Test 2- Cardiac/GI/Hematological Flashcards
1
Q
Normal BP: ___-___ mm Hg (systolic)
___-___mm Hg (diastolic)
A
100-120 mm Hg
60-80 mm Hg
2
Q
Do NOT begin exercise if SBP < __ or > ___
or if DBP > ___
A
No exercise if SBP <60 or > 200
Or if DBP >110
3
Q
Normal BP response during activity:
SBP INCREASES __ mm Hg per MET, DBP ___ change or slight ____.
A
SBP increases 10 mm Hg per MET
DBP no change or slight decrease
*Stop exercise if drop in SBP or if no increase in SBP with workload or SBP >200
Or if DBP rises above 110 mm Hg (Abnormal responses during activity)
4
Q
Normal Resting Heart Rate:
__-__ bpm
Bradycardia: < __ bpm
Tachycardia: > ___ bpm
A
60-100
<60 (Brady)
> 100 (Tachy)
5
Q
Resting RR: __-___ br/min
- May INCREASE __-__ br/min during ex in healthy adult
- Resting RR > ___ : DO NOT start exercise
- Resting RR __-__ br/min : Use caution
A
12-20 br/min
May increase 50-69 br/min during ex
> 45 DO NOT EXERCISE
35-45 br/min USE CAUTION
6
Q
SpO2: __-__%
*
A
90-100%
<90% acutely ill pt, STOP EX
<85% w chronic lung dz, STOP EX
7
Q
The cardiovascular system consists of the ___, ____, ____, ____, and ____.
A
Heart, arteries, capillaries, veins, and lymphatics
8
Q
The functions of the heart are to:
2
A
Pump oxygenated blood into the arterial system, which carries it to the cells
Collect deoxygenated blood from the venous system and deliver it to the lungs
9
Q
The heart is located in the middle of the ______.
It beats approximately ___ times per minute and pumps more than __ liters of blood per minute
A
Mediastinum
72 times per minute
5 L of blood per minute
10
Q
What is the two layered sac that encloses the heart called?
A
Pericardium
11
Q
What is the purpose of pericardial fluid?
A
To reduce the friction produced by the pumping action of the heart and cushion the heart against external trauma
12
Q
There are three layers of cardiac tissue:
___ outer- (same structure as visceral pericardium)
___ middle- (contracting mm of heart)
___ inner- (consists of endothelial tissue)
A
Epicardium
Myocardium
Endocardium
13
Q
What arteries are the blood vessels which nourish the heart with oxygen and nutrients? Where do these arteries lie?
A
Coronary arteries;
they lie on the surface of the heart and arise from the aorta
14
Q
Diastolic BP must be at least ___ mm Hg to enable adequate blood flow through coronary arteries
A
60 mm Hg
15
Q
The conduction system asked to spread the action potential initiated in one area of the myocardium throughout the whole heart. The spread of the action potential stimulates the contraction of the chambers of the heart. The conduction system consists of ___ node, ___ node, ___ ___ ___, and ____ ____.
A
SA (Sinoatrial) node
AV (atrioventricular) node
Bundle of HIS
Purkinje’s fibers
16
Q
Heart rate controlled by the _____ nervous system
A
Autonomic
17
Q
Def: Often referred to as the pacemaker of the heart; initiates each heartbeat and consists of two types of specialized cells, P and T cells.
__ cells initiate electrical impulses
__ cells transmit impulses
A
SA node
P cells initiate
T cells transmit
18
Q
Located in the lower aspect of the atrial septum; receives electrical impulses from the SA node
A
AV node
19
Q
What fuses with the AV node to form another pacemaker site, meaning that if the SA node fails this will sustain a heart rate of 40 to 60 bpm?
A
Bundle of HIS
20
Q
These are conducting strands on the endocardial surface, penetrating the myocardium of both ventricles. They spread the wave of depolarization.
A
Purkinje fibers
21
Q
Def: The atherosclerosis affecting the arterial circulation
A
Cardiovascular disease
22
Q
Def: The atherosclerosis (plaque formation) specifically affecting the coronary arteries (Includes angina pectoris, MI, silent myocardial ischemia and sudden cardiac death)
A
Coronary Artery Disease (CAD) or Coronary Heart Disease (CHD)
23
Q
(Description of a disease)
When the coronary arteries become narrowed and blocked, the area of the heart that they supply becomes ischemic and injured, and an infarction may result.
A
Coronary artery disease
**remember that ischemia is the underlying issue that leads to infarction
24
Q
Def: Irreversible tissue damage due to the lack of oxygen
A
Infarction
25
Name the 4 valves of the heart:
Tricuspid, Bicuspid (Mitral), Aortic, and Pulmonic Valves
26
The atherosclerotic (plaque build up) process leads to ____ and ____ of the heart tissue. Eventually scar tissue will be formed which does not contribute to _____ (get narrowing and stiffness).
Ischemia and necrosis
Does not contribute to contractility
27
Atherosclerosis and arteriosclerosis are different in that:
Athero- plaque formation
Arterio- plaque and hardening of arteries
28
(Atherosclerosis)
Plaque in vessels can cause bleeding, ___ formation, and distortion or rupture of blood vessels. ___ ____ and ____ are the most sudden and often fatal signs of the disease.
Before actual scar formation occurs the weakened area is susceptible to ____ development.
Clot formation
Heart attacks and strokes
Aneurysm
*Excessive localized enlargement of an artery caused by weakening of the arterial wall
29
CAD Is a progressive disorder which if not prevented or treated in the early stages can lead to sudden cardiac death, angina pectoris, conduction disturbances, and myocardial infarction. Prevention is the best medicine, reduce ___ intake, also medication can be given to reduce ____ levels and prevent clot formation.
Fat intake
Cholesterol levels
30
Name some risk factors in which alleviating has been shown to reduce the incidence of CAD:
Smoking
Elevated total serum cholesterol level
Elevated LDL cholesterol level
Hypertension
31
Def: A surgical technique in which a balloon-tipped catheter is inserted into a blocked artery to compress the plaque and open the artery. It is thought that the force of dilation on the obstruction compresses it and flattens it out, which opens the lumen and permits an increase in blood flow. This process only eases the symptoms but does not halt the process.
PTCA - Percutaneous Transluminal Coronary Angioplasty
32
Name the three conditions that are due to insufficient blood supply to the myocardium and are collectively referred to as “coronary artery disease”
Angina Pectoris
Congestive heart failure
Myocardial infarction
33
Thrombus: When there is plaque built up on the arterial wall and the blood flow is slowed a clot may form. When the blood vessel becomes blocked by the thrombus this is called ____.
Thrombosis
*A coronary thrombosis is a clot or thrombus in a coronary artery. A coronary thrombosis will often result in a heart attack
34
Def: A sudden constriction of a coronary artery whereby the blood flow is decreased or cut off. A brief one may cause only mild symptoms, but a prolonged one can cause irreversible damage such as infarct.
Spasms
35
Def: Chest pain resulting from ischemia to a part of the myocardium. It is acute pain that results from the imbalance between cardiac workload and oxygen supply to the myocardial tissues. It is usually a clinical symptom accompanying arteriosclerotic heart disease. It may also be produced by coronary spasms or by aortic stenosis or insufficiency.
Angina Pectoris
36
Angina attacks are frequently triggered in susceptible individuals by any condition which increases myocardial oxygen demand: such as stress, eating, exertion, or even extremes of temperature and humidity.
Signs and symptoms include: ____, ____, and ____ in the chest that may radiate to the ____ shoulder and down the inside of the arm to fingers.
Usually last less than __ minutes and not more than __ minutes.
Tx- reduce stress, nitroglycerin, surgery, or medication
Burning, squeezing, and tightness
To left shoulder
Less than 15 and not more than 30
37
Def: Surgical intervention that may not prolong life or reduce the occurrence of myocardial infarction, but it does reduce angina and improve activity tolerance. This type of surgery is often chosen to improve quality of life.
***It is effective treatment for severe coronary disease and the purpose is to increase blood flow to the myocardium.
CABG - Coronary Artery Bypass Graft
38
What vessels do surgeons typically use during a CABG?
The saphenous vein or the internal mammary artery
39
*Normal BP <120 SBP and <80 DBP
Elevated: __-___ mm Hg SBP and
< __ mm Hg DBP
Hypertension:
Stage 1-
___-___ mm Hg SBP OR __-__ mm Hg DBP
Stage 2-
> or equal to ___ mm Hg SBP OR > or equal to ___ mm Hg DBP
120-129 SBP and <80 DBP
Stage 1 HN
130-139 SBP OR 80-89 DBP
Stage 2 HN
greater than or equal to 140 SBP OR greater than or equal to 90 DBP
40
Normal CV response to aerobic exercise:
INCREASED workload = ___ HR, ___ SBP, limited change in DBP and ____ respiration rate.
(Increased or decreased)
Increased for all
| Remember just limited change in DBP
41
For people with history of high BP:
Monitor BP in all adults > __ yo and in younger patients who are obese, have glucose intolerance, diabetes, or renal dysfunction. Monitor both at rest and with activity.
35
42
Do not begin exercise if SBP > __ mm Hg or DBP > __ mm Hg
If SBP rises > __ mm Hg or if DBP exceeds __ mm Hg terminate exercise.
SBP > 200 or DBP > 110
If SBP rises > 200 or if DBP exceeds 110
43
Pathology description:
Linked to CAD or ischemic heart disease. When CAD causes an acute problem. Hallmark sign is ischemic chest pain due to discrepancy between myocardial O2 supply and demand. Symptoms do not occur until the lumen is at least 70% occluded.
It encompasses A variety of diagnoses ranging from unstable angina to myocardial infarction to sudden cardiac death.
Acute Coronary Syndrome
44
Description:
| Irreversible changes begin 20 min to 2 hours from onset of myocardial ischemia. Angina usually precedes.
Myocardial infarction
*Zone of injury and zone of ischemia extend beyond the initial zone of infarction thus expanding the impact of an MI and leading to inefficient muscle mechanics
45
Coronary artery distribution:
The right coronary artery supplies __ and inferior __
RA (right atrium) and inferior LV (left ventricle)
46
Left anterior descending artery supplies the Anterior rand and septal aspects of the __
Left ventricle
47
Left circumflex artery supplies the ___ and side and back of ___
Left atrium and back of left ventricle
48
S&S of ___ (men):
Retrosternal chest pain “elephant sitting on chest”, radiating pain into LUE and L jaw. Dizziness, lightheadedness, weakness, diaphoresis (excessive sweating), fatigue
(Women): Nausea and vomiting, S.O.B, pressure/pain upper abdomen/lower chest, dizziness, upper back pressure, extreme fatigue
S&S of Myocardial Infarction
49
MI: most deaths occur within first __ hours
12
50
Medical management of MI:
Pharmacology- Antiplatelets, Anti____, and Anti_____
Revascularization procedures:
___ ____ ___ ___ (PTCA)
-CABG
Antihyperlipidemics, antihypertensives
Percutaneous transluminal coronary angioplasty
51
“Move in the tube” for post ____
Prevent wound ____ and sternal instability
Sternotomy
Wound dehiscence
52
Electrocardiogram-
__ wave: atrial depolarization and contraction
P wave
53
Electrocardiogram-
___ segment: slow impulse conduction from AV done through Bundle of HIS
PR segment
*flat line before QRS complex
54
Electrocardiogram-
___ complex: ventricular muscle depolarization and contraction
QRS complex
55
Electrocardiogram-
__ segment: ventricular repolarization
ST segment
56
Electrocardiogram-
__ wave: later ventricular repolarization
T wave
57
Normal electrical conduction:
__ node>__ node>_____>Purkinje fibers>septum>ventricles
SA node
AV node
Bundle of HIS
58
Def: caused by disturbance in the electrical activity of the heart
Arrhythmias
59
Atrial arrhythmias:
Description- “Saw-tooth” pattern, multiple P waves for every QRS complex resulting in decreased cardiac output
Atrial Flutter
60
Atrial arrhythmias:
Description- “atria quivering like a bag of worms”, unpredictable conduction of disordered impulses from atrium resulting in ineffectual atrial contractions, decreased cardiac output an increased risk of thrombus formation which may lead to CVA
Atrial fibrillation
61
Ventricular arrhythmias:
| Contraction initiated in ventricle before the normal SA node, may be benign or malignant
PVC (premature ventricular contractions)
62
STEMI vs. NSTEMI Myocardial Infarction
Which is more severe?
STEMI is more severe, causes more muscle damage, larger blockage
63
Def: Uses cold or heat to scar region of the heart causing electrical abnormality to block abnormal signals
Cardiac Ablation
64
Not a disease itself, it is a manifestation of the many cardiac and pulmonary disease processes
Involves systolic and/or diastolic properties result in impaired left ventricular function
Causes: Cardiac muscle dysfunction and/or scarring, hypertension, cardiomyopathy, valvular dysfunction
Heart failure
*When accompanied by signs and symptoms of edema it is referred to as Congestive Heart Failure
65
Def: The percentage of blood in the filled left ventricle that is pumped out during a contraction
Ejection fraction
Normal is 60-70%
66
Left or right sided heart failure?
Shortness of breath, cough, crackles, wheezes, tachypnea, orthopnea, tachycardia,
Left sided heart failure
67
Left or right sided heart failure?
Peripheral symptoms: jugular distention, Peripheral Edema, Distention of the neck veins, enlargement of the liver and spleen due to congestion and veins that cannot empty properly into the heart. The liver and abdomen area become engorged with fluid leading to anorexia, nausea, and vomiting
Right sided heart failure
| Cor pulmonale
68
Systolic or Diastolic dysfunction (which description is S, which is D)
1) Compromised contractility of ventricles; decreased stroke volume, decreased cardiac output, decreased ejection fraction
2) Ventricles unable to relax and feel during diastole; decreased SV, cardiac output, but no change in ejection fraction
1) systolic dysfunction
| 2) diastolic dysfunction
69
Compensated or non-compensated heart failure?
-Congestive symptoms managed by medical intervention
Compensated
70
Compensated or non-compensated heart failure?
-Showing signs and symptoms of congestion and requires medical and pharmacological adjustment
Non-compensated
71
Almost all patients with any type of heart failure eventually display skeletal muscle wasting, osteoporosis, decreasing type one and type two muscle fibers. Therapy should focus on improving ____ and ____ ____.
Endurance and functional mobility
72
The artificial pacemaker has become a leading modality in the control of potentially dangerous dysrhythmias. Pacemakers may be temporary or permanent. The artificial Pacing system consists of a ___ ___ and ___ ___ That delivers the stimulus to the heart to control heart rate. The pacing unit initiate and maintains the heart rate when the natural pacemakers of the heart are unable to do so.
Pulse generator and pacing wire
73
Pacemakers have two basic modes of pacing:
Fixed rate and demand mode
74
Pacemaker fires electrical stimuli at a preset right regardless of the persons inherit rhythm
(Fixed or demand)
Fixed
75
Most popular mode used. The pacemaker produces a stimulus only when the persons own heart rate drops below the rate per minute preset by the physician
Demand
76
Pacemaker complications:
| Avoid contact with any ____ machinery that is not properly grounded as well as ___ fields
Electrical machinery
| magnetic fields
77
Def: Inflammation of the parietal pericardium, the saclike membrane that surrounds and protects the heart muscle. It is usually caused by a bacterial infection. Usually presents with pain on inspiration, dyspnea, increase in pulse rate and a rise in temperature.
Pericarditis
78
Pericarditis may be differentiated from ___ symptoms if patient gets relief of symptoms on ___, kneeling, leaning forward, or sitting upright.
MI
Movement
*A patient with a MI doesn’t generally get a change in symptoms upon movement or positional change
79
Def: Abnormal dilation in the wall of an artery, vein or the heart when the vessel wall becomes weakened from traumas, congenital vascular disease, infection, or artherosclerosis.
May cause thrombus formation, hemorrhage, or ischemia.
Aneurysm
80
Types of aneurysm are designated according to ___ and whether they are ___ or ____.
3 common types are:
Location
Whether they are venous or arterial
1) Abdominal
2) Thoracic
3) Peripheral artery
81
Which type of aneurysm?
Generally involves aorta between the renal arteries and iliac branches
Abdominal
82
Which type of aneurysm?
Ascending, transverse, or descending portion of the aorta
Thoracic
83
Which type of aneurysm?
The most common site is the popliteal space in the lower extremities. Popliteal aneurysms cause ischemic symptoms in the lower limbs. There may be an enlarged area behind the knee but usually no discomfort
Peripheral artery
84
Def: The narrowing or constriction that prevents the heart valve from opening fully and may be caused by growths, scars, or abnormal deposits
Stenosis
85
Def: Occurs when the heart valve does not close properly and causes blood to flow back into the heart chamber
Insufficiency
86
Def: Affects only the mitral valve and occurs when enlarged Valves bulge backward into the left atrium
Prolapse
87
3 diseases affecting heart valves that occur secondary to impairment of the valves caused by disease, congenital deformity, or infection are:
Stenosis, Insufficiency, and Prolapse
88
Def: And infection caused by streptococcal bacteria that can lead to _____ heart disease (can affect all layers of heart and valves), a condition caused by scarring and deformity of the heart valves. It is a systemic inflammatory disease affecting joints, heart, CNS, skin and other body tissues. Generally starts with strep throat and children between the ages of 5 and 15. The disease is thought to be a bacterial-induced autoimmune disorder.
**Rheumatic Fever
Can lead to rheumatic heart disease
S&S: fever, joint pain, palpitations, SOB, nocturnal cough, subcutaneous nodules
89
Def: This is a classic symptom of rheumatic fever and is characterized by pain, redness, and swelling and major joints of the extremities, and is migratory in nature. When one joint begins to heal, another becomes inflamed. It is a transient condition.
Polyarthritis
90
3 common Congenital Valvular Defects:
1) Ventricular or atrial septal defects
2) Patent ductus arterious
3) Congenital stenosis of the pulmonary, aortic, and tricuspid valves
91
Def: Holes between the ventricles and atria
| Congenital valvular defect
Ventricular or atrial septal defect
92
Def: Shunt caused by an opening between the aorta and the pulmonary artery
(Congenital valvular defect)
Patent ductus arterious
93
Def: A condition in which the mitral valve (bicuspid) extends into the left atrium causing leakage of the valves. Symptoms include fatigue that is not associated with exercise, palpitations, dyspnea
Mitral valve prolapse
94
Def: Impaired circulation that may affect the arterial, venous, or lymphatic circulatory system. Vascular disorders can be associated with occlusive arterial disease.
Peripheral vascular disease
95
Def: The most important symptoms of chronic ____ occlusive disease are intermittent claudication (caused by ischemia) producing limping due to pain, ache or cramp in the muscles of the lower extremities
*pain is dull, aching, tightness deep in muscle (not an actual cramp bc muscle doesn’t actually go into spasm)
Arterial Disease
important symptoms of chronic arterial occlusive disease
96
Arterial disease- Location of pain is dependent on ____ of arterial occlusion. Most frequently the occlusion is in the ____ ____ artery between the groin and the knee, producing pain in the calf that sometimes radiates to the popliteal region and lower thigh.
After exercise, client may have numbness in the foot as well as pain in the calf. Remember that symptoms are _____.
Site
Superficial femoral artery
Reproducible
*If they cannot be reproduced then the patient does not have intermittent claudication. Intermittent claudication is influenced by speed, incline, and surface of the walk.
Symptoms are relieved by rest!
97
Def: the most common occlusive arterial disease that causes chronic ischemia of the lower extremities.
Most often seen in elderly patients, also associated with diabetes mellitus
Arteriosclerosis Obliterans
98
Def: An intense vasculitis of small and medium sized veins and arteries in the extremities of young adults. Predominately men 20 to 40 years of age of smoke. The disease process is gradual and affects the distal extremities and then moves to upper extremities. Initially and small arteries of feet and hands.
Ulceration and gangrene are frequent complications.
Buerger’s Disease
99
Def: Intermittent episodes of constriction of small arteries or arterials and extremities. Usually due to an abnormality of the sympathetic nervous system. **These episodes of constriction occur in response to cold temperatures or strong emotions
Raynaud’s Disease
100
Blood consists of 2 major components:
Plasma and Formed Elements (Erythrocytes, leukocytes, and platelets)
101
55% of blood is ___
| 45% of blood is ____
55% plasma
45% formed elements
102
Def: The production of blood cells
Hematopoiesis
103
At birth and throughout life, hematopoiesis is confined to the ____ ____.
Hematopoiesis is thought to be controlled by ____ and ___ ____.
Bone marrow
Hormones and feedback mechanisms
104
______ governs the production of erythrocytes. (a hormone)
The mature erythrocyte consists primarily of _____ and functions to supply oxygen to the tissues, removing carbon dioxide.
Erythropoietin
Hemoglobin
105
_____: The smallest formed elements of the blood. They are important in the coagulation process by forming hemostatic plugs in small ruptured blood vessels or by adhering to any injured lining of a larger vessel.
Platelets
106
Def: Disease characterized by reduction in the number of circulating red blood cells or in the quantity of hemoglobin in the red blood cells. Thus, there is a reduction in the oxygen carrying capability.
Anemia
*In actuality, anemia is not a disease but is a symptom of many blood disorders
Anemia values:
Less than 14 g/dl for men
Less than 12 g/dl for women
107
___ ____ Anemia in otherwise healthy individuals is well tolerated, there may be no symptoms present until levels fall to half of normal. The person may appear pale.
Slow onset anemia
108
____ ____ Anemia: There is an adequate reserves of iron and the formation of hemoglobin for erythrocytes. Occurs most frequently in pre-menopausal women and adolescents.
Iron deficiency anemia
109
Most anemias or caused due to the loss of erythrocytes, hemolysis, or decrease production of erythrocytes. Anemia classification is based on erythrocyte ____ or ____ of disease.
Erythrocyte appearance or etiology of disease
110
Skin pallor especially in hands and fingernail bed, spoon nails, fatigue, dyspnea are S&S of ____
Anemia
111
____ ____ _____ Anemia: Large sized, abnormal red blood cells owing to inadequate stores of folic acid within the body. Folic acid is one of the B complex vitamins that helps form red blood cells
Folic acid deficiency anemia
112
______ Anemia: Appearance of large abnormal red blood cells due to inadequate levels of vitamin B12. Inadequate levels of a protein called intrinsic factor. Intrinsic factor is responsible for the absorption of vitamin B12 which is essential for a erythrocyte formation.
Pernicious Anemia
113
____ Anemia: Insufficient or the total absence of red blood cell production secondary to injury or distruction of the blood forming tissue in the bone marrow. Etiology: radiation, hepatitis virus, toxins
Aplastic Anemia
114
___ ____ Anemia: Hereditary, chronic anemia in which abnormally crescent shaped red blood cells are present and clump together within capillaries impairing circulation, damaging blood vessels, and producing chronic organ damage.
Etiology: The condition is due to the presence of an abnormal form of hemoglobin called Hemoglobin S.
Sickle Cell Anemia
115
Def: Characterized by increases in both number of red blood cells and the concentration of hemoglobin. The individual will have an increased whole blood viscosity and increased blood volume. This increases the chance of thrombus formation.
Polycythemia
116
Def: Reduction of the number of leukocytes (WBC) in the blood.
Below 5,000 per microliter
Leukopenia
117
Def: Increased count of leukocytes over 10,000
Leukocytosis
118
____ Leukemia: Characterized by the hyper proliferation of abnormal, immature white cell precursors called Blast.This abnormal cells accumulate in the blood, bone marrow, and body tissues
Acute leukemia
119
_____ _____ Leukemia:Characterized by the proliferation of abnormal granulocytes in the bone marrow. These granulocytes later enter the blood and other tissues.
Etiology: Abnormality on Chromosome 22
Chronic Myelocytic Leukemia (CML)
120
____ ____ Leukemia: Characterized by abnormal B lymphocytes. These cells accumulate in large portions in the lymphoid tissue, blood, and bone marrow. It is the most common form of leukemia in the US, usually affecting individuals over the age of 50.
Chronic Lymphocytic Leukemia (CLL)
121
Def: A hereditary blood clotting disorder due to abnormalities of the plasma clotting proteins known as factor VIII and IX. The person bleeds longer than the normal individual, not at a faster rate.
Etiology: Sex-linked recessive gene problem
Hemophilia
Most common type is Hemophilia “A”- involves factor VIII gene
122
Def: Sensation of food sticking in the esophagus (difficulty swallowing)
Dysphagia
123
Def: Pain during swallowing. Is relieved by one assuming an upright position
Odynophagia
124
Def:Black, tarry stool due to large quantities of blood in the stool
Melena
125
Complications due to constipation:
1) ___ pulse
2) ___ cardiac output
3) ___ Intrathoracic and intracranial pressure from increased use of the Valsalva maneuver
Decreased
Decreased
Increased
126
The inability to control evacuation of stool and is associated with a sense of urgency, diarrhea, and abdominal cramping
Fecal incontinence
127
These drugs are prescribed them in the individuals suffering from painful musculoskeletal conditions. These individuals rely on these drugs for pain relief and to improve their functional abilities. They have analgesic, anti-inflammatory, antipyretic and platelet inhibiting actions
NSAIDs
128
NSAIDs can cause gastrointestinal complications including _____, ____, and exacerbation of inflammatory bowel disease.
Ulcerations
| hemorrhage
129
Def: A lesion in the mucosal lining of the stomach. The stomach begins to digest itself. It is a breakdown in the balance between acid/pepsin secretion and mucosal defense in the stomach
Peptic Ulcer
*Treatment: bland diet, no caffeine, no smoking, reduce stress, surgery
130
Def: Inflammation of the vermiform appendix that occurs most commonly and adolescents and young adults. When the appendix becomes obstructed, inflamed, and infected, rupture may occur leading to peritonitis.
S&S: Pain proceeding nausea, vomiting and low-grade fever. Pain begins in umbilical region and localizes in the right lower quadrant of the abdomen over the appendix. Tenderness upon pressure on Mc Burney’s point
Appendicitis
131
Def: Inflammation of the pancreas that may result in auto digestion of the pancreas by its own enzymes. This disease process can be acute or chronic.
Etiology: Specific causes unknown but some attacks are thought to be due to chronic alcoholism, toxicity, and viral infections
Pancreatitis
132
95% of pancreatic function is to help with ____
Digestion
133
Def: A neoplasm usually an adenocarcinoma occurring most frequently in the head of the pancreas
S&S: Abdominal pain, jaundice, weight loss, diarrhea, boring pain in the midback
If the disease affects the Islets of Langerhans, symptoms of ____ deficiency appear. Including glucosuria, hyperglycemia, and glucose intolerance. Treatment is palliative.
Pancreatic carcinoma
Insulin deficiency
134
Def: An inflammatory disease that most commonly attacks the ileum, but it may affect any portion of the intestinal tract. You don’t absorb nutrients well. 25% of people may present with arthritis or migratory arthralgias.
Crohn’s disease
135
Def: Inflammation and ulceration of the lining of the large intestine and rectum.
S&S: Bloody diarrhea, abdominal pain, signs of dehydration, decreased serum potassium
Tx: Anti-inflammatory drugs, diet, blood transfusions (due to losing blood)
Ulcerative Colitis
136
Def: Syndrome marked by abdominal pain and altered bowel function. Typically constipation, diarrhea for which no organic cause can be determined. There is a change in colonic motility, either a decrease or increase. Generally occurs as a result of stress and diet.
PT tx: Teach relaxation exercise and proper breathing techniques
Irritable bowel syndrome
137
Def: The collective designation for a variety of malignant neoplasm that may arise in either the colon or rectum.
Etiology: May be associated with diet tie and read me and low in fiber, diseases of the digestive tract, and a history of IBS
Colorectal cancer
138
____ are outpouching of mucosa through the muscular wall of the intestine. They can occur in any part of the intestine but are most common in the sigmoid colon.
Appear to be caused by increased pressure within the lumen of the bowel which forces herniation of the mucosa through weak areas of the muscular wall. A precipitating factor may be lack of fiber and ones diet.
S&S: LEFT lower abdominal pain, pelvic pain
Diverticula
139
One form of Diverticular disease is ______ characterized by the presence of NONinflamed diverticula and in many cases asymptomatic
Diverticulosis
140
____ is a form of diverticular disease in which there is inflammation of the diverticulum
Diverticulitis
141
Def: This disease is inclusive of two inflammatory conditions; ulcerative colitis and Crohn’s disease
Extra intestinal manifestations: arthralgia, skin lesions (erythema nodosum- red/purple knots on ankles and shins. Pyoderma- deep ulcers or canker sores on shins, ankles, calves), red painful eyes, and nutritional deficiencies
Inflammatory bowel disease
142
Def: A scope of problems related to the backward movement of stomach acids and other stomach contents such as pepsin and bile into the esophagus. A.k.a. acid reflux. And adults it is generally call secondary to the relaxation of the lower esophageal sphincter.
S&S: Heartburn, chest pain, dysphagia and a sense of a lump in your throat
GERD (Gastroesophageal reflux)
*Position patient upright
143
Drug Action: Decrease BP and afterload
Indications: HTN, CHF
ACE Inhibitors
*generic name- capoten, vasotec
144
Drug action: Inhibit platelet aggregation and thrombus formation
Indications: Post op angioplasty or CABG, prophylactic to prevent DVT in patient with A-fib and prosthetic heart valves
Anticoagulant
*generic name- heparin, coumadin
145
Drug action: Break down low density Lipoproteins, decrease triglyceride levels and increase HDL levels.
Indications: Hyperlipidemia, atherosclerosis
Antihyperlipidemia
*generic name- Statins: Lipitor, Zocor
146
Drug action: Decrease myocardial O2 demand by decreasing heart rate and contractility
Indications: HTN, angina, arrhythmias, CHF
Beta blockers
*generic name- Tenormin, Lopressor
147
Drug Action: Inhibit platelet aggregation in clot formation
Indications: Post MI, A-fib, prevent arterial thrombus formation
Antithrombotic (Antiplatelet) agents
*generic name: Aspirin, Bayer, Plavix
148
Drug action: Decreased Myocardial contraction, vasodilation and decrease 02 demand of the heart
Indications: HTN, angina, arrhythmias, CHF
Calcium channel blockers
*generic name- Procardia, Cardizem
149
Drug action: Increase excretion of sodium and urine
Indications: HTN, Edema due to CHF, pulmonary Edema
Diuretics
*generic name: Diuril, Lasix
150
Drug action: Vasodilation, relaxation of smooth muscle
Indications: Angina pectoris sublingual administration of NTG to treat acute angina attack
Nitrates
*generic name: Nitrostate, Nitroglycerin (NTG)
151
Drug action: Dissolve clot
Indications: Acute MI, pulmonary embolism
Thrombolytic
*generic name: Activase
152
Drug action: Decrease nasal congestion
Indication: Seasonal allergies
Anti-histamine
*generic name: Benadryl, Allegra, Claritin
153
Drug action: Prevent bronchoconstriction
Indications:Bronchospasm, asthma
Anti-inflammatory
*generic name: AeroBid Pulmicort
154
Drug action: Relax bronchial smooth muscle
Indications:Bronchospasm, wheezing, asthma, COPD
Bronchodilators
*generic name: Atrovent
155
Drug action: Loosen mucus and reduce viscosity of mucus
Indications:Cough, mucus, congestion
Expectorants
*generic name: Mucinex
156
Drug action: Decrease viscosity of mucus. Administered via nebulizer and compressor system
Indications: Discuss mucus due to pneumonia, emphysema, chronic bronchitis, CF
Mucolytic
*generic name: Mucomys
157
Move in the tube:
Patients are [encouraged or discouraged] to pursue active living following sternotomy?
Encouraged
158
Move in the tube:
Immediately after surgery, patients [can or cannot] reach “Out of the tube” with their arms when performing non-load-bearing activities ( toilet hygiene, washing their hair, scratching their back)
Can
159
Move in the tube:
Is there a time requirement for staying in the tube?
No, patients should let pain be their guide when they attempt load-bearing activities “out of the tube”
160
Move in the tube:
What load-bearing activities can be performed? How?
Any load-bearing activity can be performed as long as the patient can modify it to be performed “in the tube”
161
Typical sternal precautions are?
| Not move in the tube
No lifting, No pulling, No pushing
