Chapter 6 Flashcards
(133 cards)
0
Q
The most common symptoms of the vascular component of a cardiovascular condition is
A
Edema and leg pain
1
Q
The cardinal symptoms of cardiac disease usually include
A
Chest, neck arm pain or discomfort, dyspnea, palpitation, syncope, cough, diaphoresis and cyanosis
2
Q
Heart is innervated by
A
C3-T4
3
Q
Fluttering sensations in the neck are usually
A
Caused by anxiety, random muscle fasciculations or minor muscle strain or overuse
4
Q
Less than ___ palpitations a minute is considered normal
A
6
5
Q
Palpitation in any person with a history of unexplained sudden death in the family needs
A
Immediate physician referral
6
Q
Caffeine sensitivity can cause palpitation like feelings because
A
Causes an overactive thyroid
7
Q
Why does paroxysmal nocturnal dyspnea wake people up
A
The amount of blood returning to the heart and lungs from the lower extremities when lying down
8
Q
People with CHF usually have these two things
A
PND and unexplained episodes of shortness of breath
9
Q
Those with CHF breathe easier when
A
Standing and when later in the day due to gravity
10
Q
Anyone who cannot climb a single flight of stairs without feeling moderately or severely winded or who awakens at night or has sob lying down needs
A
Physician referral
11
Q
When is dyspnea more likely to be of pulmonary origin
A
When it is relieved by specific breathing patterns or positional changes like leaning forward
12
Q
Syncope that occurs with no warning period of symptoms may be a sign of
A
Heart valve or arythmia problems
13
Q
What is pseudoclaudication
A
Claudication from lumbar stenosis
14
Q
Statins are used to
A
Decrease LDLs
15
Q
What is the most common mycotoxin event associated with statins
A
Myalgia
16
Q
What is myositis
A
Muscle symptoms with increased CK levels
17
Q
Risk factors for statin side effects
A
Age over 80, small body frame, kidney or liver disease, excessive grapefruit juice consumption, use of other medications and alcohol abuse
18
Q
Signs and symptoms of statin induced side effects
A
Myalgia, fever, nausea, vomiting, liver impairment symptoms
19
Q
One of the most important primary signs of CAD in women
A
Unexplained, severe episodic fatigue and weakness associated with decreased ability to carry out normal ADLs
20
Q
What is Prinzmetal’s angina
A
Coronary artery spasms that squeeze arteries shut and keep the blood from reaching the heart
21
Q
Prinzmetal’s angina typically occurs
A
At rest and at the same time everyday
22
Q
Women with signs of CAD may have isolated pain in the
A
Mid thoracic spine or right bicep
23
Q
Why does cardiac pain refer to the jaw
A
Inter nuncial fibers from the cervical spinal cord posterior horns to the spinal nucleus of the trigeminal nerves
24
80 to 90% of clients experience angina in this location
Retrosternal or slightly left of the sternum
25
The duration of angina as a direct result of myocardial ischemia is typically
1-3 minutes and no longer than 3 to 5 minutes
26
If angina like pain is not relieved with rest or up to ___ nitro tablets notify the physician and take the client to cardiac care unit
3
27
Signs and symptoms of angina
Gripping vise like feeling of pain or pressure behind Breast bone, radiating pain, toothache, burning indigestion, dyspnea, nausea, belching
28
Most common cause of MI
Coronary thrombosis
29
What is the first symptom of heart attack in half of men
Sudden death
30
MIs typically occur at what time of day
Morning (40% higher likelihood)
31
Why do MIs pose a greater risk in the morning
The body's clotting system is more active at this time, BP surges, increased HR from rest and reduced BF to heart
32
Hormone effect on having an MI in the morning
Stress hormone which can induce vasoconstriction increase in the morning
33
Warning signs of MI - classic ones
Chest pain that is unrelieved by rest of nitro tablets and lasts over 30 minutes, pain radiates for hours, pallor, sweating, nausea, vomiting
34
When working with _____ it can increase the pain associated with MI
Arms overhead
35
Most common symptom of MI in men
Feeling of pressure or discomfort in the sternal region or across the chest
36
Chest pain is less common in ____ during MI
Women
37
In women _____ may relieve the symptoms of MI
Antacids
38
Most common symptom in women one month before heart attack
Unusual fatigue
39
What is pericarditis
Inflammation of the pericardium
40
Chest pain from pericarditis mimics
Chest pain of an MI
41
How can you differentiate MI from pericarditis with position changes
MI pain will be unaffected by position,, breathing or movement whereas pericarditis may be relieved by kneeling on all fours , leaning forward or sitting upright
42
Pericardital chest pain is often worse with
Breathing, swallowing, belching or neck or trunk movements especially side bending and rotation
43
The chest pain in pericarditis may be described as
Sharp or cutting and possibly in bursts with a change in body position
44
What may reduce pericarditis pain?
Holding the breath
45
What is ventricular interdependence
The ventricles both need to be functioning, if one fails it almost always leads to failure of the other
46
Right sided ventricular failure leads to
Congestion of peripheral tissues and viscera, liver enlargement, ankle swelling and ascites (fluid buildup in abdomen)
47
What are the most common signs and symptoms of CHF
Breathlessness, exhaustion and LE edema
48
Why is cough a common symptom of left ventricular failure
A large amount of fluid is trap,led in the pulmonary tree, irritating lung mucosa
49
Why is fatigue and muscle weakness a symptom of left ventricular failure
Inadequate CO leads to hypoxic tissue and slowed removal of metabolic waste products causing them to tire easily
50
Nocturia is possible in both and r and l sided heart failure but more common in
Left
51
What is one of the early signs of right ventricular failure
Dependent edema - symmetric edema in the dependent parts of the body where venous pressure is highest
52
Clinical signs and symptoms of right sided heart failure q
Increased fatigue, dependent edema, pitting edema, edema in sacral area or back of thighs, right upper quadrant pain and cyanosis of nail beds
53
What is a dissecting aortic aneurysm
Splits and penetrates the arterial wall creating a false vessel
54
Thoracic aneurysms occur most frequently in
Men with hypertension ages 40-70
55
What is the most common site of peripheral arterial aneurysms
Popliteal space
56
Abdominal aortic aneurysms occur _ times as often than thoracic aneurysms
4
57
The most common site for abdominal aortic aneurysms is
Just below the kidney with referred Omani to the thoracic lumbar junction
58
Most AAAs are asymptomatic or symptomatic?
Asymptomatic - find out with exams
59
The most common symptom of an AAA is
A pulsating mass in the abdomen with or without pain, followed by abdominal pain and back pain
60
Palpating the width of the abdominal aorta should
Have a uniform pulse from midline out
61
The abdominal aorta passes posterior to diaphragm at what level
T12
62
The abdominal aorta bifurcates at this level
L4
63
The BP and HR values that may indicate shock
Systolic under 100 and HR over 100
64
What is stenosis
A narrowing or constriction that prevents the valve from opening fully and may be caused by growths, scars, or abnormal deposits on leaflets
65
What is insufficiency
Regurgitation, occurs when The valve does not close properly and causes blood flow to back into the heart chamber
66
Prolapse...
Involves only the mitral valve, and occurs when enlarged valve leaflets bulge backward into the left atrium
67
Signs and symptoms of valvular disease
Easy fatigue, dyspnea, palpitation, chest pain, pitting edema, Orthopnea and paroxysmal dyspnea, dizziness and syncope
68
What is rheumatic fever caused by
Stretoloccocal bacteria
69
Why is it called rheumatic fever
The two more common symptoms are fever and joint pain
70
Most typical presentation of rheumatic fever in children and young adults
Cold or sore throat followed two to three weeks later by painful joints and fever, with palpitations and fatigue
71
What is endocarditis
Inflammation of the cardiac endothelium and damages either the tricuspid, mitral or aortic valves
72
Endocarditis is caused by
Bacteria, abnormal growths on the closure lines of previously damaged valves or artificial valves
73
Two groups most at risk for endocarditis
Injection drug users and post cardiac surgical patients
74
Up to 45% of individuals with endocarditis Inititally have
Musculoskeletal symptoms including arthralgia, arthritis, low back pain and myalgia
75
The most common musculoskeletal symptom of endocarditis is
Arthralgia, generally in proximal joints
76
Most common site of arthralgia in endocarditis
Shoulder
77
If a patient is suspected of RA due to symmetric arthralgia in knees and ankles, how could you differentiate
If they have morning stiffness, it would be RA, this is not present in those with endocarditis
78
Endocarditis may produce destructive changes in the
Sacroiliac joint
79
Endocarditis induced low back pain mimics symptoms of someone with
Herniated lumbar disk
80
How do you differentiate endocarditis low back pain and herniated disk
Neurological deficits aren't present in endocarditis
81
Systemic lupus erythematosus releases
Broad spectrum of autoantibodies into the circulation
82
The most common cardiac lesion associated with SLE
Pericarditis
83
Usually symptoms of mitral valve prolapse are due to
Dysautonomia
84
There is a high incidence of mitral valve prolapse in those with
Fibromyalgia
85
The triad of symptoms for mitral valve prolapse
Fatigue, dyspnea and palpitations
86
The therapist should monitor pulse carefully before, during and after exercise in anyone who has had a
Stroke
87
Explain a fib and possible complication
Disorganization of atrial activity without effective atrial contraction, the chambers quiver rather than contract causing pooling of blood and clots to form increasing risk for a stroke
88
Which bacteria is of concern may cause A fib
H. Pylori in the stomach, confirm with high concentration of c reactive protein
89
Sinus tachycardia is defined as
More than 100 bpm
90
Bradycardia is less than
60bpm
91
What is pulse pressure
Systolic minus diastolic
92
A widened pulse pressure usually results from
Stiffening of the aorta secondary to atherosclerosis
93
If the pulse pressure widens this will increase
Stroke volume
94
Primary hypertension is also called ______ and makes up ____ of all hypertensive clients
Idiopathic, 95%
95
Secondary hypertension results from
Diseases that cause it
96
What is labile or borderline hypertension
When there is intermittent elevation of BP interspersed with normal readings
97
What is isolated systolic hypertension and what does it increase the risk for
Systolic rises but diastolic is normal and it increases the risk for stroke and death
98
This important mineral deficiency is known to contribute to hypertension
Potassium
99
Clinical signs and symptoms of hypertension
Occipital headache, vertigo, flushed face, spontaneous epistaxis, vision changes and nocturnal urinary frequency
100
How long do transient ischemic attacks last
5 to 20 minutes usually but can last up to 24 hours
101
An untreated TIA is likely to result in stroke in 10-20% of patients within
3 months
102
Signs and symptoms of TIAs
Slurred speech, difficulty with speech, or difficulty understanding others, sudden confusion, loss of memory, even loss of consciousness, temporary blindness or other dramatic visual changes, dizziness, severe headache, paralysis or weakness usually one sided, symptoms typically lasting a few minutes
103
Orthostatic hypotension is
SBP drops 20 mmHg or a drop of 10 mmHg or more of both systolic and diastolic BP upon an erect position with a 10-20% decrease in HR
104
DM is an insect or direct risk factor for heart disease
Indirect, it's the combination of what it effects that increases the risk
105
The first sign of vascular occlusive disease may be
The loss of hair on the toes
106
The most common lesion of vascular occlusive disease is the
Superficial femoral artery causing pain in the calf and lower thigh
107
What is Raynaud's phenomenon
Intermittent episodes during which small arteries or arterioles in extremities contrict, causing temporary pallor and cyanosis of the digits and changes in skin temperature
108
Unilateral Raynaud's may be a sign of
Hidden neoplasm
109
Secondary Raynaud's is known To be caused by these things
Connective tissue or collagen vascular disease like sclerderma, polymyositis/dermatomyositis, systemic lupus erthmatosus or RA
110
Raynaud's disease is
A primary vaso spastic or vaso motor disorder caused by hypersensitivity to cold, release of serotonin and congenital predisposition to vaso spasm
111
80% of those with Raynaud's disease are
Women between 20-49
112
Acute venous disorders are due to
Formation of thrombi which obstruct venous flow
113
DVT is more common in men or women and children or adults?
Women and adults
114
The most significant risk factors for a DVT are
Age over 70 and previous thromboembolism
115
Thrombus formation is attributed to what three things
Venous stasis, hypercoagulability, injury to the venous wall
116
What is venous stasis caused by
Prolonged immobilization or absence of the calf muscle pump
117
Women on progestogen only pills are at little or no increased risk of
Blood clots
118
Lymphadema is
An excessive accumulation of fluid in the tissue spaces.
119
Potassium levels should be monitored for those taking
Dieretics
120
Med in particular that lowers potassium
Digitalis
121
What are the cardiac effects of too much potassium
Ventricular arythmias and a systole or flat line
122
Magnesium deficits often accompany these deficits
Potassium and calcium
123
NSAIDs have the ability to decrease the effectivness of
ACE inhibitors
124
___ and ___ is combo with NSAIDs will
Exacerbate the effects of NSAIDs
125
Diuretics work by
Lowering BP by eliminating sodium and water and thus reducing blood volume
126
Beta blockers work by
Relaxing the blood vessels and the heart muscle by blocking the beta receptors on the SA node and myocardial cells producing a decline in the force of contraction and a reduction in heart rate
127
Alpha 1 blockers...
Lower BP by dilating blood vessels
128
Alpha 1 blocker medications all end with
"Zocin"
129
Ace inhibitors also
Vaso dilate
130
Calcium does what to blood vessels
Constricts
131
Calcium channel blocking Meds end with
Pine
132
Angina does ___ occur immediately after physical activity
Not
