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Cardiopulmonary > Week 2 CVP Exam and Assessment > Flashcards

Week 2 CVP Exam and Assessment Flashcards

1
Q

what are the elements of patient/client management?

A

examination (pt history, systems review, tests/measures), evaluation (eval of data to make a clinical judgement), diagnosis )classifies a pt within a specific practice pattern and indicates the primary dysfunctions), prognosis (determining the predicted level of optimal function), intervention, outcomes

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2
Q

what is included in the patient/client history?

A

-information on current symptoms and medical problems
-past medical history
-provides initial info to identify impairments and functional limitations

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3
Q

what should a PT look at during the medical chart review?

A

diagnosis (primary and secondary) and date of event
symptoms (not just pain) cardiac, vascular, and pulmonary
other/past medical problems (injuries, neuro conditions, integ. issues, and psychological conditions)
medications
risk factors for heart disease
risk factors for DVT
relevant social history
clinical laboratory data
radiological studies
oxygen therapy and other respiratory treatment
arterial blood gases
cardiac catheterization data
vital signs
surgical procedures
other therapeutic regimens
electrocardiogram and serial monitoring
pulmonary function tests (spirometry)
hospital course
nutritional intake
occupational history
home environment and family situation

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4
Q

what are the risk factors for heart disease?

A

HTN, smoking, elevated cholesterol, family history, stress, sedentary lifestyle, older age, obesity, diabetes

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5
Q

what are the classic cardiac symptoms?

A

chest pain, tightness, pressure, shortness of breath, palpitations, indigestion, burning

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6
Q

what are the classic pulmonary symptoms?

A

shortness of breath/dyspnea, wheezing, cough, increased work of breathing, sputum

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7
Q

what are some risk factors for DVT to look out for?

A

medications, inactivity, injury, surgery, and cancer diagnoses

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8
Q

what is the purpose of an interview with the pt and family?

A

to gather important info about the present complaint, history of medical problems, report of symptoms, risk factors, perception/understanding of the problem, family situation, readiness to learn, goals for rehabilitation

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9
Q

what is included in a systems review?

A

communication, cardiovascular and pulmonary, musculoskeletal system, neuromuscular system, integument system

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10
Q

what should a physical examination of the CVP systems include?

A

observation of general appearance, facial characteristics, evaluation of neck, evaluation of chest

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11
Q

what is the significance of tripod or professorial position?

A

they provide stabilization of the thorax and arms to increase the effectiveness of accessory muscle use during breathing

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12
Q

what is semi-fowlers postion?

A

most pts with cardiopulmonary issues cannot tolerate laying flat and will either have the head of the bed elevated or have multiple pillows

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13
Q

why should we look at body type during physical examination?

A

can give an idea of nutrition and energy to participate in PT

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14
Q

what are some facial signs of distress?

A

nasal flaring, sweating, and change in pupil focus or enlargement

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15
Q

what is the significance of pursed lip breathing?

A

sign of obstructive lung disease
improves gas exchange and decreases the trapping of air in the lungs by maintaining a back pressure that keeps the airways open

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16
Q

what should we be looking for in a patient neck during physical examination?

A

shortened and/or hypertrophied SCMs due to chronic use or forward positioning that assists with breathing
more prominent clavicles and scalenes from the muscles helping lift the chest wall during breathing

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17
Q

what is JVD (jugular venous distension)?

A

sign of right-sided heart failure and increased volume in the venous system
inspect with HOB @ 45 degrees
measure the height of the bugle from sternal angle to top.
>4cm = JVD

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18
Q

what should we be looking for in the pts chest during physical examination?

A

symmetry, configuration, rib angles, intercostal spaces and muscles
compare anterior and posterior diameters

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19
Q

what is pigeon chest?

A

sternum higher than the ribs

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20
Q

how does increased sternal depth affect cardiac function?

A

by limiting the space for the heart to work

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21
Q

how does hyperinflation affect rib angles?

A

lifting of the ribs stretches and flattens out the diaphragm. makes it less effect with less ROM

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22
Q

what are the assessment categories of a dynamic chest wall exam?

A

breathing rate
inspiratory to expiratory ration
motion of chest wall
breathing pattern

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23
Q

what is normal breath rate for adults

A

12-20 breaths pm

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24
Q

what is normal inspiration to expiration ratio for adults

A

1:2

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25
Q

what is normal inspiration to expiration ratio for pts with COPD?

A

1:3 or 1:4

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26
Q

what is apnea?

A

absence of breathing

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27
Q

what is bradypnea?

A

slow, regular, shallow or normal depth (when heavily medicated)

28
Q

what is eupnea?

A

normal rate depth and rhythm

29
Q

what is tachypnea?

A

fast, shallow, regular (restrictive)

30
Q

what is dyspnea?

A

difficulty-rapid, shallow, regular, accessory mm

31
Q

what is hyperventilation?

A

regular, fast, increased depth

32
Q

what is orthopnea?

A

difficulty breathing in supine (not erect)

33
Q

which condition results in prolonged expiration?

A

COPD

34
Q

what is phonation?

A

evaluation of speech in an assessment of shortness to breath
number of words between each breath (average is documented)

35
Q

how can you describe cough and cough production

A

strength and description of secretions (color, consistency, amount, smell)

36
Q

what is the different between a productive and non-productive cough?

A

productive = sputum
non-productive = wet but not coughed up

37
Q

what is the reason behind clear, white, or gray sputum?

A

usually indicated healthy lungs, but a lot of sputum may indicate a lung disease, allergy, or viral infection

38
Q

what is the reason behind dark yellow or green sputum?

A

can indicate a bacterial or viral infection, such as pneumonia, or cystic fibrosis, an inherited condition that involves excess mucus buildup

39
Q

what is the reason behind brown sputum?

A

often occurs in people who smoke and those with block lung disease, a condition resulting from exposure to coal dust

40
Q

what is the reason behind pink sputum?

A

can indicate pulmonary edema (fluid in lungs) from condition such as congestive heart failure

41
Q

what is the reason behind red sputum?

A

can be a sign of internal injury, lung cancer, or a pulmonary embolism

42
Q

what is digital clubbing a sign of?

A

chronic tissue hypoxia

43
Q

what is the diamond window?

A

test for clubbed finger. if there is a diamond window circulation is normal

44
Q

what are two ways to evaluate circulation?

A

capillary refill
and pulses

45
Q

what is the 4 point scale for pulses?

A

0 = absent
1+ = palpable but thready and weak, easily obliterated
2+ normal, easily identified, not easily obliterated
3+ increased pulse; moderate pressure for obliteration
4+ full bounding; cannot obliterate

46
Q

what is the depth and rebound time scale for edema?

A

1+ up to 2mm; immediate
2+ 2-4mm; <15 sec
3+ 4-6mm; 15-30 sec
4+ more than 6mm; more than 30 sec

47
Q

what is peripheral edema indicative of?

A

right-sided heart failure or peripheral problem (venous insuff)

48
Q

what is edema with ascites (distended stomach indicative of?

A

liver failure, renal failure, or disseminated cancer

49
Q

what are the four areas of the auscultations of the heart?

A

aortic: right 2nd intercostal space lateral to the sternum
pulmonary: left 2nd intercostal space lateral to the sternum
tricuspid: inferior left sternal margin
mitral: 5th intercostal space. location of the apex beat

50
Q

what is S1?

A

closure of mitral and tricuspid valves (lub: onset of systole)

51
Q

what is S2?

A

closure of aortic and pulmonary valves (dub: diastole relaxation)

52
Q

what is S3?

A

(abnormal)
immediately following S2 (early diastole)
key sign in heart failure

53
Q

what is S4?

A

(abnormal)
just before S1 (late in diastole)
associated with atrial contraction

54
Q

what are murmurs?

A

caused by turbulent flow. systolic
swishing or clicking

55
Q

what is a pericardial friction rub?

A

sign of pericarditis

56
Q

what are the common abnormal lung sounds?

A

wheezes: continuous, constant pitch, varying duration
crackles: discontinuous, brief bursts of popping bubbles
pleural rub: sounds like 2 pieces of leather or sandpaper rubbing together

57
Q

what is egophony?

A

auscultate each point while pt says “e”. with secretions sound changes to “a”

58
Q

what is bronchophony?

A

auscultate each point while pt says “99”
normal is muffled
with secretions 99 is loud and clear

59
Q

what is whisper pectoriloquy?

A

auscultate while pt whispers
normal is muffled
with secretions is loud and clear

60
Q

why is it important to examine the mediastinum (tracheal position)?

A

with a pneumothorax the lung collapses and the trachea will deviate towards that side
with solid mass of fluid from pleural effusion the trachea will deviate away from the issue

61
Q

what is fremitus?

A

the vibration produced by the voice or secretions in the airway that can be transmitted to the chest wall and palpated by placing the hands slightly on the chest wall

62
Q

what is mediate percussion? and the potential sounds?

A

evaluation of any abnormal findings especially changes in lung density and diaphragmatic excursion
dull: liver or dense tissue
tympanic sound: loud, long, hollow; hyperinflated chest

63
Q

arterial BP is a general indicator of:

A

function of heart as a pump

64
Q

what are some abnormal systolic responses to an activity evaluation?

A

hypertensive, hypotensive, blunt or flat

65
Q

what are the clinical implications of abnormal responses to an activity evaluation?

A

coronary artery disease, moderate to severe aortic valvular stenosis, or other cardiac muscle dysfunction

66
Q

what are the abnormal diastolic responses to an activity evaluation?

A

increase or decrease of more than 10mmHg; sustained elevation during recovery

67
Q

what are some symptoms of CV inadequacy?

A

angina, pericarditis, mitral valve dysfunction, bronchospasm, esophageal spasm, SOB, palpitations, dizziness, fatigue

Cardiopulmonary (23 decks)

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