Exam 1 Stuff I Really Do Not Know Flashcards
what are the 5 findings of PAD?
- intermittent claudication
- if you elevate the legs, they become pale
- when you bring them down, blood pool in the capillaries…rubor
- impaired pulses
- cyanosis and cool to the touch
what vessel is damaged if the skin is shiny, no hair, thin, pale and brittle nails
arteries
what are normal ABI readings
normally over 1
under 0.9 is PAD
0.5-0.8 is claudication
less that 0.5 is ischemia.
what is tugor
when you pull the skin away, and it does not go back right away
with squatting, will you hear louder sounds in aortic stenosis or HOCM
squatting in aortic stenosis is louder.
what are the systolic and diastolic values for stage 2 hypertension
140 and 90
what is the difference between stable and unstable angina
stable lasts for only 2-5 minutes, maybe 5-10, and no more. Anything more, unstable.
how do you decide what a patient with a pacemakers max heart rate should be?
if they know their max pacemaker setting, then do it 10 beats below that. If they do not know, add 40 to the resting HR to get the max. then still subtract 10.
what is the difference between hypertensive emergency and urgency
urgency is over 180/110 and there is no signs of organ failure. emergency is 180/120 or higher and signs or organ failure.
what is considered an exaggerated HR (hypertensive response)
220 for men, and 190 for women.
or, over 10 higher diastolic or over 90.
how should systolic and diastolic BP change when you are exercising
systolic can increase by 10mmHg with 1 MET of activity, and diastolic can increase 0-10.
what is considered a hypotensive response to exercise
when SBP drops by 10mmHg.
how can you score pitting edema
(1+) you barely have an impression
(2+) slight indent, that lasts less than 15 seconds
(3+) lasts for 30 seconds
(4+) last for more than 30 seconds.
describe a venous ulcer
blueish or brown in color, irregular margins, varicose veins and pitting edema, and even medial issues.
describe an arterial ulcer
regular margins, thick gross nails, usually on the top of the foot, or malleoli, or toes. sharp and painful and pallor, with decreased hair.
describe a neuropathic ulcer
planter surface, but the MTP heads, and look like little punch outs. they cannot feel them either!
what is normal BNP values
0-100, can tell if you have had an MI
during what phase does and S3 and S4 gallop happen
S3 is systolic, and S4 is diastolic
if your BNP is over 300… you definitely have
HF
what happens to SV with HF
it decreases
it is counterintuitive to give vasodilators to patients with HF, but why do we do it
as resistance increases, the SV decrease a lot. So we want to open things up to decrease resistance and hopefully keep SV going.
what is the muscle theory with HF
when we have HF, there is a decreased flow to the muscles, and they atrophy. We need to try to increase the flow to the muscles, so we can have these patients exercise.
what do the respiratory muscles do in HF
they steal some of the blood flow away from muscles. the lungs need the extra blood for gas exchange to occur.
TF: in HF, HR is abnormal whereas BP is higher
false, BP is abnormal and HR is higher.
when exercising with HF, do you always use VO2 max or HR max
VO2 max because their HR are always elevated, and we may not get to the true max while we test.
what are signs of decompensation to look for when exercising someone with HF
pulse narrowing, arrhythmia, fluid changes, like 3 pounds in 24 hours, or 5 pounds in a week
what is the gold standard exercise intervention for HF
aerobic training.
why do we want to exercise LE with RT
functional sympatholysis. If we work out the LE, we get dilation of the LE and constriction of the UE. this will increase BP less than if we worked with the UE. with the UE, there will be a high sympathetic response, and a higher increase in BP.
what is the triple cocktail (+) you give HF patients
diuretics, ACEi, beta blockers
Spirolactone.
TF: patients with symptomatic aortic stenosis are good candidates for exercise
false, if they were asymptomatic, you could start exercise, but you need to start slow and steady
what are signs and symptoms of pericarditis.
sharp pain, fever, worse with breathing and coughing, and pain with laying flat, imported with sitting and learning forward and friction rub can be heard.
can you use BP to monitor patients with valve issues
no, you want to use RPE
a patient comes in with muffled heart sounds, dyspnea, dysphagia, friction rub, breathing pain and chest pain. also, JVD
pericardial effusion
what do alpha 1 receptors do
vasoconstrict
