test 1 other important info Flashcards by Hanna Consoldane

S3 is normal in

athletes, children, pregnant women

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when is S3 heard + what does it mean

after S2
new blood is hitting the leftover blood when it enters the left ventricle

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when is S4 heard + what does it mean

before S1
in aortic stenosis and hypertension pts

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what is the orthostatic hypotension rule

30/20/10
HR +30
SBP -20
DBP -10

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high pulse pressure means (3)

hypertension
aging
stiff heart walls

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low pulse pressure means (3)

heart failure
blood loss
dehydration

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t/f: If the autonomic nervous system is impaired, the myocardial cells are unable to contract

cardiac cells can contract on their own

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clinical signs are indicative of a patient who has chronic mitral valve insufficiency

shortness of breath
poor exercise tolerance

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what part of the lung has the highest perfusion rate? why?

base
bc gravity

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when does the S1 heart sound occur

when all the ventricles have completely filled with blood

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is S4 always pathological

yes

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the difference between the pulse rate heard in the apical region and the pulse rate felt in a peripheral region may be due to….

arrhythmias

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vesicular sounds description

longer inspiration
soft intensity
low pitch

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bronchovesicular sounds description

equal in/expiration
intermediate intensity
intermediate pitch

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bronchial sounds description

longer expiration
loud intensity
high pitch

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tracheal sounds description

equal duration
very loud intensity
high pitch

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adventitious breath sounds

discontinuous crackles that are explosive and poppy on inspiration due to fluid accumulation

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stridor

adventitious breath sound
crowing sound on inspiration
typically in upper airway

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S1 sound is ….

closing of mitral and tricuspid valves

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S2 sound is …

closing of aortic and pulm valves

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heart murmmers

abnormal heart sounds due to turbulent blood through incompetent valves

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what type of heart valve issue does opening snap occur

stenosis

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what type of heart valve issue does systolic click occur

prolapse

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pericardial friction rub sound

leathery to squeaky due to diastole disruption

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what does ECG measure and what part of the heart does it look at the most

ejection fraction left ventricles

does CAD increase or decrease ejection fraction

decrease

how can CAD lead to more arrhythmias

Ca+ release when cells die

ST elevation indicates _________ while ST depression indicates __________

acute MI ischemia

when is it normal for T waves to be inverted

children Lead 3, V1, and aVR

do arrhythmias lead to increased or decreased cardiac output

decreased

what is responsible for slowing down the SA node

AV node

how can the renal system cause heart issues

raises BP retains Na+ and K+ Axotemia --> urea, creatinine elevation GFR decreases

HF with reduced ejection fraction

dilated cardiomyopathy

is dilated cardiomyopathy systolic or diastolic dysfunction

systolic

HF with preserved ejection fraction

hypertrophic cardiomyopathy

is hypertrophic cardiomyopathy systolic or diastolic dysfunction

diastolic

is restrictive cardiomyopathy systolic or diastolic dysfunction

diastolic

what is restrictive cardiomyopathy

hypertrophic walls WITH dilation of atria/ventricle space

why does valve malfunction cause hypertrophy

the heart has to work harder to get blood to correct spots

what is the best position for PE pts for maximal perfusion

head of bed elevated prone or lateral lying

LHF results in what symptoms while RHF results in ________

LHF = pulmonary edema RHF = body/periphery edema

BNP

stretch enzyme lab result in late stage HF (dilated heart walls)

B1 blockers control 3 things

decreases contractile force decreases HR decreases SNS

nonselective beta blockers are contraindicated against what type of patients

LUNG patients bc B2 gets blocked

2 liver lab values

ALT AST

blood transfusion rule + what vital sign is key to checking while exercising pt

wait 30 mins per unit of blood transfused SpO2

cardiac glycosides can interfere with which other organ system

renal

why are sympathomimetics only short term in the hospital

increased risk of ventricular arrhythmias (bc afterload is so reduced) ischemia in peripheries (black toes/fingers)

which med of these 3 causes reflexive tachycardia: Beta blockers calcium channel blockers nitrates

nitrates

when is phosphodiastrase used

when pt is about to die + it is the last resort

what medication is specifically bad for HF patients? why?

Calcium channel blockers they are negative iontropes --> we need to INCREASE heart contractility in HF pts

what is the difference between beta blockers and calcium channel blockers

beta = decreases O2 demand Ca+ = increases O2 supply

Stable vs unstable angina

stable = relieved by rest, predictable, nitrates help it unstable = unpredictable, can happen at any time

-one

class 3 anti-arrhythmic: K+ channel blockers

2 major side effects of class 3 anti-arrhythmic

pulmonary fibrosis liver issues

what does digitalis depress?

AV node conduction

4 phases of acute care pts

1. cant walk or stand 2. cant walk but can stand 3. low endurance 4. going home soon

which of the 4 phases in acute care should a PT spend most their time with

2 bc we dont want them to lose ability to stand

critical illness polyneuropathy

- involves sensory and motor nerves - PT is the only effective treatment - MAIN CONTRIBUTOR TO PERSISTENT DISABILITY

critical illness myopathy

- weakness in limbs - associated with COMPLETE RECOVERY

critical illness polyneuropathy and myopathy

- acute and chronic denervation - primary muscle changes

What is the main contributor to persistent disability in acute care

critical illness polyneuropathy

D-dimer is for...

detecting proteins in blood for DVTs

what is used to detect WHERE the DVT is located

ultrasound

INR measures...

effectiveness of blood thinners

a high INR indicates...

thinner blood + higher prothrobin time (PT)

pulse pressure lower than 40 happen in pt with...(2)

arrhythmias dilated cardiomyopathy

cardiogenic shock

heart stops beating completely

pts take longer to be mobilized when taking fractionated or unfractionated anticoagulants?

UNFRACTIONATED bc it is not broken down yet

does jugular vein distention occur in Right or Left sided HF

right sided

in RHF, does pulse pressure go up or down?

down shawtyyyy

what should a PT be checking when exercising a patient with an ICD

keep HR 20 beats lower than the ICD's set threshold

what anti-arrhythmic reduces depolarization

class 1: Na+