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DPT732: MAP II > MAP Practical > Flashcards

MAP Practical Flashcards

1
Q

When performing a history intake with a patient diagnosed with a cardiac dysfunction, what are some questions you could ask?

A

What makes the pain level better or worse?

Do you smoke? If so, are you trying to quit?

Do you have any family history of cardiac dysfunctions?

Are you currently taking any medications?

Do you have leg swelling or redness?

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2
Q

When performing a history intake with a patient diagnosed with a pulmonary dysfunction, what are some questions you could ask?

A

Are you waking up short of breath?

Do you smoke? If so, are you trying to quit?

Are you taking any medications?

Are you on O2?

Are you coughing?

Is it hard to breath in or out?

Are you coughing anything up? Bloody?

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3
Q

When performing a history intake on a patient diagnosed with PAD or DVT, what are some questions you could ask?

A

Do you have leg swelling or redness?

Are you getting any pain in your legs?

Are you on any medications?

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4
Q

What is an “olol” and what are some side effects of it?

A

Beta Blocker - decreases sympathetic influence on heart and decreases HR.

Could cause fatigue, cold hands, dizziness, delayed or decrease heart response.

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5
Q

What is a “pril” and what are some side effects of it?

A

ACE Inhibitor - for treatment of hypertension, heart failure, post MI

Could cause edema, cough, orthostasis/hypotension.

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6
Q

What is a “pine” and what are some side effects of it?

A

Ca2+ Channel Blockers - decrease contractility, HR, afterload, and BP

Could cause hypotension, edema, dizzyness

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7
Q

What is a diuretic and what are some side effects of it?

A

For hypertension treatment, decrease fluid volume.

Could cause hypotension.

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8
Q

What is digoxin?

A

Cardiac glycosides - increases contractility.

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9
Q

What is a “statin” used for

A

decrease cholesterol

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10
Q

What vital signs confirm orthostatic hypotension?

A

drop of > 20 mmHg systolic with any change in position in first 1-3 minutes.

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11
Q

Why does orthostatic hypotension occur?

A

patient is not calibrating back to homeostasis fast enough. Problem is that if you go to do things the patient will collapse as they do not have the stability within their arterial system to sustain.

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12
Q

What medications can cause orthostatic hypotension?

A

ACE Inhibitor “pril”
Ca2+ Channel Blocker “pine”
Diuretics

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13
Q

How do you PERFORM an ABI?

A

*Patient must be supine for 5-10 minutes before measurements, feel for pulse and apply ultrasound gel

  1. Measure systolic reading in both arms with arrow pointing down brachial artery
    - Find clear Doppler sound and then inflate cuff until sound disappears +20mmhg
    - Record first Doppler sound as cuff is deflated
    - Use highest of the two arm systolic pressures
  2. Measure systolic readings in both legs
    - Cuff applied to calf with arrow pointing down artery
    - Find clear Doppler sound and then inflate cuff until sound dissapears +20mmhg
    - Record first Doppler sound as cuff is deflated
    - Record dorsalis pedis pressure (btwn 1st and 2nd metatarsal)
    - Record posterior tibial pressure (behind medial malleolus)
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14
Q

How do you calculate an ABI?

A

Systolic Leg Reading / Highest Brachial Systolic Blood Pressure

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15
Q

What is normal range for an ABI value?

A

between .9 to 1.2

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16
Q

What is a positive ABI value and does this mean?

A

less than .9

indicates varying gradients of Peripheral Arterial Disease (PAD)

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17
Q

What is a false negative ABI value and what does it mean?

A

greater than 1.2

may indicate diabetes b/c
-vessels in diabetics are poorly compressible (hardening)
-tend to retain more fluid
=Results in falsely elevated ankle pressure

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18
Q

What are the two abnormal heart sounds we must be able to identify?

A
  1. S3

2. S4

19
Q

What does an S3 heart sound sound like?

A

“SLOSH-ing-in”

20
Q

What does an S4 heart sounds sound like?

A

“a-STIFF-wall”

21
Q

What does an S3 heart sound indicate?

A

indicative of heart failure in adults

22
Q

What does an S4 heart sound indicate?

A

stiffness of left ventricle possible due to HTN, scar tissue, or aortic stenosis

23
Q

What does a normal lung sound sound like?

A

just hear air woosh

24
Q

What are the two abnormal lung sounds?

A
  1. wheezes (rhonchi)

2. crackles (rails)

25
Q

When in breathing do you typically heart wheezes (rhonchi) and what are they indicative of?

A

exhalation - occurs with asthma and emphysema

26
Q

When in breathing do you typically hear crackles (rails) and what are they indicative of?

A

inhalation - occurs from fluid buildup in the lungs cause alveoli to pop open upon inhalation. occurs with pneumonia or left sided heart failure.

27
Q

How many points are there in heart auscultation?

A

4

28
Q

Where is the first heart auscultation point and what structure are you hearing?

A

Right 2nd interspace - Aortic Valve Area

29
Q

Where is the second heart auscultation point and what structure are you hearing?

A

Left 2nd interspace - Pulmonic Valve area

30
Q

Where is the third heart auscultation point and what structure are you hearing?

A

Left lower sternal border - Tricuspid Valve area

31
Q

Where is the fourth heart ausculation point and what structure are you hearing?

A

Fifth interspace at around midclavicular line - Mitrial Valve

32
Q

How many points are you listening to on each side of the body during lung auscultation?

A

9 (18 total)

33
Q

Where do you start at and go down to for lung auscultation?

A

Start at the apex of lungs at C7 and go to bases around T10

34
Q

How do you perform a lung auscultation?

A

Snake side to side and down, having patient inhale and exhale at each point.

points 8 and 9 are out to sides around 11/12 rib

35
Q

What two important values do you get from spirometry and what do they mean?

A

FEV1 - Forced Expired Volume in 1 second

FVC - Forced Vital Capacity: max vol of air exhaled during forced maneuver

36
Q

What ratio do you calculate with spirometry?

A

FEV1/FVC

37
Q

What is normal FVC?

A

> 80% predicted

38
Q

What is normal FEV1?

A

> 80% predicted

39
Q

What is normal FEV1/FVC

A

70 - 80% predicted

40
Q

What is abnormal FVC1/FVC and what does it mean?

A

airflow limitation and maybe COPD

41
Q

How can spirometry be used as an examination tool for Asthma

A

FEV1/FVC ratio improved by 12% with use of bronchodilator

42
Q

What is spirometry primarily used for?

A

seeing how to get air out so obstructive pulmonary (COPD, emphysema)

43
Q

How can spirometry be used as as an outcome tool?

A

pre and post treatment

44
Q

How do you perform a spirometry test with a patient?

A
  • Patient sitting/standing with nose clip.
  • Patient instructed to take a deep breath in and put mouth over mouthpiece and blow out as hard and fast as possible for 6 seconds.
  • Repeated for trial 2

DPT732: MAP II (14 decks)

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