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Cardiac
NPTE: Cardiac (scorebuilders 2008)
| Question | Answer |
|---|---|
| Phase I cardiac rehab program | • Consists of pt/family education, self-care eval, continuous monitoring of vitals, low-level exercise: AROM, amb, and self-care. • Ends with: low-level exercise test. • Lasts 3-5 days. |
| Phase II cardiac rehab program | • Lasts 2-12 wks. • Frequency = 2-3x/wk. • Pts. monitored closely and supervised during all activities. • Progress to Phase III when: clinically stable, indep. w/ self-monitoring, don't require ECG monitoring |
| Phase III cardiac rehab program | • Lasts 6-8 wk. • Frequency: 1x/wk • Includes exercise, education, and counseling. • Max symptom-limited exercise test is required. |
| Phase IV cardiac rehab program | • Lasts throughout the pts. lifetime • Requires independence with self-monitoring, stable cardiac status, no contraindications to exercise, at least 5 MET capacity |
| MET level? • Eating | 1 |
| MET level? • Toileting | 1-2 |
| MET level? • Driving a car | 1-2 |
| MET level? • Dressing | 2 |
| MET level? • Walking (2 mph) | 2-2.5 |
| MET level? • Bathing | 2-3 |
| MET level? • Cooking | 2-3 |
| MET level? • Light housework | 2-4 |
| MET level? • Light gardening | 3-4 |
| MET level? • Showering | 3.5-4 |
| MET level? • Sexual intercourse | 4-5 |
| MET level? • Dancing | 4-5 |
| MET level? • Walking (4 mph) | 4.5-5.5 |
| MET level? • Swimming | 4-8 |
| MET level? • Shoveling snow | 6-7 |
| MET level? • Mowing the lawn | 6-7 |
| Hypertension in: • Infant | >90/60 mmHg |
| Hypertension in: • Children | >120/80 mmHg |
| Hypertension in: • Adults - borderline | >140-159/90-99 mmHg |
| Hypertension in: • Adults - moderate | >160-179/100-109 mmHg |
| Hypertension in: • Adults - severe | >180/110 mmHg |
| Hypotension exists if: | Systolic pressure <100 mmHg |
| Pathological Changes in ECG: • Depressed QRS | Indicates: heart failure, ischemia, pericardial effusion, obesity, COPD |
| Pathological Changes in ECG: • Ectopic foci | A location where abnormal myocardial depolarization originates. Occurs if the rhythm of the ectopic pacemaker increases, the rhythm of normal pacemakers is inhibited, or if the conduction path from the normal pacemaker to the ectopic foci is blocked. |
| Pathological Changes in ECG: • Elevated QRS | Hypertrophy of myocardium |
| Pathological Changes in ECG: • Q wave | previous myocardial infarction |
| Pathological Changes in ECG: • ST segment elevation | acute myocardial infarction |
| Pathological Changes in ECG: • Atrial fibrillation | hypertension, CHF, CAD, rheumatic heart disease, cor pulmonale, pericarditis, illegal drug use |
| Pathological Changes in ECG: • Supraventricular tachycardia | mitral valve prolapse, core pulmonale, digitalis toxicity, rheumatic heart disease |
| Pathological Changes in ECG: • Premature atrial contraction | intake of caffeine, emotion stress, smoking, pathologies like CAD, electrolyte imbalance, infection, CHF |
| Pathological Changes in ECG: • Ventricular tachycardia | post myocardial infarction, rheumatic heart disease, CAD, cardiomyopathy |
| Pathological Changes in ECG: • Ventricular fibrillation | long-term or severe heart disease, post myocardial infarction, hypercalcemia, hypokalemia, hyperkalemia |
| Pathological Changes in ECG: • Multifocal ventricular tachycardia | hypokalemia, hypomagnesemia, hypothermia, drug-induced through antiarrhythmic medications |
| Pathological Changes in ECG: • Premature ventricular contractions | intake of caffeine, emotional stress, smoking, pathologies like CAD, digitalis toxicity, cardiomyopathy, myocardial infarction |
| Pathological Changes in ECG: • Complete heart block (3rd degree) | infection, electrolyte imbalance, CAD, anteroseptal myocardial infarction, impairment with the AV conduction system |
| Pathological Changes in ECG: • Asystole | failure of all pacemakers to initiate, conduction system failure, acute MI, ventricular rupture |
| Cardiac markers for MI | CK/CK-MB, Trop I, Trop II, Myoglobin, LDH-I |
| Blood test for CHF | BNP, should be below 100 normally |
| Total cholesterol level | <200 |
| Triglyceride levels | 10-140 |
| LDL level | 60-160 |
| HDL level | 29-77 |
| PT level | prothrombin time. 10-13. Assesses clotting ability of factor I, ii, v,vii, x. Used with Coumadin |
| PTT level | partial thromboplastin time. 60-70. Assesses clotting ability of all factors except vii, xiii. More sensitive than PT in detecting minor deficiencies. Monitors oral anticoagulants. |
| Hematocrit | Percent of packed RBC in total blood volume. Used to identify abnormal states of hydration. Low = weakness, chills, dyspnea. High = increased risk of thrombus. - Normal: Males = 40-54. Females = 37-47. Newborns = 49-54. Children = 35-49. |
| Hemoglobin | assess for blood loss. Low = hemorrhage. High = polycythemia or dehydration. - Normal: Males = 14-18. Females = 12-16. Newborns = 16.5-19.5. Children = 11.2-16.5 |
| Catheterization: Name what it measures: • Swan-Ganz | Pulmonary artery catheterization. Immediate cardiopulmonary pressure measurements: pulmonary artery pressure. |
| Catheterization: Name what it measures: • Hickman catheter | indwelling right atrial catheter: inserts into the right atrium, allows removal of blood samples, administration of medication, and monitoring of central venous pressure. |
| Normal HCO3 level | 22-26 mEq/L • If the HCO3 is below 22, the patient is metabolic acidotic. If the HCO3 is above 26, the patient is metabolic alkalotic. |
| Normal pCO2 level | 35-45mmHg. • Below 35 is resp alkalotic, above 45 is resp acidotic. |
| Auscultation of: • Aortic valve | 2nd intercostal space on right by sternum |
| Auscultation of: • Pulmonic valve | 2nd intercostal space on left by sternum |
| Auscultation of: • Tricuspid | under 4th rib on left by sternum |
| Auscultation of: • Bicuspid (Mitral) | under 5th rib on left midclavicular line. |
Created by:
liz124714
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