CVP Flashcards
Absolute indications for terminating GXT
- ST elevation >1mmHg
- drop in systolic >10mmHg accompanied by signs of ischemia
- neurological symptoms (ataxia, dizziness, near syncope)
- signs of impaired perfusion ie cyanosis pallor
- sustained VTach
- mod-severe angina, pt desire to stop, technical difficulties, acute infections such
Relative Indications for terminating GXT
- ST depression >2mmHg
- drop in systolic >10mmHg without signs of ischemia
- hypertensive response (systolic >250, diastolic >115, or both)
- arrhythmias other than VTach ie PVCs, supraventricular tachycardia, heart blocks
- fatigue, leg cramping, SOB,, wheezing, claudication
- Chronic infections such as hepatitis
Left-sided heart failure sxs
resp. sxs
1. dyspnea
2. paroxysmal nocturnal dyspnea
3. orthopnea
4. cyanosis
5. pulm. congestion
-cough, crackles, wheeze, tachypnea
Right-sided heart failure sxs
systemic sxs
1. dependent edema
2. distended jugular veins
3. swelling in hands and feet
4. ascites, enlarged liver and spleen
5. increased peripheral venous pressure
Obstructive pulmonary disease
difficulty getting air OUT
FEV1/FVC decreased (<70)
lung volumes increased (result of air trapping)
COPD, bronchitis, emphysema, bronchiectasis, asthma
Restrictive pulmonary disease
difficulty getting air IN
FEV1/FVC normal (>70) or elevated (>80)
lung volumes decreased (lungs less able to expand)
Pulmonary fibrosis, sarcoidosis, atelectasis
GOLD Classification for COPD
Stage 1: mild COPD (FEV1 >80% of normal)
Stage 2: mod COPD (FEV1 50-79% of normal)
Stage 3: severe COPD (FEV1 30-49% of normal)
Stage 4: very severe COPD (FEV1 <30% of normal)
Hypertension and Classification
primary: no cause
-risk factors: diet, obesity, sedentary lifestyle, genetics, atherosclerosis
secondary: 2/2 underlying medical condition (usually renal disease)
normal: <120 systolic and <80 diastolic
elevated: 120-129 systolic and <80 diastolic
stage 1 HTN: 130-139 systolic OR 80-89 diastolic
stage 2 HTN: >140 systolic OR >90 diastolic
crisis: >180 systolic and/or >120 diastolic
Valsalva Maneuver
forced expiration against a closed glottis
increases intrathoracic and venous pressure
decreases CO and BP
baroreceptors reflexively increase HR and myocardial contractility through sympathetic stimulation, then decrease in HR and BP observed due to parasympathetic stimulation,
Vertebral artery test
extension, lateral flexion, and rotation
(+) nystagmus, dizziness, slurred speech
*tests contralateral vertebral artery
Wells Criteria for DVT
<1 low risk
1-2 mod risk
>2 high risk
ABI Index
Rigid arteries >1.4
Normal 1.0-1.4
Mild 0.8-0.99
Mod 0.4-0.79
Severe <0.4
Lung Volumes
ERV: max volume of air that can be exhaled after normal exhalation
IRV: max volume of air that can be inhaled after a normal inhalation
Arterial Blood Gases (ABG)
pH: 7.35-7.45
HCO3-: 22-26 mEq/L
PaCO2: 35-45 mmHg
PaO2: 80-100 mmHg
SaO2: 95-98%
Metabolic acidosis: pH down, PaCO2 down, HCO3- down
Metabolic alkalosis: pH up, PaCO2 up, HCO3- up
Respiratory acidosis: pH down, PaCO2 up, HCO3- up
Respiratory alkalosis: pH up, PaCO2 down, HCO3- down
Complete Blood Count (CBC)
white blood cells: 4,000-11,000
hematocrit:
- 37-47% (females)
- 41-53% (males)
hemoglobin:
- 12-16 (females)
- 13-18 (males)
platelets: 150,000-300,000
