Heart Disease (Big Red Ch. 13) Flashcards
1
Q
Normal heart sounds
A
- S1: mitral and tricuspid valves closing
- S2: aortic and pulmonary valves closing
2
Q
Systole
A
- Between S1 and S2 sounds
- Contraction phase
3
Q
Diastole
A
- Between S2 and S1 heart sounds
- Filling phase
4
Q
Abnormal heart sounds
A
- S3: early diastole; CHF
- S4: late diastole; MI or hypertension
5
Q
P wave
A
Sinus node and atrial depolarization
6
Q
PR segment
A
Conduction through the AV node
7
Q
QRS complex
A
Electrical flow through the ventricles causing ventricular depolarization
8
Q
ST segment
A
Initiation of ventricular repolarization
9
Q
T wave
A
Completion of ventricular repolarization
10
Q
Reasons to terminate exercise
A
- Moderately severe or increasing angina
- Marked dyspnea
- Dizziness, lightheadedness, or ataxia
- Cyanosis or pallor
- Excessive fatigue
- Leg cramps or claudication
- Failure of systolic BP to rise as exercise continues
- Progressive fall in systolic BP >10mmHg with increasing exercise
- BP >200/>110 mmHg
- Significant change in cardiac rhythm
11
Q
Signs and symptoms of ACS
A
- Angina
- Injury
- Infarction
12
Q
Myocardial injury
A
- Presence of a new MI
- Tissue is being acutely injured
13
Q
Myocardial infarction
A
- Old heart attack with irreversibly dead tissue
- Happens in 20min - 2hrs
14
Q
Beta blockers (for ACS)
A
- Decrease HR and contractility
- Reduce energy demands
15
Q
Calcium channel blockers (for ACS)
A
- Reduce BP
- Decrease work of the heart
- Prevent coronary smooth muscle spasm
- Increase myocardial blood supply
16
Q
Nitrates (for ACS)
A
- Decrease preload and afterload
- Decrease myocardial work
- Dilate coronary arteries
17
Q
Signs and symptoms of CHF
A
- Fatigue
- Dyspnea
- Weight gain
- Peripheral edema
- S3 heart sound
- Paroxysmal nocturnal dyspnea
- Orthopnea
- Bendopnea
18
Q
Indications for pacemaker
A
- HR is too slow
- HR fails to increase with exercise
- Blocked electrical pathway resulting in AV delays and bundle branch blocks
- Avg life span between 5-10 years
19
Q
Sympathetic NS effects on cardiovascular system
A
- Norepinephrine stimulates beta-adrenergic receptors to increase overall heart activity by increasing HR.
- Adrenal cortex secretes epinephrine as part of the normal exercise response which increases HR and contractility.
20
Q
Parasympathetic NS effects on cardiovascular system
A
- Vagus nerve impacts RHR
- Decreases HR back to normal
21
Q
Abnormal heart beat orientation (?)
A
22
Q
CHF Tx interventions
A
23
Q
Types of exercise that increase BP d/t Valsalva
A
- isos
- resistance ex
24
Q
How to safely increase amb walking distance
A
Short duration, frequent intervals
25
- Normal BP
- Elevated BP
- HTN Stage 1
- HTN Stage 2
- Normal: <120/<80
- Elevated: 120-129/<80
- HTN Stage 1: 130-139/80-89
- HTN Stage 2: >140/>90
26
Risk factors for CAD
- Age (male over 45 yo)
- Smoking
- Sedentary lifestyle
- HTN
- Obesity
- Dyslipidemia
- Prediabetes
- Total serum cholesterol >200 mg/dL
27
Sternal guidelines/precautions
Avoid:
- Lifting, pushing, pulling >10lb
- Shoulder flexion >90 with UE weighted
- Scap retraction past neutral
- Trunk flex/rot with supine to sit transfers
- UE use with sit to stand
- Limit driving
Encourage:
- AROM in pain-free range
- Sternal counter pressure (splinting) with cough
28
Ectopic heart beat
Originates somewhere other than the SA node
29
What is Digoxin used for? How does it work?
- A fib, cardiac arrhythmias
- Enhaces parasympathetic activity/depresses sympathetic activity
- Slows HR, depresses electrical conductivity
30
How do beta blockers affect vitals during exercise? How can you tell if pts are working at an optimal level?
- Keep HR from increasing with exercise
- Use RPE scale
31
Position contraindicated for CHF and why
- supine, head below chest, especially with legs elevated
- overloads heart
32
What does an Exercise Tolerance Test (ETT) measure? Positive result indicates...?
- ETT measures heart function during exercise, and whether the heart muscle is getting enough oxygen.
- Positive result indicates ischemia of cardiac muscle.
33
Digox (digoxin) is primarily used to treat...?
Atrial fibrillation, cardiac arrhythmias
34
position contraindicated for CHF
Supine with legs elevated
35
open pack position for shoulder
55° abd, 30° hor add
