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IER Chapter 3

Cardiovascular PT (IER Chapter 3)

QuestionAnswer
Stroke Volume (SV) Amount of blood ejected with each contraction. Normal: 55-100mL/beat
Cardiac Output (CO) Amount of blood ejcted per minute. (SV x HR). Normal: 4-5L/min
Cardiac Index CO divided by body surface area. Normal: 2.5-2.3L/min
Ejection Fraction (EF) Percentage of blood emptied from LV during systole. Normal: 60-70%
Myocardial Oxygen Demand (MVO2) Energy cost to the myocardium. Calculated by rate pressure product (RPP)
Rate Pressure Product (RPP) Heart rate times systolic blood pressure (HR x SBP)
Hyperkalemia Increased concentration of potassium decreases HR & force of contraction. Produces wide PR interval & QRS, and tall T waves.
Hypokalemia Decreased concentration of potassium. Produces flat T waves, prolonged PR & QT intervals. May lead to V-Fib.
Aortic Valve Auscultation 2nd right intercostal space at the sternal border
Pulmonic Valve Auscultation 2nd left intercostal space at the sternal border
Tricuspid Valve Auscultation 4th left intercostal space at the sternal border
Mitral Valve Auscultation 5th left intercostal space at the midclavicular area
Apical Pulse Palpation Point of maximal impulse (PMI). 5th intercostal space at the midclavicular line.
S1 ("lub") closing of mitral & tricuspid valves. Beginning of systole. Decreased in first degree heart block.
S2 ("dub") Closing of aortic & pulmonary valves. End of systole. Decreased is decreased in aortic stenosis.
S3 Ventricular filling. In older individuals it may indicate CHF of LV.
S4 Ventricular filling & artial contraction. Indicates pathology such as: CAD, MI, aortic stenosis, or chronic HTN.
P wave Atrial depolorization
P-R interval Time it takes for impulse to travel from Atria to Purkinje Fibers
QRS complex Ventricular depolarization
ST segment Beginning of ventricular repolarization
T wave Ventricular repolarization
Stage 1 HTN 130-140/90-100mmHg
Stage 2 HTN 140-160/100-110mmHg
Stage 3 HTN >160/110mmHg
Dyspnea Shortness of breath. Dyspnea on exerction (DOE)
Orthopnea Inability to breathe when in a reclined position.
Paroxysmal Nocturnal Dyspnea (PND) Sudden inability to breathe occuring during sleep.
Dyspnea Scale +1 mild, noticeable only to Pt+2 mild, noticeable, some difficulty+3 moderate , but can continue with activity+4 severe & cannot continue with activity
Hypoxemia Low amount of oxygen in the blood. Saturation <90%.
Hypoxia Low oxygen level in the tissues
Anginal Scale 1+ light, barely noticeable2+ moderate, noticeable3+ severe, very uncomfortable4+ most severe pain ever experienced
Inferior MI Occlusion of the RCA, affecting RV & upper conduction system.
Lateral MI Circumflex artery occlusion
Anterior MI Occlusion of the LAD, affecting the lower conduction system
Signs Associated with Right Sided CHF Nausea, weight gain, peripheral edema, murmur of tricuspid insuffiency
Signs Associated with Left Sided CHF Fatigue, cough, SOB, DOE, orthopnea, PND, diaphoresis, tachydardia, crackles, confusion, decreased urine output, murmur of mitral insufficiency
Nitrates (Nitroglycerin) Causes peripheral & coronary vasodilation, reduces myocardial oxygen demand, and reduces chest pain (angina)
Beta-adrenergic Blockers Cause a sinus bradycardia and AV block to decrease HR & contractility to reduce BP
Calcium Channel Blockers Inhibit the flow of calcium, decrease HR, dilate coronary arteries, reduce BP & contractility
Digitalis (digoxin) Increases contractility but decreases HR by slowing conduction through the AV node. Primarily used to treat CHF
Percutaneous Transluminal Coronary Angioplasty (PTCA) Surgical dilation of a blood vessel using a balloon tipped catheter inflated insude the lumen to relieve obstructed blood flow.
Intravascular Stents An endoprosthesis (wire mesh) is implanted post-angioplasty
Coronary Artery Bypass Grapht (CABG) Surgical bypass of a coronary artery occlusion using either a saphenous vein or internal mammary artery.
Ventricular Assist Devices (VADs) An accessory pump that improves tissue perfusion & maintains circulation. Used in severely involved patients.
Thromboangitis Obliterans (Buerger's Disease) Chronic, inflammatory vascular occlusive disease of small arteries & veins. Common in young adults who smoke.
Raynaud's Disease Abnormal vasoconstrictor reflex exacerbated by cold or emotional stress.
Dopamine Alpha-adrenergic effects to vasoconstrict & increase BP. >5mcg used as a pressor to increase BP (contraindication to ex). <5mcg used for renal perfusion (ok to ex).
Levophed Used to increase BP and is a contraindication to ex/walking.
Cardiogenic Shock Often a direct result of MI. Global hypoperfusion, decreased urine output, altered mentation, hypotension.
Cholecystectomy Gall bladder removal
Cardiac Temponade A condition in which the heart is unable to fully expand due to pericardial effusion.
Normal Arterial Blood Gas Values(ABG's) pH (7.35-7.45); PaO2 (70-100mmHg); PaCO2 (35-45mmHg); HCO3 (22-26mEq/L); O2 Sat (>95%)
Respiratory Alkalosis When ventilation is increased, more carbon dioxide is removed causing pH to increase (more base).
Respiratory Acidosis When ventilation is decreased, less carbon dioxide is removed causing an increase in carbonic acid and lowering the pH (more acidic).
Metabolic Alkalosis When bicarbonate (HCO3) levels are high. Possible causes: vomitting, nasogastric suction, certain diuretic meds...HCO3 may also elevate to compensate for respiratory acidosis.
Metabolic Acidosis When bicarbonate (HCO3) levels are low. Possible causes: diabetic ketoacidosis, uremia (with renal disease), lactic acidosis...HCO3 may also decrease to compensate for respiratory alkalosis.
Created by: carsonwolf on 2010-03-14



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