Week 1 Flashcards
Why monitoring of vital signs is important
- Detection/monitoring of medical issues - OTA/PTAs must monitor vital signs before, during, after mobilization
- Contra-indications to activity or exercise – review chart, recognize and act accordingly to changes during session
Heart Rate
Abbreviation?
What is it?
Expressed?
Normal range?
What affects it?
HR
The number of times the heart beats each minute
Expressed in beats per minute (bpm)
Normal range at rest for 1) Adults: 60-100 2) Children: 80-200 (since heart is not as developed, elastic can’t stretch as far so requires more frequent smaller pumps to pump blood through body)
Body positioning, medications, caffeine affect HR
What are the 3 ways of measuring HR?
- Radial check – index and third finger on radial bone
- Pulse oximeter – probe placed on patient’s finger to check oxygen levels and HR
- Telemetry – measures heart activity continuously over prolonged period of time
Bradycardia
: SLOW HR of less than 50 BPM (at rest)
Tachycardia
VERY FAST HR of more than 100 BPM (at rest)
Arrythmia
IRREGULAR heart beats
Systolic
Heart contracting
Diastolic
Heart at rest
Blood Pressure:
Abbreviation?
What is it?
Expressed?
How is it presented?
How is it measured?
BP
Indicator of the force and rate of the heartbeat and the diameter and elasticity of the arterial walls
Expressed in millimeters of mercury (mmHg)
Recorded with systolic # first/on top, diastolic #last/on bottom
1) Measured manually – sphygmomanometer
2) Measured automatically - Automated blood pressure monitors
Normal BP (healthy adult)
120/80
Prehypertension levels
120 – 139
Hypertension (HTN) Stage 1
140 -159
Hypertension (HTN) Stage 2
160 or higher
Hypertensive crisis
Higher than 180
Hypotension
Symptoms?
Low blood pressure
(isn’t serious unless pt is experiencing symptoms)
- Fatigue
- Dizziness
- Fainting
- Lightheaded
- Nausea
What are 2 important reasons for monitoring BP?
- Silent killer (often asymptomatic)
- Contraindication to exercise (BP may change while exercising should check before AND after)
Hypertension
High blood pressure
Hypotension
low blood pressure
Orthostatic hypotension
Low blood pressure which suddenly occurs when standing from a siting/supine position
Peripheral Oxygen Saturation
Abbreviation?
What is it?
Expressed?
SpO2
Noninvasive and measures the saturation of oxygen carried in RBC with pulse oximeter
expressed in %, 1st #: oxygen saturation, 2nd #: Heart rate
If finger reading is not working, probe can be placed on toe or ear
Finger needs to be warm, no nail polish, pulse oximeter adequate battery life
Normal SpO2
95% - 100%
Normal SpO2 in people with COPD
88% to 92%
Hypoxic/Yellow flag
proceed with caution
85% to 94%
Severely Hypoxic/Red flag
stop intervention
85% or lower
Respiratory Rate
Abbreviation?
Expressed?
Normal limits?
RR
Expressed in breaths per minute (bpm)
Normal (healthy adult): 12 to 20
Function of heart
pump the blood, rich in oxygen and nutrients, through the blood vessels to the different parts of the body and then picks up metabolic waste to be expelled
Atria vs Ventricles
Atria = receives blood
Ventricles = pump blood
Arteries vs Veins
Arteries = carry oxygenated blood away from the heart
Veins = recover deoxygenated blood from the body
Is heart disease more common in men or women?
Heart disease is more common in women than men, it’s the #1 killer of women 35+ years old accounting for more deaths every year than all cancers
In which age group is heart attack rates increasing?
Women 20-55 is the only age group in which heart attack rates are increasing
Angina
ANY SYMPTOM of a heart attack (ex: crushing chest pain, back pain, SOB)
CORONARY ARTERY DISEASE (CAD):
how does it develop?
symptoms?
what anatomy?
develops when the major blood vessels that supply your heart with blood, oxygen and nutrients become damaged or diseased
symptoms: angina, shortness of breath (SOB), heart attack
problems with ARTERIES specifically
higher risk of stroke if you have had a heart attack, vice versa
MYOCARDIAL INFARCTION (MI):
how does it develop?
symptoms?
occurs when blood flow to your heart is reduced, preventing it from receiving enough oxygen
Usually, the result of a partial or complete blockage of your heart’s arteries (coronary arteries)
Symptoms: neck/jaw/arm pain, tachycardia, SOB, nausea/vomiting, Diaphoresis
CABG
Coronary artery bypass graft surgery (The surgeon attaches the ends of the graft below the blocked heart artery. This creates a new pathway for blood to flow around a blockage
HEART FAILURE (HR)
how does it develop?
symptoms?
occurs when your heart muscle doesn’t pump blood as well as it should.
CAD or high blood pressure, can leave your heart too weak or stiff to fill and pump efficiently
Symptoms: fatigue, SOB, edema (swelling, mostly in legs)
ARRHYTHMIAS:
how does it develop?
symptoms?
occur when the electrical impulses that coordinate your heartbeats don’t work properly, causing your heart to beat too fast, too slow or irregularly.
symptoms: fluttering, tachycardia, chest pain, SOB, dizzy, fainting
CAD
coronary artery disease
HTN
hypertension or high blood pressure
SOB
shortness of breath
Edema
swelling in the body due to increase of fluid
HF
Heart failure
Atherosclerosis
(athero meaning gruel/oatmeal or paste and sclerosis meaning hardening):
deposit of plaque on arterial walls
Tachycardia
fast heart rate
Diaphoresis
sweating
ANGIOGRAM
A special dye is injected into your blood vessel and an xray machine takes images of the inside of your vessels
When to get a stent vs a bypass surgery
If necessary, surgeon will insert a stent into the blocked vessel to allow blood to flow through, if there are multiple blockages, bypass surgery may be done
ECHOCARDIOGRAM
ultrasound of the heart
Evaluates the pumping action of the heart.
Often combined with color Doppler to evaluate blood flow across the heart’s valves.
HOLTER
A wearable device to measures heart rate activity of a period of 24-72 hours
EXERCISE STRESS TEST
measures blood flow to your heart at rest and while your heart is working harder as a result of exertion or medication.
uses an ECG to monitor your heart rate while you walk on a treadmill. The speed and incline gradually increase until you experience symptoms or you reach the target heart rate
CARDIOVASCULAR DRUGS may be prescribed to…
- Promote healing
- Cure disease
- Control or slow progression of disease
- Prevent disease
- Decrease risk of complications
- Increase comfort level
- Reduce excessive activity in the body
- Sedative
How drugs affect the function of the heart:
1) Affect the force of contraction of the heart muscle
2) Affect the frequency of the heartbeat, or heart rate
3) Affect the regularity of the heartbeat
ACE inhibitors
manages hypertension
Need to monitor blood pressure, HR, edema, dyspnea
Name ends in “pril” (i.e. ramipril)
Side effects: dizzy, weak, cough, hypotension
BetaBlocker
manages tachycardia/AFib
“Blocks” elevation of HR
Name ends in “lol” (i.e. metoprolol)
Side effects: dizzy, tired, low blood sugar, headache
Diuretics
manages hypertension and edema
Need to monitor blood pressure and HR
Side effects: dizzy, muscle cramps
Vasodilators
– used to relieve angina
Need to monitor HR
Side effects: tachycardia, dizzy
What do medications generally impact
Medications will impact BP and HR – important to take this into consideration
The normal heart rate range and expression in correct units for a healthy adult is:
80-120 mm Hg
60-100 mm Hg
80-120 bpm
60-100 bpm
60-100 bpm
Select the best answer. A pulse oximeter measures:
blood pressure
heart rate
oxygen saturation and heart rate
oxygen saturation
oxygen saturation and heart rate
Hypotension is:
Low blood pressure when changing position
High blood pressure
High blood pressure when changing position
Low blood pressure
Low blood pressure
Your blood pressure is recorded as two numbers. The first number indicates _______________ blood pressure, and the second number indicates ____________ blood pressure
systolic, diastolic
manual, automatic
primary, secondary
diastolic, systolic
systolic, diastolic
It is important for rehabilitation assistants to recognize cardiac symptoms so that they can:
Diagnose some accurately
Always avoid exercising someone with symptoms
Educate patients
Monitor patients to determine treatment threshold
Diagnose some accurately
Always avoid exercising someone with symptoms
Educate patients
Monitor patients to determine treatment threshold
The rehab assistant has been assigned to a cardiac patient and measured a resting heart rate of 140 bpm at rest. What should they do?
Provide no treatment until further information is received and contact the therapist.
Treat the patient and contact the therapist afterwards.
Provide no treatment until further information is received and contact the therapist.
A blood pressure measurement of 110/80 mm Hg is considered within the normal range.
True False
True
What action would you take if during exercise your patient’s oxygen saturation levels decrease to 89%?
Continue exercise at the same level
Call for help immediately
Rest the patient for a few minutes, while monitoring the SpO2 levels
Rest the patient for a few minutes, while monitoring the SpO2 levels
Match the vital signs with the correct definition (adult range).
95 to 100
120/80
140/100
12 to 20
- Normal oxygen saturation (%)
- High blood pressure (mm Hg)
- Normal respiratory rate (breaths per minute)
- Normal blood pressure (mm Hg)
__1__
95 to 100
\_\_4\_\_ 120/80
__2__
140/100
_3__
12 to 20
You measure your patient’s oxygen saturation levels at rest by using the pulse oximeter. The pulse oximeter shows that your patient’s level of saturation is 98. Using proper abbreviations, how would you document your objective finding in your note?
SpO2 at rest = 98%
SaO2 at rest = 98%
SpO2 at rest = 98%
