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(3) Cardio-Pulmo-Renal Rehabilitation > S1 L1.1: Subjective Assessment > Flashcards

S1 L1.1: Subjective Assessment Flashcards

1
Q

T/F: PPTA still has no special interest group for cardiopulmonary PTs

A

False
Currently, there is currently a subgroup specialization for Cardiopulmonary PTs in PPTA.

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2
Q

Elements of Patient Management

The process of obtaining a history, performing a systems review, and selecting and administering tests and measures to gather data about the patient/client.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

A

a. Examination

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3
Q

Elements of Patient Management

Determination of the level of optimal improvement that may be attained through intervention and the amount of time required to reach that level.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

A

d. Prognosis (c Plan of Care)

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4
Q

Elements of Patient Management

Results of patient/client management, which include the impact of physical therapy interventions to the patient.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

A

f. Outcomes

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5
Q

Elements of Patient Management

Both the process and the end result of evaluating examination data, which the physical therapist organizaes into defined clusters, syndromes, or categories to help determine the prognosis and the most appropriate intervention strategies.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

A

c. Diagnosis

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6
Q

Elements of Patient Management

Purposeful and skilled interaction of the physical therapist with the pt/client using various physical therapy methods and techniques to produce changes in the condition that are consistent with the diagnosis and prognosis.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

A

e. Intervention

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7
Q

Elements of Patient Management

A dynamic process in which the physical therapist makes clinical judgements based on data gatehred during the examination.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

A

b. Evaluation

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8
Q

Elements of Patient Management

The _____ is a comprehensive screening and specific testing process that leads to a diagnostic classification.

A

Initial Examination

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9
Q

Elements of Patient Management

T/F: Examination includes subjective and objective assessment

A

True

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10
Q

Elements of Patient Management

The _ specifies the interventions to be used and their timing and frequency.

A

Plan of Care

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11
Q

Elements of Patient Management

a. Decision to reexamine
b. Process of reexamination

  1. May also identify the need for consultation with or referral to another provider
  2. Based on new clinical findings or on lack of patient progress
A
  1. B (Process of Reexamination)
  2. A (Decision to Reexamine)
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12
Q

4 Sources of History Taking

A
  1. Patient/Family/Caregiver Interview
  2. History & Data Forms
  3. Medical Chart Review
  4. Information from Other Health Care Providers
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13
Q

What do you do if the patient is not viable to answer the question during the interview?

a. Wait until the patient can answer
b. Interview the family/caregiver
c. Proceed with the other patient examinations

A

b. Interview the family/caregiver

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14
Q

Questions to probe when a pt has Hypertension in their medical history?

A
  1. Clinically diagnosed?
  2. Controlled/uncontrolled type?
  3. Given medications and respective intake
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15
Q

Questions to probe when a pt has Diabetes in their medical history?

A
  1. Clinically diagnosed?
  2. Type 1 or 2?
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16
Q

Questions to probe when a pt has Asthma in their medical history?

A
  1. Was it aquired since birth or when only triggered?
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17
Q

Chief Complaint

This is aso known as “Air Hunger” and is considered as one of the most common symptoms of cardiac and pulmonary diseases.

A

Dyspnea

(Shorttness of Breath)

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18
Q

Chief Complaint

Which of the ff are TRUE regarding Dyspnea:
a. Occurs when the body’s requirement for breathing is less than the body’s capacity to provide it
b. Gas exchange is compromised
c. Unconsious breathing.

A

Only B is correct.
The body’s requirement for breathing exceeds the body’s capacity to provide it thus having the pt be conscious of their breathing.

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19
Q

Chief Complaint

T/F: An affectation in the phrenic nerve can cause Dyspnea

A

True.
Phrenic Nerve innervates the diaphragm (C3-C5)

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20
Q

Chief Complaint

Possible locations that can cause abnormalities in the ventilatory system?

A
  1. Thoracic Cage
  2. Lungs
  3. Heart
  4. Kidneys
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21
Q

Chief Complaint

Dyspnea should be assessed based on _ of the appearance and progression

A

Time course

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22
Q

Chief Complaint

a. Acute Dyspnea
b. Dyspnea on Exertion (DOE)
c. Paroxysmal Nocturnal Dyspnea (PND)
d. Functional Dyspnea

Dyspnea during functional (extreme) exercises (aggravating factor and subsides during rest

A

Dyspnea on Exertion (DOE)

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23
Q

Chief Complaint

a. Acute Dyspnea
b. Dyspnea on Exertion (DOE)
c. Paroxysmal Nocturnal Dyspnea (PND)
d. Functional Dyspnea

Inability to breath/SOB when pt is sleeping. Onset of dyspnea 2-3 hours after the onset of sleep

A

Paroxysmal Nocturnal Dyspnea

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24
Q

Chief Complaint

What position relieves Paroxysmal Nocturnal Dyspnea?

A

Upright position (Which is why pt often wakes up in the middle of the night.

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25
Q

Chief Complaint

Paroxysmal Nocturnal Dyspnea (PND) is d/t _

A

Pulmonary Congestion

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26
Q

Chief Complaint

a. Acute Dyspnea
b. Dyspnea on Exertion (DOE)
c. Paroxysmal Nocturnal Dyspnea (PND)
d. Functional Dyspnea

Associated chest pain (which can be d/t spontaneous pneumothorax or embolism), chest trauma, decompensating left ventricle, possible heart failure.
SOB is even present during rest.

A

Acute Dyspnea

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27
Q

Chief Complaint

a. Acute Dyspnea
b. Dyspnea on Exertion (DOE)
c. Paroxysmal Nocturnal Dyspnea (PND)
d. Functional Dyspnea

Present at rest but absent during exertion/exercise. It is short-term and more common in women.

A

Functional Dyspnea

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28
Q

Chief Complaint

Assessed based on Body Position;
a. Orthopnea
b. Platypnea
c. Trepopnea

SOB in one lateral position (in side lying position). This is common for pt c unilateral lung problem and mitra stenosis.

A

c. Trepopnea

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29
Q

Chief Complaint

Assessed based on Body Position;
a. Orthopnea
b. Platypnea
c. Trepopnea

SOB in recumbent (supine) position and is relieved when backrest is elevated.

A

a. Orthopnea

Congestive heart failure, Chronic pulmonary diseases

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30
Q

Chief Complaint

Document; “I cannot sleep well lying flat on bed but I can sleep well if I have 3 pillows.”

A

3-pillow orthopnea

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31
Q

Chief Complaint

Assessed based on Body Position;
a. Orthopnea
b. Platypnea
c. Trepopnea

SOB when assuming sitting from supine. Happens with pts with pulmonary fibrosis, hypoxemia, and ventilation-perfusion mismatch (less O2/Hemoglobin=mismatch)

A

b. Platypnea

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32
Q

DYSPNEA SCALE (Grade 0-4)
Walks slower than people of the same age on level ground d/t SOB or has to stop for breath when walking at own pace on level ground

A

GRADE 2

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33
Q

DYSPNEA SCALE (0-4)
Too breathless to leave the house or during dressing or undressing

A

GRADE 4

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34
Q

DYSPNEA SCALE (0-4)
Not troubled by breathlessness except with strenuous exercise

A

GRADE 0

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35
Q

DYSPNEA SCALE (0-4)
Stops for breath after walking 100m or after few mins on level ground

A

GRADE 3

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36
Q

DYSPNEA SCALE (0-4)
Troubled by SOB when hurrying on level ground or walking up a slight hill

A

GRADE 1

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37
Q

Another way to measure the SOB where O2 and HR are directly proportional with one another (6-20)

A

Borg RPE

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38
Q

As PTs settle at the yellow score (__) while avoid red scale (__) when doing exercises.

A
  1. 12-16
  2. 17-20
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39
Q

2nd most common symptom/CC

A

Chest Pain

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40
Q

T/F: Not all chest pain is related to angina

A

TRUE
Differential diagnosis should be precise and done well to make sure it is not just traumatic pain on the chest instead of an actual angina

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41
Q

For CP pts, there is a greater chance that the chest pain is brought by ___ which may lead to ____ which may lead to ____.

A

Ischemia > Chest Pain > Myocardial Ischemia > Myocardial Infarction

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42
Q

TYPES OF CHEST PAIN
a. Ischemic Chest Pain
b. Stable Angina
c. Unstable Angina
d. Prinzmetal Angina
e. Microvascular Angina

Less serious type of angina where the heart must work harder during physical exertion but lasts a short time ( >5mins). May feel like gas or indigestion.

A

b. Stable Angina

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43
Q

TYPES OF CHEST PAIN
a. Ischemic Chest Pain
b. Stable Angina
c. Unstable Angina
d. Prinzmetal Angina
e. Microvascular Angina

Due to coronary microvascular disease at the distal segments or spasms on the walls of small arteries

A

e. Microvascular Angina

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44
Q

TYPES OF CHEST PAIN
a. Ischemic Chest Pain
b. Stable Angina
c. Unstable Angina
d. Prinzmetal Angina
e. Microvascular Angina

A diffuse retrosternal pain that immediately needs to be resolved. It presents (+) Levine Sign and discomfort or heaviness in the shoulder, jaw, arm, elbow, and upper back

A

a. Ischemic Chest Pain

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45
Q

TYPES OF CHEST PAIN
a. Ischemic Chest Pain
b. Stable Angina
c. Unstable Angina
d. Prinzmetal Angina
e. Microvascular Angina

A more serious type of angina that occurs during acute coronary syndrome. This causes a blot clot on heart artery which may lead to a heart attack

A

c. Unstable Angina

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46
Q

TYPES OF CHEST PAIN
a. Ischemic Chest Pain
b. Stable Angina
c. Unstable Angina
d. Prinzmetal Angina
e. Microvascular Angina

Occurs at rest and observed on younger pts.It is caused by spasms in the coronary arteries.

A

d. Prinzmetal Angina

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47
Q

What is the positive presentation of the Levine Sign

A

Fist close to the heart because of chest pain

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48
Q

TYPES OF CHEST PAIN
a. Ischemic Chest Pain
b. Stable Angina
c. Unstable Angina
d. Prinzmetal Angina
e. Microvascular Angina

Sx can be associated with dyspnea, sweating, indigestion, dizziness, syncope, and anxiety

A

a. Ischemic Chest Pain

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49
Q

What occurs when oxygenation is problematic to a patient

A

The body will not be able to supply an adequate amount of oxygen anymore

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50
Q

T/F: The heart muscle does not require its own supply of oxygen.

A

False.
It requires it own supply of oxygen. Once deprived, it willnow result in angina.

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51
Q

What can relieve a stable angina?
a. Rest
b. Nitroglycerin
c. Both
d. None

A

c. Both

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52
Q

How can chest pain be relieved with the use of nitroglycerin?

A

Placed under the tongue (sublingual)

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53
Q

How can you determine that the type of angina is stable using nitroglycerin?

A

When the reaction to the medication is immediate.

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54
Q

T/F: Smoking is a very strong risk factor in triggering a stable angina

A

True.
It can also be triggered by emotional stress, extremes of temp, and a heavy meal

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55
Q

Which of the ff is an indication of an unstable angina?
1. Occurs when a awake
2. Lasts longer than a stable angina
3. Rests and medicine (nitrates) relieve the pain
4. Pain usually lasts for 30mins

A

2 and 4
1. It occurs when resting or sleeping
3. Rests and medicine do not relieve pain

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56
Q

This artery is the blood vessel that supplies O2 and nutrients to the heart muscle

A

Coronary Artery

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57
Q

What occurs when there are spasms in the coronary artery?

A

It impedes the delivery of O2 and nutrients to the heart muscle

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58
Q

Diff Diagnosis of Chest Pain
a. Pleuritic Chest Pain
b. Pulmonary Hypertension
c. Pericardial Chest Pain
d. Esophageal Chest Pain
e. Chest Wall Pain

Substernal pain radiating on one or both arms and is relieved by sublingual nitroglycerin and antacids

A

d. Esophageal Chest Pain

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59
Q

Diff Diagnosis of Chest Pain
a. Pleuritic Chest Pain
b. Pulmonary Hypertension
c. Pericardial Chest Pain
d. Esophageal Chest Pain
e. Chest Wall Pain

Pain close to thoracic cage (superficial) and worsens sharply with inspiration, coughing, or laughing (Pain comes from the pleura and felt during the inflation of lungs)

A

a. Pleuritic Chest Pain

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60
Q

Diff Diagnosis of Chest Pain
a. Pleuritic Chest Pain
b. Pulmonary Hypertension
c. Pericardial Chest Pain
d. Esophageal Chest Pain
e. Chest Wall Pain

Midline pain felt from each heartbeat (pericardium) and is aggravated by deep inspiration, coughing, swallowing, or lying down. The pain is relieved by sitting up, leaning forward or lying on right side

A

c. Pericardial Chest Pain

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61
Q

Diff Diagnosis of Chest Pain
a. Pleuritic Chest Pain
b. Pulmonary Hypertension
c. Pericardial Chest Pain
d. Esophageal Chest Pain
e. Chest Wall Pain

This may mimic angina pectoris and occurs during exertion. This is associated with dyspnea and not relieved by nitrates.

A

b. Pulmonary Hypertension

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62
Q

T/F: Not all chest pain that does not react to nitrates is unstable angina

A

True. Look at other
symptoms of unstable angina

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63
Q

T/F: Pulmonary Hypertension is similar to stable angina

A

False. It is similar to both stable and unstable angina

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64
Q

Diff Diagnosis of Chest Pain
a. Pleuritic Chest Pain
b. Pulmonary Hypertension
c. Pericardial Chest Pain
d. Esophageal Chest Pain
e. Chest Wall Pain

This is an intermittent type with variable intensity. It may have a traumatic history on the chest wall

A

e. Chest Wall Pain

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65
Q

Syndrome that has chest wall pain that presents with local tenderness and costochondral of the 2nd-4th costochondral junction

A

Tietze Syndrome

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66
Q

This syndrome is a tumor on superior sulcus that compresses brachial plexus. It also presents with radiating pain in the shoulder, scapular or medial aspect of arm and hand

A

Pancoast Syndrome

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67
Q

Angina Rating Scale (1-4)
Moderately severe, very uncomfortable

A

Grade 3

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68
Q

Angina Rating Scale (1-4)
Moderate, bothersome

A

Grade 2

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69
Q

Angina Rating Scale (1-4)
Most severe or intense pain ever experienced

A

Grade 4

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70
Q

Angina Rating Scale (1-4)
Mild, barely noticeable

A

Grade 1

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71
Q

Type of cough that expels sputum

A

Productive cough

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72
Q

No sputum is expelled but may sometimes contain saliva

A

Non-productive

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73
Q

T/F: Cough may only be due to acute infections of the lungs

A

False. It may be due to acute or chronic infection of the lungs.

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74
Q

Acute Infection of the Lungs

Cough associated with sore throat, runny nose & eyes

A

Tracheobronchitis

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75
Q

Acute Infection of the Lungs

Cough preceded by Sx of upper respiratory infection; dry cough → productive

A

Lobar Pneumonia

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76
Q

Acute Infection of the Lungs

Starts as acute bronchitis; dry or productive cough

A

Bronchopneumonia

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77
Q

Acute Infection of the Lungs

Paroxysmal cough (sudden increase or occurrence of symptoms)

A

Viral Pneumonia

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78
Q

Acute Infection of the Lungs

Chronic productive cough; mucoid sputum → purulent (greenish or yellowsih sputum)

A

Exacerbation of Chronic Bronchitis

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79
Q

Chronic Infections of the Lungs

Chronic productive cough for more than 3 consecutive months for 2 successive years; mucoid → mucopurulent sputum

A

Chronic Bronchitis

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80
Q

Chronic Infections of the Lungs

Cough copious; foul smell; purulent

A

Bronchiectasis

81
Q

Chronic Infections of Lungs

Persistent cough for weeks to months; often with blood-tinged sputum

A

Tuebrculosis

82
Q

Non-productive to productive cough for weeks or months; recurrent small hemoptysis

83
Q

Upper airway: cough with sign of asphyxiation (nasamid)

Lower airway: non-productive cough, persistent, associated with localizing wheeze

A

Foreign Bodies

84
Q

Cough most marked in morning; slightly productive is due to?

85
Q

Often initiated by postural changes & relieved by assuming an upright position; non-productive; nocturnal and episodic

86
Q

T/F: If wheezing is associated with dyspnea, then the condition may be a pulmonary or cardiac disease.

87
Q

Manifestation of a narrowed airway and thickened bronchial walls d/t pulmonary edema

A

Wheezing in cardiac patients

Whistling or sumisipol

88
Q

Wheezing or Stridor?
Laryngotracheal narrowing

89
Q

Wheezing or Stidor?
Thickened bronchial walls d/t pulmonary edema

A

Wheezing

Not in the larynx and trachea

90
Q

This chief complaint is the awareness by patient of heart rhythm abnormalities such as pounding, fluttering, racing heartbeat. It can be triggered by stress, exercise, or medications

A

Palpitation

91
Q

What are the different causes of palpitation?

A
  1. Lack of sleep
  2. Caffeinated drinks
  3. Medication that is related to heart rhythm
  4. Alcoholic drinks
  5. Stress and some diseases
92
Q

This chief complaint may be d/t reduced cardiopulmonary endurance and/or physical inactivity, antihypertensive medication, hypokalemia, and other mental health problems (depression, anixiety, emotional stress)

93
Q

What does hypokalemia do to the body

A

Potassium is depleted -> absence of potassium -
muscles will be weak

94
Q

This type of edema is d/t congestive heart failure

A

Pedal/bipedal edema

95
Q

How does edema form d/t congestion on the heart?

A

Congestion on the heart → blood can no longer go back → accumulation of blood that retains in the LE/UE → forming edema

96
Q

Accumulation of fluid inside the abdominal
area

97
Q

T/F: Weight gain is an earlier indication of fluid retention d/t CHF

A

True.
I.e. ascites- increased abdominal girth

98
Q

What can be other causes of edema?

A

Lymphatic obstruction, localized trauma (e.g. on the hand)

99
Q

HPI

Patterns of Sx that must be taken note of:

A
  1. Sudden/gradual onset
  2. Constant/intermittent sx
  3. Sx during at rest/exertion
  4. Sx reaction to medication
  5. Time of day the sx is present
100
Q

What is the primary goal of PTs for pts within the ICU?

A

Achieve hemodynamic stability tability and optimal oxygen transport for each patient who is critically ill → optimal function

101
Q

Since PTs also treat pts in the ICU, implication must be considered like:

A
  1. Monitoring the patient (ECG, arterial and venous lines, ICP)
  2. Making sure drainage (thoracostomy) is upright and is lower than point of insertion
  3. Careful that attached IV lines might get disloge
  4. Assess fluid and electrolyte imbalance
  5. Check for sx of acid-base imbalances
102
Q

Fluid & Electrolyte Imbalance: Head and Neck

A

Fluid Excess: Distended neck veins; facial edema
Fluid Loss: Thirst, dry mucous membranes

103
Q

Fluid & Electrolyte Imbalance: Extermities

A

Fluid Excess: Dependent “pitting” edema
Fluid Loss: Muscle weakness, tingling, tetany

104
Q

Fluid & Electrolyte Imbalance: Respiration

A

Fluid Excess: Dyspnea, orthopnea, productive cough, moist breath sounds
Fluid Loss: Changes in rate and depth of breathing

105
Q

Fluid & Electrolyte Imbalance: Circulation

A

Fluid Excess: Htn, visible jugular pulse at 45° sitting angle, atrial dysrhythmias
Fluid Loss: Irregular pulse rate, dysrhythmia, postural hypotension, sinus tachycardia

106
Q

Fluid & Electrolyte Imbalance: Skin

A

Fluid Excess: Warm, moist, taut, cool feeling when edematous
Fluid Loss: Dry, decreased turgor (skin elasticity)

107
Q

Fluid & Electrolyte Imbalance: Abdomen

A

Fluid Excess: Increased girth, fluid wave
Fluid Loss: Abdominal cramps

108
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Hypercapnia

109
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Lightheadedness

110
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Convulsions

111
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Comatose

112
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Headache

113
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Numbness of digits

114
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Tetany

115
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Drowsiness

116
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Hypocapnia

117
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Tetany

118
Q

Acidosis or Alkalosis (Respiratory Disturbances)

DTR

119
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Hypoventilation

120
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Comatose

121
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Hyperkalemia

122
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Hypokalemia

123
Q

Acidosis or Alkalosis (Respiratory Disturbances)

Visual Disturbances

124
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Hypokalemia

125
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Bicarbondate deficit

126
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Hyperventilation

127
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Convolusions

128
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Headache

129
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Tetany

130
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Muscle Twitching

131
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Numbness of digits

132
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Mental dullness

133
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Dizziness

134
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Deep Respirations

135
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Mental confusion

136
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Depressed respirations

137
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Stupor

138
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Comatose

139
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Bicarbonate excess

140
Q

Acidosis or Alkalosis (Metabolic Disturbances)

Hyperkalemia

141
Q

T/F: Cardiopulmonary system works alone. Once it becomes problematic, it is the only system affected.

A

False
It works with the renal system and kidney. Once the cardiopulmonary system is problematic, the kidney will adapt and compensate and vice versa.

142
Q

PT Implication: What to do when sx arise during the PT session?

A
  1. Stop the PT session first
  2. Check Blood Gasses
  3. Assess Arousal and Brain Activity
143
Q

Blood Gasses: measures function and
non-functional hemoglobin; measured by extracting blood and analyzing it

A

Arterial Blood Oxygen Saturation

144
Q

Blood Gasses: only measures functional hemoglobin; measured with the pulse oximeter

A

Peripheral Oxygen Saturation

145
Q

What scale can be used to assess arousal and brain activity

A

Glasgow Coma Scale

146
Q

Other scale used to assess the arousal state

A

Richmond Agitation-Sedation Scale

147
Q

May also provide
information about cerebral functioning

A

Electroencephalogram

148
Q

PT Implication: Thorasis Surgery
a. Muscle is cut
b. Tissue is cut

  1. result to pain
  2. result to weakness
149
Q

In CABG, why must not be the arms be raised beyond 90deg?

A

To give time for the wound to heal so it won’t open

Results to LOM

150
Q

This type of thoracotomy may possibly cut these muscles: pectoralis major, pectoralis minor, serratus anterior, intercostals

A

Anterolateral Thoracotomy

151
Q

This apporach is when only a few muscles will be cut

A

Muscle Sparing approach

152
Q

This type of thoracotomy uses the muscle-sparing approach (only intercostals) where the muscles that are possibly cut arelatissimus dorsi, serratus anterior, lower trapezius, intercostals, and sometimes could reach the rhomboids and middle trapezius

A

Posterolateral thoracotomy

153
Q

Thoracotomy that cuts pectoralis major or linea alba of rectus abdominis

A

Median Sternotomy

154
Q

A process of inserting a tube after surgery for drainage to evacuate excessive air and fluid

A

Thoracostomy

155
Q

a. Vasodilators
b. NSAIDS + ACE inhibitors
c. NSAIDS + Digitalis
d. Diuretics
e. Beta-blockers
f. Alpha-1 Blockers
g. ACE Inhibitors
h. Calcium Channel Blockers

Monitored during physical exertion for elevated BP

A

b. NSAIDS + Ace Inhibitors

156
Q

a. Vasodilators
b. NSAIDS + ACE inhibitors
c. NSAIDS + Digitalis
d. Diuretics
e. Beta-blockers
f. Alpha-1 Blockers
g. ACE Inhibitors
h. Calcium Channel Blockers

close monitoring of RPE and
bradycardia; cautious when using HR in monitoring pt

A

e. Beta-blockers

157
Q

a. Vasodilators
b. NSAIDS + ACE inhibitors
c. NSAIDS + Digitalis
d. Diuretics
e. Beta-blockers
f. Alpha-1 Blockers
g. ACE Inhibitors
h. Calcium Channel Blockers

hypotension, reflex tachycardia (medicines that end in “zosin”)

A

f. Alpha-1 Blockers

158
Q

a. Vasodilators
b. NSAIDS + ACE inhibitors
c. NSAIDS + Digitalis
d. Diuretics
e. Beta-blockers
f. Alpha-1 Blockers
g. ACE Inhibitors
h. Calcium Channel Blockers

muscle weakness & spasms, dizziness, headache, incoordination, nausea

A

d. Diuretics

159
Q

a. Vasodilators
b. NSAIDS + ACE inhibitors
c. NSAIDS + Digitalis
d. Diuretics
e. Beta-blockers
f. Alpha-1 Blockers
g. ACE Inhibitors
h. Calcium Channel Blockers

rash, persistent dry cough (Medicines that end in “pril”)

A

g. ACE Inhibitors

160
Q

a. Vasodilators
b. NSAIDS + ACE inhibitors
c. NSAIDS + Digitalis
d. Diuretics
e. Beta-blockers
f. Alpha-1 Blockers
g. ACE Inhibitors
h. Calcium Channel Blockers

fatigue, confusion, arrhythmias

A

c. NSAIDS + Digitalis

161
Q

a. Vasodilators
b. NSAIDS + ACE inhibitors
c. NSAIDS + Digitalis
d. Diuretics
e. Beta-blockers
f. Alpha-1 Blockers
g. ACE Inhibitors
h. Calcium Channel Blockers

swelling on feet and ankles, hypotension, headache, nausea (Due to excessive vasodilation)

A

h. Calcium Channel Blockers

162
Q

a. Vasodilators
b. NSAIDS + ACE inhibitors
c. NSAIDS + Digitalis
d. Diuretics
e. Beta-blockers
f. Alpha-1 Blockers
g. ACE Inhibitors
h. Calcium Channel Blockers

may produce hypotension, dizziness and syncope (loss of consciousness)

A

a. Vasodilators

163
Q

a. Nitrates
b. Anticoagulants
c. Thrombolytic Drugs
d. Beta-2 receptor agonists
e. Theophylline and Aminophylline
f. Corticosteriods

Clearance if DVT resolves (If a clot is present, these drugs are used).

A

c. Thrombolytic Drugs

164
Q

a. Nitrates
b. Anticoagulants
c. Thromolytic Drugs
d. Beta-2 receptor agonists
e. Theophylline and Aminophylline
f. Corticosteriods

Can also lead to osteoporosis, growth degradation, cushing’s syndrome

A

f. Corticosteriods

165
Q

a. Nitrates
b. Anticoagulants
c. Thromolytic Drugs
d. Beta-2 receptor agonists
e. Theophylline and Aminophylline
f. Corticosteriods

headache, dizziness, tachycardia, OH

A

a. Nitrates

166
Q

a. Nitrates
b. Anticoagulants
c. Thromolytic Drugs
d. Beta-2 receptor agonists
e. Theophylline and Aminophylline
f. Corticosteriods

for asthma attacks (albuterol, formoterol, salmeterol, etc)

A

d. Beta-2 receptor agonists

167
Q

a. Nitrates
b. Anticoagulants
c. Thromolytic Drugs
d. Beta-2 receptor agonists
e. Theophylline and Aminophylline
f. Corticosteriods

hematoma, nose-bleeding (heparin or warfarin, prevent clot formation)

A

b. Anticoagulants

168
Q

a. Nitrates
b. Anticoagulants
c. Thromolytic Drugs
d. Beta-2 receptor agonists
e. Theophylline and Aminophylline
f. Corticosteriods

Monitoring because of toxic effects. Advanced asthma but has toxic effects on body

A

e. Theophylline and Aminophylline

169
Q

Chest X-Rays:
a. Air
b. Fats
c. Muscle, other soft tissues
d. Bone/metals

Light Gray

A

c. Muscle, other soft tissues

170
Q

Chest X-Rays:
a. Air
b. Fats
c. Muscle, other soft tissues
d. Bone/metals

Dark

171
Q

Chest X-Rays:
a. Air
b. Fats
c. Muscle, other soft tissues
d. Bone/metals

White

A

d. Bone/metals

172
Q

Chest X-Rays:
a. Air
b. Fats
c. Muscle, other soft tissues
d. Bone/metals

Dark Gray

173
Q

T/F: Advnace CT Scans and MRI’s were discovered in the 1980’s-1990’s

A

False
1970’s-1980’s

174
Q

Provide excellent images of heart, lungs and vascular tissues; more precise; ionizing effect (drawback)

A

Computed Tomography (CT Scan)

175
Q

Higher-quality views of soft tissues. It is more expensive and non-ionizing (takes an hour to complete)

A

Magnetic Resonance Imaging (MRI)

176
Q

Checks the heart’s rhythm
and its electrical activity (Usually use 12 leads)

A

Electrocardiogram (ECG / EKG)

177
Q

Laboratory procedure that
includes RBC count, variety of RBC indices, differential WBC count, hematocrit (Hct), hemoglobin (Hgb), and platelet count.

A

Complete Blood Count (CBC)

178
Q

What needs to be assessed under the Lvl of Physical Activity (3)

A
  1. Including exercises and sport activities
  2. Current vs. prior lifestyle
  3. Active vs. sedentary lifestyle
179
Q

Need to be taken into account under Functional Status (2)

A
  1. Work/School (Current vs. Prior)
  2. Occupational History
180
Q

Formula in getting the BMC Public Health Classification (Pack-years)

A

(No. of packs a day) x (Current age - Age first started smoking)

181
Q

A.F. is a 55 yrs old smoker who smokes 1 pack a day. He started smoking at the age of 25. Document the pack years.

A

Lifestyle > pt is a moderate smoker c Hx of 30 pack-years

182
Q

BMC Public Health Classification
a. Non-smoker
b. Light smoker
c. Moderate smoker
d. Heavy smoker

21-40 pack years

A

c. Moderate smoker

183
Q

BMC Public Health Classification
a. Non-smoker
b. Light smoker
c. Moderate smoker
d. Heavy smoker

0 pack years

A

a. Non-smoker

184
Q

BMC Public Health Classification
a. Non-smoker
b. Light smoker
c. Moderate smoker
d. Heavy smoker

> 40 pack years

A

d. Heavy smoker

185
Q

BMC Public Health Classification
a. Non-smoker
b. Light smoker
c. Moderate smoker
d. Heavy smoker

1-20 pack years

A

b. Light smoker

186
Q

Categories of Alcoholic Beverage
a. Social
b. Conformity
c. Enhancement
d. Coping
e. Alcohol Abuser
f. Alcoholic

Drink to fit in, not necessarily because they would normally drink in the situation

A

b. Conformity

187
Q

Categories of Alcoholic Beverage
a. Social
b. Conformity
c. Enhancement
d. Coping
e. Alcohol Abuser
f. Alcoholic

Extreme consumption (Considered as a psychological disorder)

A

e. Alcohol Abuser

188
Q

Categories of Alcoholic Beverage
a. Social
b. Conformity
c. Enhancement
d. Coping
e. Alcohol Abuser
f. Alcoholic

Drink to celebrate; pastime

189
Q

Categories of Alcoholic Beverage
a. Social
b. Conformity
c. Enhancement
d. Coping
e. Alcohol Abuser
f. Alcoholic

Drink because it is exciting; likely to actively seek to get drunk

A

c. Enhancement

190
Q

Categories of Alcoholic Beverage
a. Social
b. Conformity
c. Enhancement
d. Coping
e. Alcohol Abuser
f. Alcoholic

Addiction to alcohol - Excessive alcohol consumption is related to heart diseases, heart failure, atrial fibrillation, even hemorrhagic stroke

A

f. Alcoholic

191
Q

Categories of Alcoholic Beverage
a. Social
b. Conformity
c. Enhancement
d. Coping
e. Alcohol Abuser
f. Alcoholic

Drink to forget about their worries, may lead to worse long-term consequences

192
Q

Type of Alcoholic Beverage Drinker:
● 1 drink/day (women); 1-2 drinks/day (men)
● Beer: 12 fluid ounces (355 milliliters)
● Wine: 5 fluid ounces (148 milliliters)
● Distilled spirits (80 proof): 1.5 fluid ounces (44 milliliters)

A

Moderate Drinker

193
Q

Type of Alcoholic Beverage Drinker:
High-risk drinking; >3 drinks on any day or >7 drinks/week (>65 y/o), and >4 four drinks on any day or >14 drinks/week for men (65 y/o)

A

Heavy Drinker

194
Q

Type of Alcoholic Beverage Drinker:
4 drinks within 2 hours for women and 5 drinks within 2 hours for men

A

Binge Drinker

195
Q

Drug Abuse: What can opoid use cause?

A

arrhythmias, stroke, endocarditis

196
Q

Drug Abuse: What can Methamphetamine (shabu) cause?

A

congestive heart failure, arrhythmia, and damage to heart muscles and
blood vessels via inflammation

197
Q

Nutritional Intake through providing food through tube in nose, stomach, or intestine

198
Q

Nutritional Intake through providing food intravenously; bypassing eating and digestion

A

Parenteral

199
Q

Which of the ff statements are true about the Pt’s Goal?
a. Allows the clinician to align the care provided with what is most important to the patient
b. Establishes the most medically appropriate, realistic, and agreed goal of patient care
c. Both
d. None

(3) Cardio-Pulmo-Renal Rehabilitation (34 decks)

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