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Acute > Week 3 > Flashcards

Week 3 Flashcards

1
Q

Automaticity

A

the heart has the ability to initiate its own electrical impulse

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2
Q

Excitability

A

heart’s ability to respond to electrical stimulus

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3
Q

Conductivity

A

allows the heart to transmit electrical impulse from cell to cell of the myocardium

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4
Q

Contractility

A

heart needs to function as one unit, so contractility allows the heart to stretch as a single unit, then passively recoil while actively contracting – ability to function as a whole unit

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5
Q

Rhythmicity

A

the heart needs to repeat is cycle in synchrony and with regularity – will have issues getting enough blood down to the heart (arrythmia) – treatment is medication or pacemaker

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6
Q

Which side of the heart is a low pressure system? high pressure system?

A

Right side of heart: low pressure system

Left side of heart: high pressure system

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7
Q

atrial systole

A

period of atrial emptying, includes atrial kick – try to make sure atrium is completely empty

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8
Q

atrial diastole

A

period of atrial filling

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9
Q

What is the 1st reading of BP?

A

ventricular systole - period of ventricular contraction

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10
Q

What is the 2nd reading of BP?

A

ventricular diastole - period of ventricular filling

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11
Q

What is heart pump dysfunction?

A

congestive heart failure

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12
Q

What is container dysfunction?

A

dysfunction of blood vessels

- HTN will cause vasoconstriction and ischemia

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13
Q

What does anaphylaxis and septic shock cause and lead to?

A

causes massive vasodilation leading to lethal hypotension

- also known as distributive shock

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14
Q

What is content dysfunction?

A

dysfunction of blood

- any kind of sustained bleeding or hemorrhaging will cause a loss of blood content

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15
Q

What is mean arterial pressure and what should it be?

A

measure of tissue perfusion - > 75 mmHg

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16
Q

P wave

A

atrial depolarization

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17
Q

PR interval

A

elapsed time between atrial depolarization and ventricular depolarization

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18
Q

QRS complex

A

ventricular depolarization and atrial repolarization

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19
Q

ST segment

A

elapsed time between end of ventricular depolarization and beginning of repolarization

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20
Q

QT interval

A

elapsed time between beginning of ventricular repolarization and end of repolarization

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21
Q

T wave

A

ventricular repolarization

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22
Q

What does ST depression of 1-2 mm mean?

A

ischemia

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23
Q

What does ST elevation mean?

A

MI

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24
Q

What does T wave inversion mean?

A

MI

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25
Q

What does prominent Q wave mean?

A

MI

26
Q

What does a wide QRS mean?

A

bundle branch block

27
Q

A-fib EKG

A

QRS wave is down

28
Q

V-fib EKG

A

squiggly mountains

- would need AED to shock rhythm back into rhythm

29
Q

V-tack EKG

A

sharp QRS wave up

30
Q

More than ______ PVS in a minute – stop exercising! Why?

A

6

- ventricles are not filling all the way and less blood is getting to the tissues

31
Q

What lab value is used to ID congestive heart failure? What is the cutoff value?

A

Brain natriuretic peptide (BNP)

- anything under 100 is normal

32
Q

SaO2 vs PaO2

A

SaO2 - saturation of peripheral O2 - percentage of available binding sites on hemoglobin that are bound with oxygen in arterial blood

PaO2 - partial pressure of O2 - amount of O2 in arterial blood

33
Q

What is normal PaO2 and PaCO2?

A

PaO2 - > 80 mmHg

PaCO2 - 35-45 mmHg

34
Q

What happens during carbon monoxide poisoning? What device shouldn’t be used and why?

A

CO bumps O2 off hemoglobin and using a pulse ox will give you a false thinking that the person has O2 in blood

35
Q

Agonal rhythm

A

irregular, < 20bpm, near death

36
Q

Atrial fibrillation - what does it lead to?

A

most common arrhythmia

  • can lead to syncope due to no atrial kick
  • found w/ CHF, CAD, HTN, and other cardiac conditions
37
Q

Ventricular tachycardia

A

rate > 100 bpm, usually regular rhythm, most common after acute MI

38
Q

Ventricular fibrillation

A

chaotic rate and rhythm, will lead to death if untreated

- need shock from AED

39
Q

Multifocal VT (torsades de pointes)

A

irregular rhythm and rate > 150 bpm

40
Q

AV block

A

rhythm disturbance where electrical conduction from atria to ventricles is partially or completely blocked

41
Q

What type of tachycardia is a product of exertion and which one is pathological after MI?

A

exertion - Atrial tachycardia

pathological - V-tach

42
Q

What position should be avoided with CHF?

A

supine

43
Q

What precautions are used after a CABG?

A

sternal precautions for 8 weeks

44
Q

What are PT considerations after cardioversion/pacemaker?

A

closely monitor activity response w/ HR and BP

- know if device has rate modulation

45
Q

What is AICD/ICD? What are precautions?

A

automatic cardiac defibrillator

- patient can’t use that arm that pacemaker is on for 1-3 days post surgery

46
Q

What type of patient uses a life vest? What should you do if walking and it notifies it will apply a shock?

A
  • patient who is high risk for cardiac arrest - awaiting heart transplant or not a candidate for a heart transplant
  • If walking a patient and it alerts, sit them down and figure out if shock is necessary or not – can manual override
47
Q

What is VAD? What are rehab and precautions?

A

ventricular assist device

  • rehab - phase 1-2 cardiac rehab
  • precautions - know emergency procedures in case of battery failure, maintain patency of drive lines w/ external pump, monitor hemodynamics
48
Q

What predicts likelihood of discharge of CAD?

A

Marburg Heart Score

55+ in men, 65+ in women
Known CAD or cardiovascular disease
Pain not reproducible by palpation
Pain worse with exercise
Patient’s assumption that pain is cardiogenic in origin
49
Q

Cardiac PT Interventions goals

A
  • assess hemodynamic response
  • maximize activity tolerance
  • patient/caregiver education for activity/behavior modification
50
Q

Absolute Indications and withhold treatment

A
  • decompensated CHF
  • 2nd degree heart block w/ PVC
  • 3rd degree heart block
  • > 10 PVC/min at rest
  • chest pain w/ new ST segment changes
  • New onset A-fib w/ rapid ventricular response at rest (HR > 100 bpm)
51
Q

Relative Indications to modify or withhold treatment

A

resting HR > 100 bpm
resting HTN > 160 systolic and > 90 diastolic
hypotension at rest (<80 systolic)
ventricular ectopy at rest
A-fib w/ rapid ventricular response at rest (HR > 100 bpm)
psychosis/unstable psych condition

52
Q

How many beats over resting HR is generally safe intensity level?

A

20-30 bpm

53
Q

Patients on beta-blockers: do not exceed____ beats above resting HR

A

20

54
Q

AICD: target HR ______ beats below threshold rate on defibrillator

A

20-30

55
Q

T/F: You can use HR to prescribe exercise post-heart transplant

A

False - You CANNOT use HR to prescribe exercise after heart transplant

56
Q

What is HHR (HR recovery)?

A

difference between peak HR w/ exercise minus HR at 60 seconds

57
Q

What is an abnormal response to BP?

A
  • systolic decrease of 10 mmHg below resting
  • systolic response >180 mmHg
  • diastolic response > 110 mmHg
58
Q

What is goal of phase 1 cardiac rehab? When does it start?

A

starts as soon as patient is stable

goal is to tolerate ADL’s, walking functional distances, climbing stairs
- education is essential

59
Q

What is goal of phase 2 cardiac rehab? When does it start?

A

starts about 2 weeks after cardiac event

continue patient education and progresses exercises and activities

60
Q

When does phase 3 of cardiac rehab begin?

A

usually begins 2-3 months after cardiac event

61
Q

As O2 stats drop, the patient becomes more what?

A

acidotic

Acute (14 decks)

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