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NPTE: Cardio/Pulm
Cardiovascular & Pulmonary Review
| Question | Answer |
|---|---|
| Normal pH, whole blood | 7.35-7.45 |
| Normal SaO2 Value | > or equal to 95% |
| When does a person usually require supplemental O2? | When SaO2 value is less than 88-90% or PaO2 < 58 mmHg |
| Normal adult value for WBCs? | 5,000-10,000 cells/mm^3 |
| Type of exercise for pt with WBC > 5,000 cells/mm3 | Light exercise |
| Type of exercise for pt with WBC < 5,000 cells/mm^3 and a fever | Exercise is contraindicated |
| Normal RBC value for adult male | 4.7-6.1 10^6/mm^3 |
| Normal RBC value for adult female | 4.2-5.4 10^6/mm^3 |
| Normal Hematocrit value for adult male | 42-52% |
| Normal Hematocrit value for adult female | 37-47% |
| Type of exercise for pt with < 25% Hematocrit value | Exercise is contraindicated |
| Type of exercise for pt with > 25% but less than normal Hematocrit value | Light exercise only |
| Normal Platelet count value | 150,000-450,000 cells/mm^3 |
| Define Atherosclerosis | Thickening of blood vessel wall from focal accumulation of lipids, platelets, monocytes, plaque & other debris affecting moderate & large arteries not limited to coronary arteries |
| Define Angina Pectoris | Pain in chest, jaw or L arm secondary to temporary, localized ischemia |
| Define Cor Pulmonale | Failure or hypertrophy of R ventricle resulting from disorders of the lungs, pulmonary vessels or chest wall; lung pathology produces pulm artery HTN, usually chronic |
| List Signs Associated with R-sided Heart Failure | Nausea, Anorexia, Wt gain, Fullness in Abdomen, Venous stasis, Peripheral edema |
| List Signs Associated with L-sided Heart Failure | Weakness, Fatigue, SOB, DOE, Cough, Orthopnea, Crackles |
| When is heart failure termed "Congestive"? | When edema is present |
| Define R-sided Heart Failure | Reduced venous return to heart from systemic circulation due to failure of R Ventricle |
| Define L-sided Heart Failure | Reduced Cariac Output with blood not being adequately pumped into systemic circulation due to inability of L Ventricle to pump |
| Medications to treat Congestive Heart Failure | Diuretics, Digitalis |
| Effects of Digitalis | Strengthens contraction of the heart, Slows HR, Helps eliminate fluid from the body, Increases urination |
| Effects of Diuretics | Decrease vascular fluid volume, Decrease Preload & Afterload, Control HTN |
| Effects of Nitroglycerin | Vasodilator, Reduce BP & preload, Reduce O2 demand of heart |
| Signs & Symptoms of MI | Deep visceral pain of aching or pressure, radiating to jaw and L arm, more severe than angina & unimproved with nitroglycerin |
| Which medication will pt will most likely be given if they have a heart block? | Atropine |
| Effects of Atropine | Increases HR by inhibiting vagal influence on heart |
| Appearance of first degree AV block on ECG | PR prolongation |
| Which type of AV block is a medical emergency? | Third degree AV block = complete heart block |
| Which serum enzymes appear in circulation following cardiac muscle death? | Creatine phosphate, Lactate Dehydrogenase, Serum Glutamic Oxalacetic Transaminase |
| A weak or thready pulse most likely indicates... | Low stroke volume |
| A bounding, full pulse most likely indicate... | Shortened ventricular systole & Decreased peripheral pressure |
| A bruit heard on auscultation most likely indicates... | Murmur of arterial or venous origin indicating atherosclerosis |
| The first heart sound (S1) or lub sound is made by... | Normal closure of mitral/tricuspid (AV) valves (beginning of systole) |
| The second heart sound (S2) or dub is made by... | Normal closure of aortic/pulmonary valves (end of systole) |
| The Right Coronary Artery supplies... | R atrium/ventricle, AV/SA nodes, interventricular septum & inf wall of L ventricle |
| If Right Coronary Artery is blocked, could cause... | Arrhythmies (possibly fatal) |
| The Left Coronary Artery supplies... | Ant, Sup, & Lat walls of L ventricle & interventricular septum |
| If Left Coronary Artery is blocked, could cause... | L ventricular failure which leads to pulmonary edema |
| What are the CONTRAs to Cardiac Rehabilitation Program? | Unstable angina, Resting SBP >200 or DBP > 110, Orthostatic BP drop >20 with symptoms, Acute systemic illness or fever, Uncontrolled atrial/vent arrhythmias, sinus tachycardia, active pericarditis/myocarditis, recent embolism, thromboembolism... |
| Adverse responses leading to exercise discontinuation in cardiac pts | SBP >orequal to 220, DBP >orequal to 110, Decr in SBP >20 mmHg, Signif vent/atrial dysrhythmias, ST displacement(2mm horiz/downsloping), >+3PVCs, 2nd or 3rd degree heart block |
| Signs & Symptoms of Exercise Intolerance in Cardiac pts | Angina, marked dyspnea, EKG changes suggestive of ischemia; such as multi-focal PVCs, V-tach, ST segment elevation, 3 or more PVCs |
| ST segment downsloping depression of 2-3mm or more indicates | Ischemia |
| ST segment elevation indicates | New infarct or injury or pericarditis |
| Ventricular tachycardia will have what appearance on EKG? | Run of 3 PVCs or more (showstopper) |
| Define Hyperventilation | Increased inspiration/expiration of air as a result of an increase in rate and/or depth of respiration; results in decreased CO2 (resp alkalosis) |
| Signs & Symptoms of Hyperventilation | Increased RR, Decreased BP, vasoconstriction, possible syncope, marked anxiety, wrist cramping |
| Sputum that has foul smell indicates what & can be associated with which pathology? | Anaerobic infection; COPD, Pneumonia, TB |
| Sputum that is Purulent (yellow/green appearance) indicates what & can be associated with which pathology? | Infection; Bronchitis, Cystic Fibrosis |
| Sputum that is frothy is associated with... | Pulmonary edema |
| Sputum that is mucoid (clear/thick) is indicative of... | Cystic fibrosis or conditions with chronic cough; Asthma, Bronchitis |
| Define Hemoptysis | Blood in sputum |
| Pulmonary Functions that are decreased in Obstructive Diseases | Vital Capacity & FEV1 |
| Pulmonary Functions that are decreased in Restrictive Diseases | Total Lung Capacity, Forced Respiratory Capacity, Residual Volume, Vital Capacity, PaCO2 |
| Define Cystic Fibrosis | Genetically inherited, thickening of secretions of all exocrine glands |
| Signs & Symptoms of Cystic Fibrosis | Freg resp infections, inability to gain wt, positive sweat electrolyte test, rales, wheezing, productive large amounts of mucoid, may have hemoptysis |
| Define Crackles | "rales" discontinuous sounds heard primarily during inspiration; L ventricular CHF |
| Define Rhonchi | continuous, low pitched, sonorous breath sounds most prominent in expiration; freq present with asthma & chronic bronchitis |
| Define Stridor | continuous adventitious sound of inspiration assoc with upper airway obstruction |
| Define Wheezes | continuous breath sounds high-pitched, sibilant, musical, often assoc with Asthma |
| In a pneaumothorax, the trachia will deviate.... | Away from the affected side |
| Effects of Pursed-Lip Breathing | Prolongs exhalation to slow breathing rate, Relieves SOB, Reduces work of breathing |
| Effects of Glossopharyngeal Breathing | Means of increasing inspiratory capacity when mm are severely weak, Increases vital capacity |
| Effects of Segmental Breathing | Facilitates expansion of adjacent regions of thoracic cavity that may have decreased ventilation |
| Diaphragmatic Breathing most likely taught to pts with... | Hyperventilation, Anxiety, & Stuttering |
| Glossopharyngeal Breathing most likely taught to pts with... | High Spinal Cord Injury |
| Pursed Lip Breathing most likley taught to pts with... | Emphysema |
| Effects of Diaphragmatic Breathing | Improves gas exchange & increases lung volume |
| Normal PaO2 values | 75-100 mmHg |
| Techniques to Improve gas exchange & Increase lung volumes | Diaphragmatic breathing, Segmental Breathing, Maximal Inspiratory effort |
| Techniques to Decrease Dyspnea & Increase Efficiency | Pursed lip breathing, Pacing of breath with activity or exercise, Diaphragmatic breathing |
| Techniques to Increase Expiratory force or cough | Train inspiratory muscles using resistance during inspirations, manually or with devices |
| One MET equals... | 3.5 mL of O2 per gram of body wt OR 200-250 mL of O2/min |
| Total Normal Cholesterol Values should be... | < 200 mg/dL |
| Describe Phase I (acute)of Cardiac Rehabilitation | Intensity: initially 2-3 METS, 3-5 METs by discharge Freq: 2-3xs/day Duration: short exercise sessions |
| Describe Phase II (subacute, OP or Home program) Cardiac Rehabilitation | Intensity: D/C at 9 METs Freq: 3-4xs/wk Duration: 30-60 mins with 5-10min warm-up & cool-down |
| Describe Phase III (post-acute, community exercise program) of Cardiac Rehabilitation | Intensity: must function at 5 METs in order to begin this phase; progress to 50-80% functional capacity Freq: 3-4xs/wk; Duration: 45 min per session Type: progress supervised to self-regulated |
| Define Vital Capacity | The maximum amount of air that can be exhaled after maximum inhalation |
| Define Total Lung Capacity | Vital Capacity + Residual Volume The maximum volume lungs can be expanded with greatest possible inspiratory effort |
| Residual Volume | Air remaining in lungs after maximum expiratory effort |
| Functional Residual Volume | The volume of gas in lungs at resting expiratory level |
| Forced Vital Capacity | The amount of air that can be forced out of the lungs after maximum inspirations |
| Expiratory Reserve Volume | The amount of additional air that can be pushed out after the end expiratory level of normal breathing |
| Inspiratory Reserve Volume | The additional air that can be inhaled after normal tidal breath |
| Inspiratory Capacity | The maximal volume that can be inspired following normal expiration |
| Functional Residual Capacity | Amount of air left in lungs after tidal breath out |
| Normal FEV1/FVC Ratios... | Are closer to 1 OR > 70% |
Created by:
zimrizzle
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