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Advanced Procedures > Mod 7: Cardiopulmonary > Flashcards

Mod 7: Cardiopulmonary Flashcards

1
Q

decreased PaO2 in blood

A

hypoxemia

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2
Q

increased PaCO2 in blood

A

hypercapnia

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3
Q

inc. PaCO2 causes s/s: disoriented, dizzy, cyanosis, stupor & dec. ventilation

A

respiratory acidosis

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4
Q

dec PaCO2 causes s/s: dizzy, lightheaded, tachycardia, hyperventilation

A

respiratory alkalosis

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5
Q

dec. HCO3 causes s/s: hyperventilation, HA, weak, cardiac arrythmia

A

metabolic acidosis

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6
Q

inc. HCO3 causes s/s: nausea, diarrhea, confusion, mm cramps, hypoventilation

A

metabolic alkalosis

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7
Q

when you fall asleep & wake up a couple hrs later SOB (ex: CHF, PE)

A

paroxysmal nocturnal dyspnea

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8
Q

type of breathing thats difficult prone/supine but relieved when sitting

A

orthopnea

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9
Q

type of breathing with prolonged inhalation d/t TBI

A

apneustic breathing

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10
Q

irregular depths of breathing d/t cerebellar dysfunction

A

ataxic

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11
Q

FEV1: what it stands for? tests what?

A

forced expiratory volume in 1 sec
tests pulmonary function
(FEV1/FVC)

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12
Q

FEV1/FVC for restrictive LD vs. obstructive LD

A

RLD: normal or >80%
OLD: <70%

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13
Q

decreased lung volumes w/ normal expiratory flow rates

A

RLDs

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14
Q

decreased expiratory flows & narrowed airways but increase lung volumes/capacities
hyperinflated lungs
dec. surface area & gas exchange at alveoli

A

OLDs

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15
Q

s/s: chronic cough, inc mucus, wheezing, dyspnea w/ exertion, accessory mm hypertrophy

A

OLDs

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16
Q

s/s: dec. compliance of breathing structures, dec. volume moving in/out lungs, tachypnea, inefficient, inc. accessory mm use, dec. breath sounds, hypoxemia, dyspnea, mm wasting

A

RLDs

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17
Q

loss of lung compliance causes hypoxemia
inflammatory process that causes irreversible fibrotic scarring of lung walls
dec. TLC, VC etc, dyspnea w/ exertion, cough, sleep disturbances

A

idiopathic pulmonary fibrosis
/ interstitial lung disease

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18
Q

ideal FITT Rx for respiratory pts

A

20-30 min/day, 5x/wk
if discontinuous, shorter sessions 1-2x/day

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19
Q

RPE range

A

6-20
easy- veryvery hard(90% MHR)

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20
Q

what is the increase in Syst BP per MET level?

A

8-12 mm Hg

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21
Q

secretion mobilization techniques:

A

postural drainage
percussion
vibration (upon exhalation)
PEP devices
hydration
gen. mobility
assisted & self-assisted cough techniques

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22
Q

respiratory mm training techniques:

A

paired body motions w/ inhalation/exhalation (thoracic ext/flex)
mm recruitment- diaphragmatic (or accessory mm if only option, COPD)
inspiratory mm training w/ incentive spirometer

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23
Q

what does an incentive spirometer do?
how to perform?

A

strengthen diaphragm & intercostals for inspiration
full exhale, slow/full inhale & hold 3 sec, exhale; 5-10x/hr

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24
Q

4 stages of effective cough

A

inspiration > TV
glottis closure
abs & intercostals contract to inc. thoracic pressure
sudden glottis opening & forceful expulsion of inspired air

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25
Q

how to perform self-assisted cough

A

pt supports abdomen or anchors UEs to inc. intraabdominal pressure

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26
Q

techniques for cough assistance

A

max inspiratory phase w/ vc, positioning & arm movement
-facilitate w/ tapping, manual cues, arm flexion & head ext
mm contraction & trunk movement to max out intraabd/intrathoracic pressure
“bear down” or dig deep

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27
Q

drugs for bronchospasm & asthma
-prevent inflammatory mediated bronchoconstriction & reverse capillary permeability

A

anti-inflammatory agents

28
Q

drug for allergies, rhinitis, sneezing, motion sickness
has SE of arrhythmia, postural hypotension, dizzy, drowsy. etc

A

antihistamine agents

29
Q

drug for bronchospasm, wheezing, SOB (asthma), COPD
- stimulates receptors causing bronchodilation & blocks receptors causing brochoconstriction

A

Bronchodilator agents

30
Q

drug for cough, congestions, thick mucus
- increases respiratory secretions, loosens mucus to improve efficacy of cough
-perform airway clearance 1 hr after intake**

A

expectorant agents

31
Q

drug for pneumonia, emphysema, chronic bronchitis, Cystic fibrosis
-decreases viscosity of mucus by altering its composition/consistency
-delivered via nebulizer

A

mucolytic agents

32
Q

technique to dec. RR, PaCO2, & dyspnea, maintain pos. pressure in bronchioles, improve TV, SAO2 & activity tolerance
-perform slowly

A

pursed lip breathing

33
Q

technique to dec. RR & use of inspiratory mm groups, improve TV, dyspnea & activity tolerance

A

diaphragmatic breathing

34
Q

how to perform diaphragmatic breathing

A

place hand on upper chest & below rib cage
-use semi-fowler’s position
“sniff” to facilitate

35
Q

technique used to dec. work of breathing & prevent dyspnea & breath holding
for pts w/ dyspnea at rest or minimal activity

A

paced breathing & exhale w/ effort

36
Q

how to perform paced breathing

A

with an activity at comfortable temp
-use comfortable ratio to synch w/ exertion
-inhale during before/easy part & exhale w/ exertion/hard part

37
Q

4 positions for dyspnea relief

A

Reverse Trendelenburg
forward lean on arm support (seated/standing)
Semi-fowler’s w/ sidelying
standing lean w/ back against wall

38
Q

how to perform active cycle of breathing

A

1-breathing control for 5-10 sec
2-thoracic expansion exercise in postural drainage position (deep inhale w/ relaxed exhale 3-4x)
3-repeat cycle
4-breathing control for 5-10 sec
6-forced expiratory technique (1-2 huffs)
7-breathing control for 5-10 sec

39
Q

Autogenic Drainage is: ____
w/ 3 phases:
Tx time:

A

controlled breathing at 3 lung volumes
unsticking phase (slow breath w/ hold)
, collecting phase (TV breath w/ hold)
, evacuating phase (deep breath w/ hold & 2 huffs)
25-30 min

40
Q

technique to improve ventilation for pts w/ dec. lung volume & dec. chest wall lung compliance
-a thoracic expansion exercise

A

segmental breathing

41
Q

how to perform segmental breathing

A

therapist puts pressure at end of exhalation to pt chest wall area needing expansion
- pt deep inhale and expands ribs under therapist hands
therapist provide resistance or dec. hand pressure during

42
Q

chronotropic vs inotropic effect

A

chrono: inc/dec HR
ino: inc/dec force of contraction

43
Q

neural reflex that maintains BP

A

baroreceptor reflex

44
Q

neural reflex that inc. HR d/t increased venous return

A

Bainbridge reflex

45
Q

neural reflex that responds to changes in pH

A

chemoreceptor reflex

46
Q

what is the scale of pulse amplitude?

A

0- absent
1-small
2- normal
3- large/bounding (ex pregnant)

47
Q

drug for HTN & benign prostate hypertrophy
- reduces peripheral vascular tone by blocking alpha 1 adrenergic receptors (cause vasodilation)

A

alpha andrenergic antagonist agents

48
Q

drug for HTN & CHF
-decreases BP & afterload by suppressing enzyme that converts angiotensin 1 to II

A

ACE inhibitors

49
Q

drug for CABG, post PTCA, DVT prevention, embolism
-inhibits platelet aggregation & thrombus formation

A

Anticoagulant agents

50
Q

drug for hyperlipidemia, atherosclerosis, & coronary disease prevention
-inhibits enzyme action in cholesterol synthesis, increases HDLs & breaks down LDLs

A

Antihyperlipidemia Agents

51
Q

drug for post MI, A-fib and thrombus prevention
-inhibits platelet aggregation & clot formation

A

Antithrombotic/Antiplatelet Agents

52
Q

drug for HTN, angina, arrhthmias, CHF, migraines, essential tremor
-decreases myocardial O2 demand by decreasing HR & contractility by blocking beta-adrenergic receptors

A

Beta Blocker Agents

53
Q

drug for HTN, angina pectoris, arrythmia, CHF
-decreases entry of Ca into vascular smooth mm cells causing dec. myocardial contraction, vasodilation & O2 demands on heart

A

Calcium channel blocker Agents

54
Q

drug for HTN, Edema from CHF, pulmonary edema & glaucoma
-increases excretion of Na & water to decrease BP

A

Diuretic Agents

55
Q

special considerations for tx w/ pts on diuretics

A

-prevent fluid overload
-OH
-mm may be weak/cramping
-monitor edema/weight

56
Q

drug for angina pectoris
-decreases ischemia through smooth mm relaxation & dilation of peripheral vessels

A

Nitrate Agents

57
Q

drug for heart failure & A-fib
-increases force & velocity of myocardial contraction, dec. HR, AV node conduction & SNS activity

A

Positive Inotropic Agents

58
Q

drug for acute MI, PE, ischemic stroke, arterial/venous thrombosis
-facilitates clot dissolution

A

Thrombolytic Agents

59
Q

norms for O2 saturation, HR, BP, & RR

A

> 90%
60-100
120/80
12-18 bpm

60
Q

what is P, QRS complex, T wave & ST segment?

A

P: atrial depolarization (atria contract)
QRS: ventricular depolar (ventricle contract) [& atrial repolarization]
T wave: ventricular repolarization (ventricle relax)
ST: time between ventricular depolar/repolar

61
Q

what do wide/prolonged Q waves mean?

A

MI or other pathologies

62
Q

ST elevation on EKG indicates?

A

STEMI
Myocardial Infarction - emergency

63
Q

ST depression on EKG indicates?

A

ischemia from NSTEMI or angina
*yellow flag- check lab values

64
Q

T wave inversion indicates?

A

angina/ischemia, healing STEMI or NSTEMI
*yellow flag- check lab values

65
Q

what are PVCs?
3+ PVCs indicate what?
& then can progress to what?

A

premature ventricular contractions
ventricular tachycardia
ventricular fibrillation- no CO

66
Q

at what levels of BP (S/D) should you terminate exercise?

A

systolic: 210 mm Hg
diastolic: 110 Hg

Advanced Procedures (7 decks)

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