of the acinus
- found in lower lungs
Paraseptal emphysema destroys _______
Alveoli in lower lobes
This type of emphysema results in blebs along the lung periphery
Paraseptal
Characteristics of emphysema patients
- Barrel chest, rounded shoulders
- Rosy
- Pursed lip breathing
Emphysema: formation and rupture of bullae and blebs can lead to
Pneumothorax
This is a serious complication that can occur with advanced emphysema
Cor pulmonale
Emphysema: pharmacological mgmt
- bronchodilators
- mucolytics
- anti-inflammatory agents
- mast cell membrane stabilizers
- antihistamines
This type of MI involves the full thickness of the myocardium
Transmural
This type of MI involves the subendocardial area (inner third of the myocardium)
Nontransmural
3 zones that form concentric circles around the point of infarction
- zone of infarct
- zone of hypoxic injury
- zone of ischemia
Approximately ⅔ of patients experience prodromal symptoms days to weeks before an MI, including:
- unstable angina
- SOB
- fatigue
Primary tool to detect MI
12 lead ECT
ECG: An inverted T wave indicates
Myocardial ischemia
ECG: An elevated ST segment indicates
Acute infarction
ECG: A depressed ST segment indicates
Pending subendocardial or transmural infarction
Arrhythmias occur in 90% of pts post-MI and are caused by
- ischemia
- ANS impairment
- electrolyte imbalance
- conduction deficits
- chemical imbalances
This accounts for 90% of all cases of angina
CAD
PVD aka
Arteriosclerosis obliterans
Primary risk factor for developing PVD
Atherosclerosis
During the early stages of PVD, this may be the only manifestation
Intermittent claudication
It is fairly common for a pt with PVD to also have these dx’s
- CAD
- DM
PVD: these meds may be indicated due to increased risk for DVT
Anticoagulants
Antiplatelet agents
Thrombolytics
Symptomatic PVD has a ____% risk of death within 5 years
30%
Symptomatic PVD has a ____% risk of death within 10 years
50%
Symptomatic PVD: death usually results from
MI or cerebrovascular disease
Most likely clinical presentation for RLD
Decrease in lung volumes
RLD: diagnostic testing for confirmation
- chest radiograph
- ABG
As RLD progresses, respiratory muscle fatigue will lead to
- impaired alveolar ventilation
- CO2 retention
What are complications and outcomes of advanced RLD?
- Cor pulmonale
- Hypoxemia
- Pulmonary HTN
- Severe decrease in oxygenation
- Ventilatory failure
