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Clinical Management of the Cardiopulmonary Patient > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Normal pH

A

Acidic 7.35 - 7.45 Alkalotic

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2
Q

Normal PaCO2

A

Alkalotic 35 - 45 Acidic mmHg

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3
Q

Normal PaO2

A

80 - 100 mmHg

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4
Q

Normal HCO3

A

Acidic 22 - 26 Alkalotic mmHg

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5
Q

Hypoxemic

A

PaO2 less than 60 mmHg (SpO2 <90%)

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6
Q

Hypercapnic

A

PaCO2 greater than 50 mmHg

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7
Q

Duke Activity Status Index (DASI)

A

Estimates VO2 max up to 34 ml/kg/min or 9.8 METS
1-4 Light home activities.
5-9 Cilmb a flight of stairs, run a short distance.
>10 Strenuous Activity.

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8
Q

Respiratory Reserve Ratio

A 
pO2/FiO2
476 = normal person
>300 = sufficient respiratory reserve for mobility
<300 = ask senior PT, much caution.
<200 = Poor
<100 = Very Poor
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9
Q

Abdominal Paradoxical Breathing

A

Chest out, abdominal in

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10
Q

Minimal Aerobic Capacity to Remain Functionally Independent

A

Males 18 ml/kg/min or 5.14 METs

Females: 15 ml/kg/min or 4.3 METs

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11
Q

Normal FEV1, FVC and FEV1/FVC

A

greater than or equal to 80%.

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12
Q

Point Change on the SPPB to be minimally clinically difference.

A

1-2 point change.

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13
Q

Risk of hospitalization and/or Death SPPB 0-4 score

A

Five fold increase risk

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14
Q

Risk of hospitalization and/or Death SPPB 5-7 score

A

2.6 fold increased risk

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15
Q

A one point increase in SPPB?

A

Gives a 14% reduction in risk.

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16
Q

Global Initiative for COPD Stage 1

A 
FEV1/FVC = <0.70
FEV = greater than or equal to 80% of predicted
Smokers Cough
Little or no SOB
No clinical Signs of COPD
FEV1 greater than 80%

Add reduction of risk factors, add short acting bronchodialtor

17
Q

Global Initiative for COPD Stage 2

A

FEV1 < 80% of Predicted
Shortness of Breath
Some clinical signs of COPD
Sputum producing cough

Add regular treatment with one or more long-acting bronchodialators and add pulmonary rehab

18
Q

Global Initiative for COPD Stage 3

A

SOB on mild exertion
FEV1 < 50% of predicted.

Add inhaled glucocorticosteroids if repeated exacerbations.

19
Q

Global Initiative for COPD Stage 4

A

SOB on mild exertion
Right heart failure
cyaosis
FEV1 < 30% of predicted.

These people will need long term O2 if in chronic respiratory failure. Consider Surgical Treatments

20
Q

BODE Index Definition

A

A multidimensional index developed to assess an individuals risk of death from COPD.

  1. Weight
  2. Airway Obstruction (FEV1)
  3. Dysnpea (Medical Research Council Dyspnea Score)
  4. Exercise Capacity (6 min walk test)
21
Q

BODE Index Scores

A 
0-2 = 80% survival
3-4 = 67% Survival
5-6 = 57% survival
7-10 = 18% survival
22
Q

O2 reccommended for Patients with PaO2 or SpO2 of?

A

PaO2 < 60 mmHg

SpO2< 90%

23
Q

PaO2 is titrated between what?

A

PaO2 60-65 mmHg

SpO2 90-93%

24
Q

Sufficient Cardiovascular Reserve

A

Resting HR < 50% of their age predicted max heart rate
Blood pressure <20% variability recently (meaning an increase or decrease in BP of 20% or more representing hemodynamic instability.
ECG normal
Other major cardiac conditions excluded.

25
Q

Sufficient Respiratory Reserve

A

PaO2/FiO2 Ratio > 300
SpO2 > 90% and <4% recent decrease in SpO2
Respiratory Pattern Satisfactory
Mechanical ventilation to be maintained during Tx

26
Q

MRC Sum Score

A 
Assesses for critical illness weakness.
Similar to MMT but no +/-
UE: Wrist extension, elbow flexion, shoulder abduction
LE: DF, Knee extension, Hip flexion.
Total Range 0-60
27
Q

MRC Score diagnosis for critical illness weakness?

A

<48/60

28
Q

Hemodynamic Stability with Body Positioning and Changes

A

Heart Rate20-30 from resting my be appropriate.
BP no greater than a 10-20 mmHg drop (go with 10)
Diastolic should remain the same or increase 10.

29
Q

Neoadjuvant and Adjuvant Chemo Effect on Cardiopulmonary System

A 
Cardiotoxicity (Cardiomyopathy)
Pulmonary Toxicity
Fatigue
Weakness
Risk of Infection
Decreased Aerobic Activity
30
Q

Lung Metastasis and Ressection of Lung Tissue

A 
Lung Damage
Decreased ventilation/perfusion
Decreased FRC
Increased WOB
SOB
Inflammation
Cough
Fatigue
31
Q

Premorbid History of Asthma

A 
Inflammation Brochoconstriction
Increased Mucous
Difficulty Breathing
Increased WOB
SOB
Coughing
Wheezing.
32
Q

Pediatric Objective Examination

A

Communication: Affect/cognition/language and learning style.
Consistent with age/ development
Family Centered
Culturally Sensitive

Clinical Management of the Cardiopulmonary Patient (3 decks)

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