Final Flashcards
What means the ability to transmit electrical current for one cell to another
conductivity
the P wave of an ECG complex represents
Firing of the SA node and Atrial depolarization
What phase is the plateau stage of the action potential
phase 2
The imaginary line that can be drawn between the positive and negative electrodes in leads I, II, and III is called
axis
Parasympathetic nervous system
slows the heart rate and AV conduction
You do a 12 lead ECG on a chronic emphysema pt and note large, peaked P waves in leads I and II this would be termed as
Cor Pulmonale
Which of the following are unipolar leads I. aVL II. Lead II III. Lead III IV. aVR V. V6
I. aVL
IV. aVR
V. V6
QRS complex represents
Ventricular depolarization and Ventricular contraction (A and D)
What is the rapid upstroke in the action potential (phase)
Phase 0
The entire sequence of electrical changes during depolarization and repolarization is called
action potential
The PR interval represents
Total atrial electrical activity prior to the activation of the bundle of His
What conducts electrical impulses from the SA node directly to the left atrium
Bachmanns bundle
An increased duration or amplitude of the P wave indicates the presence of atrial abnormalities, such as hypertension, valvular disease, COPD, and CHF T/F
True
Which of the following monitor the elctrical activity of the heart in the frontal plane
aVL, aVF, lead II, lead I
The sympathetic neural fibers innervate the
Atrium of the heart and Ventricles of the heart
An elevated ST segment above the isoelectric line can be a sign of
myocardial injury
The small squares on standard ECG paper represent
0.04 seconds
Which of the following phases is called the resting state
Phase 4
T waves are sensitive indicators for the presence of a number of abnormalities such as I. Acid-Base imbalances II. Hyperventilation III. Hyperkalemia IV. Ischemia V. Various drugs
(all of the above)
An electrical difference across the fibers of the heart is called
resting membrane potential
the norm duration of the P wave is no longer than
0.8 to 0.11 seconds
When the parasympathetic system is stimulated the heart rate increases T/F
False
When can a strong stimulus cause an unwanted depolarization of the heart
Relative refractory period
If there is a complete heart block at the AV node, the ventricular escape rate at which the ventricles will pace themselves is
20-40 bpm
U waves are of opposite polarity of the T wave T/F
false
5 small boxes are found in each larger box on ECG paper. this is equal to A. 0.04 B. 0.20 C. 0.5 D. B &C
D. B&C
The AV node is located
just behind the tricuspid valve in the lower portion of the right interatrial septum
All electrical deflections above the isoelectric line are termed
positive deflections
The SA node is also called the
Pacemaker
The QT interval is measured from the beginning of the QRS complex to the end of the T wave T/F
True
The normal duration of the PR interval is no longer than
0.20
there is an electrical delay at the AV node which allows I. The atrium to finish contraction II. For the atrium to repolarize III. The ventricles to fill with blood IV. Maximize the preload
I, III, IV
Normal QRS complex is less than
0.12
The normal duration of the T wave is
0.20
A normal 12 lead ECG contains 6 limb leads and 6 chest leads
true
Regulation of the heart is controlled by
I. the autonomic nervous system
II. The sympathetic nervous system
III. The para-sympathetic nervous system
All of the above
What leads monitors the right ventricle
VI and V2
What leads monitors the left ventricle
V5 and V6
What leads monitor the AV septum
V3 and V4
When doing an ECG the paper speed of the recorder is standard at
25 mm/ second
When the ventricles depolarize, they contraction in a downward direction T/F
false
Electrical conductive pathway of heart
Superior Vena Cava, SA node, Left atria, Right Atria, AV node, Bundle of His, Bundle branches, Purkinje fibers, Interventricular septum
Norm body temp
98.6
Norm BP
120/80
Norm HR
60-80 bpm
Norm RR
12-20
The top number in a BP reading is the
Systolic pressure
If a pt has a blood pressure of 88/50, this is called
Hypotension
The term afebrile means
the patient does not have a fever
A now common fifth vital sign in the hospital is
pain
Appropriate use of touch is
a reassuring squeeze of the hand
Pt oriented x3
Name, place, time
Thick, viscous, colored, and often in globs with an offensive odor describes which type of sputum
mucopurulent
the term used to describe fainting is
syncope
A cough is considered chronic if it lasts more than
Eight weeks
Tachypnea
Both an increased depth and rate of breathing
Cyclic changes in breathing pattern: respirations stop for 5-30 seconds and gradually increase in volume and then gradually decreases in intensity until other pause occurs
Kussmauls breathing
An increased alveolar ventilation that causes the PaO2 to decrease
Hyperventilation
Short, rapid breathing episodes, interrupted with 1-30 second pauses
Biots breathing
Absense of spontaneous breathing
Apnea
Rapid breathing
Hyperpnea
Shortness of breathing except when sitting upright
Orthopnea
Presence of normal spontaneous breathing
Eupnea
Decreased alveolar ventilation that causes an increased PaCO2
Hypoventilation
A subjective realization by the pt that breathing is difficult
dyspnea
Term for low temp
hypothermic
Term for high heart rate
tachycardia
Term for high BP
Hypertension
high RR
Tachypnea
If a pt has a BP of 88/50 this is called
hypotension
Afebrile
the pt does not have a fever
Dependent edema
swelling of the feet
Increased Jugular venous pressure is indicative of
Right heart failure
Pt wakes up in the middle of the night sweating profusely is having
diaphoresis
THe liver is located in which abdominal quadrant
Right upper
Most common symptom in pt with pulmonary disease
shortness of breath
a PT with heart sounds S1 and S2 has
normal heart sounds
Chest pain thats sharp in nature and on inspiration only is most likely
pleuritic
Which term is used to describe the expectoration of sputum containing blood
Hemoptysis
an acute onset of a cough is usually from
a common cold
fainting term
syncope
Pt with fixed and dilated pupils and decerebrate posturing most likely has
minor brain damage
Social distance and interaction
4-12, formal- introduction
Personal distance and interaction
0.5-4 , interview
Intimate distance and interaction
0-18, taking vitals
A pt present with a fever, chills and night sweats. which of the following should be a possible diagnosis
heart failure
Term for Normal breath sounds
Vesicular
Term for loud, high pitched sounds that frequently may be heard without a stethoscope, usuually on inspiration
Stridor
High or low pitched continuous sounds hear mainly on expiration
Wheezes
Discontinuous sounds that can be fine or coarse
Crackles
Abnormal breath sounds
Adventitious
Loud sounds with equal sound during inspiration and expiration, similar to sounds heard over large upper airways
Bronchial
Discontinuous abnormal lung sounds are called
Crackles
Continous abnormal lung sounds are called
wheezes
late inspiratory crackles are indicative of
atelectasis
bronchospasm will most likely produce which type of lung sound
wheezes
Consolidation of the lung tissue will produce which type of lung sounds
Bronchial
The sound heard when collapsed airways pop open during inspiration are called
crackles
How to listen to breath sounds
Use the flat side, and compare side to side
Stidor is associated with which disease
croup
Low pitched wheezes are a sign of
mucus in the airway
A pleural friction rub is caused from
irritated pleural lining
4 components of the physical examination of the chest
inspection, palpation, percussion, ausculation
Increased A-P diameter is also known as
barrel chest
Cardiac murmur is an extra sound heard in conjuction with S1 and S2 murmurs occur when
blood regurgitates into the chamber from which it came
On palpation of the chest subcutaneous emphysema is indicative of
air leaks from the lungs
A pt with kyphoscoliosis would be detected on which exam
inspection
a pt with dullness to percussion over the right lower lobe probably has
consolidation
a pt comes into the ER with shortness of breath and blue cast to the mucousal membrane, what condition pt have
central cyanosis
COPD showing signs of resp distress, which would be expected to observe
Nasal flaring, pedal edema, accessory muscle use, pursed lip breathing
Pt with digital clubbing has a chronic hypoxia, which of the following diseases would not lead to this? A, Cystic fibrosis B. COPD C. CHF D. acute asthma
D. acute asthma
Normal SpO2 for an adult on RA
93-97%
Sputum containing blood
hematemesis
Low pitch wheezes and coarse crackles are also known as
rhonchi
Whose law defines the relationship between the concentration of a substance and the amount of light absorbed
Beer-lamberts law
Transcutaneous blood gas monitoring occurs where on the pt
the skin surface
What % accuracy does pulse oximetry have is the O2 saturation is above 80%
+/- 4%
What other two things can attach to the hemoglobin that would affect the O2 saturation
methehemoglobin, carboxyhemoglobin
How does impedance pneumography work
detects distance change between 2 electrodes on the chest
what two light wave lengths does oximetry use to detect O2 saturation
red and infrared
Other than carboxyhemoglobin and methemoglobin what two other things can induce considerable error in pulse oximetry accuracy
Motion, poor perfusion
Main advantage of Mass Spectrometers
They are able to analyze all resp gases, breath by breath
5 different oximetry probes
Finger, toe, forehead, ear, foot
What does sidestream capnography use to obtain the exhaled CO2 sample
small bore tubing is used to aspirate gas from or adjacent to the airway
List 3 things that might cause an increase in the PetCO2
Fever, Hypoventilation, Increased metabolic rate
End-tidal PCO2 often is an imprecise reflection of PaCO2 T/F
true
Red light wave length (660nm) is absorbed by the
oxyhemoglobin
Impedance pneumography detects resp effort, but does it ALWAYS mean there is lung ventilation?
NO
SaO2 of 90% is equivalent to
PaO2 of 60mmHG
What patient population is transcutaneous monitoring used mostly on
infants
4 advantages of mainstream capnography
No lag time, Close to pts airway, Accurate reading of CO2, heated to decrease build up of secretions
Impedance pneumography is detecting resp effort, but the airflow sensor at the mouth is not sensing any airflow, this might indicate
Obstructive apnea
Transcutaneous blood gas monitoring is able to monitor both O2 and CO2
True
Pt goes apneic what alarm would you expect to be triggered first
capnography
Most significant hazard if transcutaneous blood gas monitoring is the possibility of
thermal injury to the skin beneath the electrode site
Mainstream capnography may be adversely affected by what
mucus debris secretions
Capnography be beneficial when
CHF, Pulmonary emolism, COPD
Standard chest Xray
Posterior-anterior
ETT placement check on heavily sedated pt what type of xrap
portable anterior-posterior
ETT placed what should the primary focus be
ETT placement
ETT positioned
3-5cm above the carina
Pleural space on xrap
black
First sign of hypoxia
increase HR confusion
ARDS is characterized by which radiological finding
reticular pattern (ground glass)
Pt with elevated diaphragms and volume loss on their chest radiograph most likely has which condition
atelectasis
A pt with a consolidation in the right lower lobe may have which findings on a chest xray
air bronchograms
A pt with hyperinflation due to COPD will usually have which type of findings on a chest xray
- flat diaphragm
- small narrow heart
- increased anterior-posterior
- atelectasis
I, 2, and 3
A pt with a pleural effusion may have which finding on a chest film
blunting of the costophrenic angles
a small pneumothorax is more easily seen on which type of fild
expiratory film
Chest xray shows Kerley B lines and an enlarged heart, which condition is most probable
CHF
Pneumonia is associated with which of the following
Air bronchograms, Volume loss, Pneumonia
A pt has a shadow in their lower lobe, to best locate the possible tumor which test would be most helpful
CT scan of the chest
A pt has a suspected pulmonary embolism, which of the following tests would be most helpful
CT scan of the chest
A pt with black areas around the edge of the lung with no lung markings, a visible lung border on the left and a mediastinal shift to the right most likely has
a tension pneumothroax on the left
If a pt has obscuring of the diaphragm on a PA chest radiograph which test would be used to assess if there is free fluid in the pleural space
lateral decubitus
ECG rhythms that is fatal if not treated immediately
ventricular fibrillation
Which test uses magnets to detail body organs
MRI
Oxygen is what color
green
A pt comes in with an elevated WBC caused by high neutrophils what is the most likely cause
bacterial infection
COPD pt with chronically low PaO2 levels may develop which of the following conditions to help correct the chronic hypoxemia
polycethemia
Which values should you check before you draw an ABG
INR
Low WBC
Leukopnea
Allergy induced asthma with what type of WBC
Neutrophils
Cardiac pt has a potassium level of 2.5. what would this be called
Hypokalemia
Wheening which test could be an indicator that the pt may not have a good muscle strength
Electrolyte imbalance
Which of the following values is the lowest “safe” level for oxygenation of all the tissues in the body
SpO2 of 90%
A pt on Lasix (diuretic) should have which type of the following electrolyte replaced
KCL
A patient with hyperglycemia may have which type of the following conditions
diabetes
RBC count
4.7-6.1
Hemoglobin (male) values
12-16g/100ml
Hematocrit (male) values
42-52%
WBC values
4000-11,000
A reduced hemoglobin
I. Is called Anemia
II. Reduces the O2 carrying capacity of the blood
III. Can be caused by a electrolyte imbalance
IV. Usually accompanies a reduce hematocrit
I, II, and IV
A pt that has a heart attack will usually have an elevated troponin due to
tissue damage
The skin used to test for TB is
mantoux
How does impedance pneumography work
Detects distance change between 2 electrodes on the chest
Test is used to identify an abnormal clotting time and is used to identify pulmonary embolism or deep vein thrombosis
D-Dimer
A prolonged prothrombin time can be reversed with
Fresh frozen plasma and Vitamin K
The mantoux test uses what ingredient
PPD
