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Cardiopulm > Other Cardiovascular conditions > Flashcards

Other Cardiovascular conditions Flashcards

1
Q

what lung sounds go with CHF? why?

A

rales/crackles fluid in alveoli

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2
Q

what heart sounds goes with CHF?

A

S3- hallmark! non-compliant LV

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3
Q

what is pulsus alternans?

A

alteration of strong/weak pulse in femoral and radial arteries= depressed myocardial fxn

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4
Q

What condition is marked by end-inspiratory dry rales?

A

IPF!

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5
Q

what will a chest X ray show if there is pneumonia?

A

> bacterial pneumonia= lobar consolidation in one or more lobes
viral pneumonia= fluffy shadows
necrotizing pneumonia= cavities

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6
Q

what will breath sounds sound like over pneumonia?

A

bronchial sound over lobar pneumonia, or absent/dull percussion

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7
Q

differentially diagnose between bacterial and viral pneumonia based on S&S

A

bacterial= high fever, productuve cough, pleuritic pain
viral= moderate fever, nonproductive cough, myalgias
*both come with dyspnea and tachypenea

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8
Q

pulmonary effusion, types:

A

accumulation of fluid in the pleural space
>transudate= low protein
>exudate= high protein

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9
Q

what pulmonary pathology is verified by presence of kerly B. lines?

A

pulmonary edema

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10
Q

what lung sounds go with chronic bronchitis

A

ronchi and wheezing

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11
Q

which types of pulmonary patients assume the tripod position for ease of breathing?

A

COPD

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12
Q

what diagnosis goes with a radiograph with netlike shadows and rales/crackles and rhonchi, blood streaked sputum, large amounts of purulent phlegm and sinusitis?

A

bronchiectasis

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13
Q

what causes bronchiectasis?

A

irreversible dilation of one or more bronchi with chronic inflammation and infection

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14
Q

what is literflow vs. FIO2?

A 
literflow= liters of gas per minute (speed at which gas is moving)
FIO2= fraction of inspired oxygen (part of a whole)
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15
Q

when do u need to use a bubbler/humidifier?

A

for flowrates greater than or equal to 4 liters per minute

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16
Q

if using upwards of 24 Lpm, what type of mask do u use?

A

a Venti-mask

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17
Q

what does a non rebreathing mask do?

A

100% O2 non-invasively

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18
Q

downside to non-rebreathers?

A

can’t humidify them- also can’t eat with it on, need NC for meals

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19
Q

FIO2 range for all purpose nebulizers?

A

21%-100%

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20
Q

IPAP and EPAP

A

> inspiratory positive airway pressure

>expiratory positive airway pressure

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21
Q

IPAP+EPAP=??

A

CPAP

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22
Q

what is used as a priming mechanism to enhance coughs?

A

huff breaths!

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23
Q

PS/ CPAP?

A

Pt. initiates breath with a preset inspiratory pressure to aid in WOB. – pressure support, continuous pressure – constant flow of positive pressure to help

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24
Q

A/C:

A

Tidal Volume and RR rate are preset. Can take added breath at preset Vt. – minimum minute ventilation – can be generated by patient whenever they want – pressure applied when he breathes. Also set up a predesired parameters but can be over ridden. Can become hyperventilation. (respiratory alkalosis)

25
Q

SIMV:

A

Partial ventilatory support with some mandatory breaths. – synchro intermittent mandatory ventilation – patient spontaneously breaths – positive pressure with breath – pt controlled RR, given to decrease breathing work – preset TV with each breath plus mandatory breaths in between

26
Q

APRV:

A

(Airway Pressure Release Ventilation). Release in pressure to allow expiratory phase. Helpful in ARDS when compliance is reduced.

27
Q

how is alveolar recruitment treated?

A

> incentive spirometry (visual aid devices/games),
positive epiratory pressure therapy (PEP)
Intermittent positive pressure breathing (IPPB)= most aggressive

28
Q

what is Lupus?

A

systemic lupus erythematosus (SLE): multi-system autoimmune disease, increased production of autoantibodies, immune complexes cause diffuse, widespread inflammation in the joints, skin,brain, kidney, heart. Ppl usually die from heart or pulmonary complications.

29
Q

what type of lung impairment is common after cardiac surgery?

A

left lower lobe atelectasis

30
Q

what is significant to know for PTs who are working with a patient who has had an anterior lateral thoracotomy?

A

pec major has been cut and serratus anterior seperated

31
Q

what mm are cut in a lateral thoracotomy?

A

serratus ant. and latissimus dorsi is moved around and messed with

32
Q

who is a candidate for a carotid endarterectomy?

A

> symptomatic pt with carotid stenosis of greater than or equal to 50-70%
or asymptomatic with stenosis of 60%

33
Q

what do pacemakers correct?

A

arrhythmias, 2nd or 3rd degree heart blocks, tachycardias and bradycardias

34
Q

which pacemakers are used with LBBB and severe heart failure

A

tripolar pacing system- leads in R atrium, R vent. and L vent.

35
Q

what is an implantable cardioverter defibrillator? (ICD/ shock box)

A

designed to correct-life threatening arrythmias- decects and corrects all tachycardias, bradycardias and V. fibs

36
Q

who benefits most from an ICD?

A

ppl with LVEF less than or equal to 30%

37
Q

absolute contraindications for organ transplant?

A 
>active malignancy within 2 years
>HIV
>untreatable psychiatric condition
> non operable CV condition
>DM with microvascular disease
>chest wall or spinal deformity
38
Q

relative contraindications for organ transplant

A

> irreversible renal dysfunction
severely limited functional status with poor rehab potential
morbid obesity

39
Q

how do they decide who gets an organ when one is available?

A 
heart= person who needs it most
lung= first come first serve basis
40
Q

PT after transplant?

A 
transfers
ambulation
ADLs
strength and ROM
pulm. hygiene and chest wall mechanics
41
Q

how soon after an organ transplant can u do a PT eval?

A

12-36 hours

42
Q

how high can u push a patient after an organ transplant?

A

MET level 1-3

43
Q

what is normal MAP?

A

70-110 mmHg

44
Q

what is too low for MAP to provide adequate purfusion pressure?

A

less than 60 mmHg

45
Q

intermittent mandatory ventilation (IMV)

A

preset breath rate

pt can take optional breaths

46
Q

syndchronized intermittent mandatory ventilation (SIMV)

A

mandatory breaths plus optional ones with assistance

* avoid stacking because only mandatory if not breathing on their own

47
Q

pressure support ventilation (PSV)

A

when patient inhales the ventilator supports it

48
Q

inspiratory hold

A

provides a hold during inhalation, for hyperventilation and restrictive lung disease

49
Q

positive end expiratory pressure

A

applied at end of expiration to prevent alveolar collapse

50
Q

when is positive end expiratory pressure

A

emphysema
ppl in shock
pulmonary edema

51
Q

expiratory retard

A

prolongs expiration phase

52
Q

who needs expiratory retard?

A

COPD

53
Q

constant positive airway pressure- CPAP

A

constant pressure throughout inspiration and expiration to keep airway open (sleep apnea)

54
Q

when should bronchodilators and aerosolized antibiotics be taken in conjunction with postural drainage and percussion?

A

bronchodilators= BEFORE

aerosolized antibiotics= AFTER

55
Q

4 stages of an effective cough

A

1) inspiration greater tidal volume
2) closure of the glottis
3) abdominal and intercostal mm contract
4) sudden opening of glottis and air forced out

56
Q

what population of pts has trouble with coughing?

A

obstructive lung diseases

57
Q 
technique for helping cough? 
Pump cough:
breath holding: 
pursed lip breathing:
diaphragmatic breathing:
A

3 huffs then 3 short coughs, repeat x3 until spontaneous coughing begins
holding inhale may help too.
pursed lip breathing helps ppl with obstructive disease by controling exhale

58
Q

small breath=?
medium breath?
large breath?

A

small breath= small cough
medium breath= med. cough
large breath= large cough

Cardiopulm (10 decks)

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