practice test 1/21 Flashcards
what pathology?
chest pain and ST segment changes on an electrocardiogram
myocardial ischemia
what pathology?
crackles (rales) and large volumes of secretions.
bronchiectasis
bronchial tubes of your lungs are permanently damaged, widened, and thickened.
- allow bacteria and mucus to build up and pool in your lungs; frequent infections and blockages of the airways.
what pathology?
assess dyspnea, accessory muscle use, cyanosis, and abnormal heart and lung sounds.
using ventilator
Ventilatory pump dysfunction
what pathology?
- S3 heart sound
- crackles (rales) are heard on inspiration and do not disappear with coughing.
- Crackles (rales) may be absent at rest and appear during exercise
what next?
cardiovascular pump failure, heart failure
-Exercise should be terminated, and dose must be adjusted prior to resuming exercise.
exercise-induced asthma leads to bronchospasm
worst environment?
better environment?
worse - cold, dry environment
better - warm, humid
what symptoms expected?
electrocardiograph (ECG)
ST-segment depression, which is upsloping
myocardial ischemia - angina.
what symptoms expected? supraventricular arrhythmias
Palpitations
heart sound in person >40yo
indicates ventricular failure?
S3
- normal in children and young adults,
- abnormal > 40 years.
- indicative of ventricular failure or lack of ventricular compliance.
heart sound indicates
- cardiomyopathies and - coarctation of the aorta ( birth defect in which a part of the aorta is narrower than usual.)
S4
which intervention?
-commonly performed by postoperative patients to reduce the incidence of respiratory complications.
Incentive spirometry
which intervention?
- pt has COPD
- high RR
- overuse accessory muscles - upper trap and SCM
- PaCO2 30mmHg
Pursed-lip breathing slows the respiratory rate.
hyperventilating
which intervention
- cystic fibrosis not expanding lungs in all areas
segmental breathing is used to augment localized lung expansion.
which intervention
- high-level tetraplegia
- want to improve respiratory capacity and increase vital capacity
Glossopharyngeal breathing, frog breathing
- take gulps of air into your lungs using your lips, tongue and throat. This gulping action looks like a frog gulping
why do you need to have close supervision of pt in aquatic therapy w
- COPD?
- heart failure
COPD - hydrostatic pressure, additional respiratory challenge
Heart failure - increase in cardiac volume that occurs during immersion may overwhelm the pumping ability of the heart
contraindications to lumbar traction?
spinal infection,
rheumatoid arthritis,
osteoporosis,
spinal cord pressure secondary to discal herniation
pregnancy -
Positioning and exercise in supine position are contraindicated after what trimester?
why?
first trimester
Supine hypotension syndrome- per the American College of Obstetricians and Gynecologists (ACOG) guidelines, due to the possibility of compression of the inferior vena cava from the growing uterus that has now moved to a more vertical position. The inferior vena cava can become even more compressed with active contraction of the abdominal muscles. This compression can result in decreased return venous flow to the heart and a sudden reduction in blood pressure
symptoms of atrial fibrillation?
generally exhibit
shortness of breath,
palpitations,
fatigue
symptoms of ventricular arrhythmias
anxiety to light-headedness
syncope to a weak pulse
symptoms of cardiac tamponade ?
- Pulsus paradoxus, distended jugular veins due to increased volume to the right side of the heart,
- hypotension due to decreased left ventricular ejection volume
what test? assessment of acid-base balance, ventilation, oxygenation. -monitor the condition of patients in critical care to modify respiratory interventions
Blood gas analysis
what test?
- diagnose and monitor the progression of chronic obstructive lung disease
- volume of air the lung contains and information on the different lung capacities
Pulmonary function testing, i.e., spirometry
-Two forced spirometry measures that can be followed over time include forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC); the ratio of these values decreases as the severity of lung obstruction increases
what test?
- most important noninvasive procedure used in the diagnosis and management of patients who have coronary artery disease.
maximal exercise test may be used to measure functional capacity and to diagnose coronary artery disease
what pathology?
- joint pain and swelling triggered by an infection in another part of your body — most often your intestines, genitals or urinary tract.
- usually targets your knees and the joints of your ankles and feet.
- Inflammation also can affect your eyes, skin and urethra.
Reactive arthritis
normal respiratory rate for a child who is 1 year old
25 - 35 breaths/minute.
normal respiratory rate for an adult
12-20breaths/min
normal respiratory rate for a
child who is 10 years old
15-20 breaths/min
what breathing technique?
mechanism used to move mucus into large airways in order to produce an effective cough
Huffing
arterial or venous?
- Pallor, or lack of color
- Shiny skin
- Absence of hair growth
arterial
what term?
- refers to the volume of air that participates in gas exchange
- confirmed by an arterial blood gas test, can be invasive
Alveolar ventilation
what term?
- largest volume of air that can be inspired in one breath from the resting expiratory level
- how to measure?
Inspiratory capacity
- incentive spirometer
what term?
-total volume of air inspired or expired in 1 minute without discrimination between lung expansion or increase in respiratory rate.
Minute ventilation
what med?
decrease vascular volume and cause reflex tachycardia
Loop diuretics
what med?
-negative chronotropic and dromotropic effects on the heart, clinically resulting in decreased heart rates at rest and during exertion.
Beta receptor antagonists
beta blocker
beta-adrenergic blocking agents
(antiarrhythmic)
what med?
cause vasodilation and a reflex tachycardia
- major uses are for hypertension, symptomatic benign prostatic hypertrophy
Alpha-1 receptor antagonists
alpha-blockers
(BP med)
what med?
relaxation of blood vessels as well as a decrease in blood volume,
- lowers blood pressure and decrease oxygen demand from the heart.
Angiotensin-converting enzyme inhibitors
BP med
UE vs LE exercise?
- higher Heart rate
- Systolic blood pressure
- rate pressure produce
UE
UE vs LE exercise?
Stroke volume higher
LE
percussion is contraindicated in what patients?
- bones: over fractures, spinal fusion, or osteoporotic bone.
- tumor area.
- don’t spread: has a pulmonary embolus.
- condition in which hemorrhage could easily occur.
- unstable angina.
- chest wall pain.
- recent neurosurgery, head down position is contraindicated.
- If patients has a hyper-reactive airways and severe bronchospasm
why use percussion?
what pathologies?
- help in the removal of secretions Cystic fibrosis Emphysema Chronic bronchitis Pneumonia Adult Respiratory distress syndrome (ARDS) Bronchiectasis Chronic obstructive pulmonary disease (COPD)
Risk factors
- recent hip or knee arthroplasty,
- history of heart failure,
- age greater than 60 years,
- immobility
- Examination findings that increase the suspicion of a DVT, according to the Wells Clinical Decision Rule, are unilateral swelling, localized tenderness, and a history of
deep vein thrombosis (DVT) of the posterior lower leg.
what are snoring sounds called?
caused by?
rhonchi
upper airway caused by partial obstruction by secretions.
what are high-pitched crowing sound called?
caused by?
stridor
indicative of an upper airway obstruction, which would be common with a tracheal or glottis problem.
what are Rattling/bubbling sounds sound called?
caused by?
crackles (rales)
caused by secretions in the lung common in patients who have heart failure.
what are Continuous whistling sound called?
caused by?
wheezing
Asthma is a restrictive airway disease with a hallmark wheezing sound on auscultation
Contralateral tracheal deviation cause?
occupies space:
- pleural effusion
- space occupying lesion
Ipsilateral tracheal deviation cause?
collapse:
- pleural fibrosis
- lobar atelectasis
- pneumonectomy
postural drainage position?
anterior segments of the upper lobes
Supine with the head elevated to 30°
postural drainage position?
patient is positioned in right sidelying with the trunk rotated to the left 45° and the head lower than the hips
lingular segment of the left upper lobe
postural drainage position?
Sitting and leaning on pillows at a 60° angle with the head flexed forward
apical segment of the upper lobes
normal International normalized ratio? value
goal is 2-3.5
patient on coumadin or warfarin.
INR 5 high or low?
need to increase or decrease coumadin/warfarin?
high, goal is 2-3.5
decrease - blood clots are slow, patient is at risk for bleeding
INR 1 high or low?
need to increase or decrease coumadin/warfarin?
low, goal is 2-3.5
increase, blood clots too quickly
