CV Exam Flashcards
orthopenia is indicative of..
L heart failure (dyspnea when supine)
pitting edema is indicative of – heart failure
R
how does HDL contribute to risk of heart disease?
can be a NEGATIVE risk factor if HDL > 60 mL
diaphoresis is.. -is a sign of ?
excess sweating and cool clammy skin; sign of decreased CO & low O2 sat
where can you palpate the apical pulse in a typical person?
pt supine, palpate at 5th interspace, midclavicular vertical line
grade for a normal pulse is..
2+
why should you assess the pulse of the carotid artery one side at a time?
reduce the RISK OF BRADYCARDIA thru stimulation of the carotid sinus baroreceptor
what is the best place to take a pulse in infants? -also, what is their anticipated HR?
brachial pulse -newborn 127bpm, normal = 90-164 bpm
where is the auscultation landmark for the aortic valve
the 2nd right intercostal space at the sternal border
what is the sound that marks the beginning of systole? What produces the sound?
S1 - sound is normal closure of mitral and tricuspid valves
What sound marks the end of systole? -what produces the sound?
S2 (dub) marks the end of systole aka the closing of the pulmonary and aortic valves
if a murmur occurs between S1 & S2 it could be indicative of..
mitral valve prolapse (it’s systolic dysfunction)
if a murmur can be felt upon palpation and is more of an abnormal tremor, it is considered a ..
thrill
what is a BRUIT and what does it indicate?
adventitious sound or murmur of arterial OR venous origin; -indicates ATHEROSCLEROSIS
an S3 heart sound in older individuals may be indicative of ..
CHF
S4 heart sound could be indicative of..
CAD, MI, aortic stenosis OR chronic HTN
QRS wave is indicative of..
ventricular depolarization
the PR interval is..
the time req for the impulse to travel from atria thru conduction system to Purkinje fibers
when are PVCs considered abnormal?
> 6 per min paired or in sequential runs;
absent P wave, bizarre/wide QRS that’s premature
what is considered “ventricular tachycardia”?
3 or more PVCs occuring sequentially
What is ventricular fibrillation (VF)?
a pulseless, emergency situation, req CPR /defibrillation/meds
- chaotic activity of ventricle originating from multiple foci
- unable to determine rate
NO QRS complexes
clinical death within 4-6 minutes
an AV block is.
abnormal delays or failure to conduct thru normal conducting system
which AV block is a life threatening situation?
3rd degree AV block - COMPLETE block, req meds/PPM
what causes ST segment depression?
-& what is considered significant?
impaired coronary perfusion (ischemia or injury)
-depression OR elevation > 1mm in 2 consecute leads
acute ST elevations present 2/2 ..
an acute MI
quinidine is used for..
antiarrythmia med
-lengthens the QRS (extends ventricular depolarization)
“orthostasis” qualification =
systolic decr >20 mmHg, diastolic decr >10 mmHg
what should a 3-5 y/o child’s BP be?
113-116 / 67-74 mmHg
Mean arterial pressure is..
= [SBP + (2 x DBP)] / 3
NORMAL = 70-110 mmHg
tachypnea is ..
an incr in RR >22 Breaths per min
the modified borg scale is rated on a scale of ..
What is considered “severe”?
0-10;
>5 is severe
crackles (rales) are indicative of..
secretions in the lungs
what do rhonchi sound like?
whistling sounds
where does pain from a dissecting aortic artery refer to?
the back
hypoxemia VS hypoxia
hypoxemia is abnormally low O2 in the blood (sat level <90%) ; hypoxia is low O2 in tissues
clubbing is indicative of..
chonic O2 deficiency, chronic pulmonary disease or heart failure
rubor is..
dependent redness with PAD
b/l edema is indicative of..
CHF
what is Stemmer’s sign and what does it indicate?
dorsal skin folds of toes OR fingers resistant to lifting
-indicates fibrotic changes and lymphadema
if a pt has heart failure, they are at risk for acute decompensation. What are the signs of that?
increased SOB, sudden wt gain, incr LE edema or abdominal swelling, increased pain or fatigue, pronounced cough, lightheadedness, or dizziness
when dealing with pts with heart failure, begin at an intensity of..
40-60% of functional capacity, and warm up/cool down for slightly longer than the typical 5-10 minutes
why shoudl you be cautious of supine or prone positioning with pts w Heart failure/
orthopnea risk
if a pt is diagnosed with class II HF, what is their physical activity limitation?
up to 4.5 METs (walking)
why is HR not an appropriate measure of exercise intensity in pts after cardiac transplant?
heart is denervated and pts tend to be tachycardic
when treating pts with PAD with intermittent claudication , walking program should proceed HOW?
intensity should be so that pt reports 1 on claudication scale within first 3-5 minutes & doesn’t surpass a 2
-30-60 min aerobic exercise 3-5 days/week
what is the most effective manner of increasing LE bloodflow in PAD?
resistive calf exercises
after an acute DVT, when can ambulation take place ?
after a dose of low molecular weight heparin
if a pt has chronic venous insufficiency, how should they position the limb with edema?
elevate a minimum of 18 inches above the heart
when applying an unna boot for edema compression therapy, how long should it be applied for ?
4-7 days
what ABI value is contraindicated to use compression therapy?
ABI <0.8 OR if there is evidence of active cellulitis or infection
what type of activities are contraindicated in patients with stage I lymphadema?
jogging, strenuous activities
-likely to exacerbate lymphadema
what modalities are contraindicated when dealing with phase I lymphadema?
ice, heat, hydrotherapy, saunas, contrast baths and paraffin
ALL cause vaodilation and incr lymphatic load of water
NO electrotherapeutic modalities greater than 30 Hz
when dealing with Phase II lymphadema, what is the maximum pressure for compression therapy?
45 mm Hg
how many compressions/minute should you do for CPR in an adult?
100 comp/min
what is the sequence of actions in CPR for adults?
CAB (compressions, airways & breathing)
how long should it take for a minor cut to clot?
10 minutes
what does a venous bleed present like?
low pressure, steady flow, dark red or maroon blood
if blood soaks thru the original layer of gauze, what do you do?
put on an additional layer of gauze DO NOT REMOVE GAUZE
when someone is experiencing internal bleeding, what does their body part look like?
swollen, tender and firm; ecchymosis (black and blue)
when you see someone in shock, how should you test for peripheral blood flow?
capillary refuill test - should return to refill in <2 seconds
if someone is in shock, you should elevate their legs over 12 inches UNLESS..
there is a suspected spinal injury or painful deformity of the LEs
