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Cardio Final


Mucoid Sputum clear, thin= Asthma
Frothy Sputum Pulmonary Edema
Purulent sputum thick, colored (pus)
Yellow/Green/Copious Sputum Cystic Fibrosis w/ pseudomonas infection
Rusty Sputum Streptococcal pneumonia
Fetid Sputum Foul smelling = lung abscess
Tachycardia causes > 100/min - hypoxemia, hypertension, fever, anxiety
Bradycardia causes < 60/min - complete heart block, endurance athletes, beta blockers
Tachypnea causes > 20/min - "J" receptor stimulation, metabolic acidemia, anxiety
Bradypnea causes < 10/min - drug o.d., head trauma, hypothermia
Hypertension causes > 150/90 - high SVR
Hypotension causes < 90/60 - hypovolemia, shock, CHF
Pursed lip breathing seen in COPD, prevents airway closure
What is Ptosis? Causes? Drooping eyelids. Myasthenia Gravis
What is JVD? Common cause? Jugular Venous Distention: method quantifying R heart pressure. Cor Pulmonale(abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels)
Suprasternal Notch Groove at the top of the Manubrium. Palpate to check for tracheal shifts.
Barrel Chest occurs? COPD
Obstructive Breathing 'Pursed Lips', prolonged exhalation, active neck accessories w/ 'clavicular lift'
Restrictive breathing rapid, shallow, decreases WOB
Vocal Fremitus Vibrations from vocal cords
Tactile Fremitus Palpation to assess vocal fremitus, pt repeats '99'
Paradoxical Movement Chest wall goes in w/ inspiration, out w/ expiration
Abdominal Paradox Abdomen sinks in w/ inspiration, seen in COPD pts w/ impending ventilatory failure
Acrocyanosis Peripheral - nailbeds, due to poor perfusion, low CO, often in COPD pts
Central Cyanosis Oral mucosa, due to severe -
Increased Tactile Fremitus Denotes increased density(consolidation)(less air), pneumonia, atelectasis, fibrosis
Decreased Tactile Fremitus Denotes decreased density(more air), pneumothorax, emphysema
Thoracic Expansion - Bilateral Decrease causes COPD, neuromuscular diseases
Thoracic Expansion - Unilateral Decrease causes Lobar consolidation, atelectasis, pneumothorax, pleural effusion
Subcutaneous Emphysema Air w/in subq tissues, noted w/ pneumomediastinum & pneumothorax, feels like bubble wrap & sounds like rice crispies
Normal Percussion sound Easy to hear, low pitch
Hyperresonant sound & causes Pneumothorax. Hyperinflation from asthma, emphysema (more air)
Dullness sound & causes Atelectasis, pleural effusion, consolidation(pneumonia) (less air, dull, dense, fluid)
Bronchial causes Denotes loss of alveoli - consolidation, atelectasis
Diminished causes Hypoventilation, hyperinflation, pneumothorax(absent), pleural effusion
Adventitious sound & causes Heard in the airways - crackles - 'velcro'. Fluid in the airways, CHF, secretions
Wheezing sound & causes bronchospasm, asthma, large airway obstruction, chronic bronchitis
Stridor causes Upper airway obstruction - croup, post-extubation
Hepatomegaly enlarged liver, Assoc w/ Cor Pulmonale
Ascites Serous fluid in the peritoneal cavity. Assoc w/ CHF
Clubbing Enlargement of terminal phalanges. Assoc w/ CHF, COPD
Pedal Edema Fluid in the subq tissues of the ankles/feet. Assoc w/ CHF, Cor Pulmonale
Slow Capillary Refill assoc w/ Hypovolemia, CHF
Cold hands, feet assoc w/ Shock, hypovolemia
COPD inspection JVD, 'pursed lips', active neck accessories w/ 'clavicular lift', barrel chest, hepatomegaly, clubbing, acrocyanosis, pedal edema, Decreased tactile fremitus, thoracic expansion bilateral decrease, Hyperresonant. Diminished, wheeze
Consolidation inspection Increased tactile fremitus, thoracic expansion unilateral decrease, Dullness. Bronchial breath sounds
Tension Pneumothorax inspection Thoracic expansion unilateral decrease, tracheal shift(away), Hyperresonant. Absent breath sounds. Blood pressure drops, peak vent pressure increases
Pleural Effusion inspection thoracic expansion unilateral decrease, tracheal shift(away), Dullness. Absent breath sounds
Cor Pulmonale inspection JVD, hepatomegaly, pedal edema
Shock/Hypovolemia Slow capillary refill, peripheral skin temp decreased
What is Radiolucent? black areas on xray, low density, air (pneumothorax, bullae, pneumatoceles, parenchyma)
What is Radiopaque? White or grey areas on xray, high density, fluid, fat, bone
The trachea shifts towards problems within the lungs and? away from problems outside of the lungs
PA engorgement = Cor pulmonale
Cardiac silhouette description Heart ratio should be< 50% size of chest area, Right diaphragm 2cm higher than Left
Atelectasis xray description Lobar, tracheal shift toward affected area, hemidiaphragm elevation, narrowed posterior rib spaces, volume loss
Pneumothorax xray description Black hemithorax, lung mass toward Hilum, tracheal shift away from affected area
Hyperinflation (copd) xray? Narrow tear/pear shaped heart, prominent PAs, low & flat diaphragms, wide posterior rib spaces, horizontal posterior ribs, radiolucent lung fields, small or narrow heart shadow
A miliary pattern in the apicies? TB
If there is white where there should be black on an xray, this is called? consolidation, Aleolar opacification (white areas)
Interstitial Disease xray description "Cobbwebs", Honeycombing, miliary pattern, diffuse nodules 2-4cm diameter
A ground glass appearance? ARDS
Cardiogenic Pulmonary Edema (CHF) xray desription? Increased heart ratio > 50%, Kerly B lines - prominent in R lung base, lymph vessels full of fluid. Blunted C/P Angles - notably on R side, dense fluffy lung field opacities that project out from the Hilar areas that look like a 'batwing' or 'butterfly'
Blunting of the costophrenic angles and a menicus sign are noted with? pleural effusion
What is a stemi? an elevated or depressed ST segment. ST elevated MI, not getting enough O2 to the heart causing ischemia
Frothy white or pink sputum is noted with Pulmonary edema
The two most common causes of hemoptysis are bronchogenic carcinoma and chronic bronchitis
A child with croup will exhibit a cough most commonly referred to as barking, can have stridor
Wheezing is commonly described as chest tightness
An increase in the cardiothoracic (C/T) ratio is most commonly associated with CHF
Hemidiaphragm elevation and loss of lung volume are noted on chest film with atelectasis
A D-Dimer blood test is ordered for a suspected blood clot? positive results indicates clot
A CPK test if? marker of stress to muscle tissue, could be heart or even exercise, and systemic inflammation
A 3rd heart sound is abnormal and indicates? CHF
A 4th heart sound is abnormal and indicates? cardiomegaly or MI, left cardiomegaly (COPD) Right cardiomegaly( High BP)
When an MI is suspected, troponin levels are drawn? >0.1 indicate an MI
An elevated brain natriuretic peptide (BNP) ? CHF
Shock is? not getting enough 02 to a vital organ
When tissues don't get enough 02 they produce lactate, a lactate great than 2 indicates? shock, improving lactate mean 02 therapy is working
A low BP can cause organs to not get enough 02 because of lack of blood circulation, this can cause? septic shock, when blood pressure drops significantly
Systemic vascular resistance is normally 900-1400, a reduced SVR indicates? sepsis
Cardiogenic pulm edema occurs with an elevated PCWP >20, non cardiogenic? pulm edema with normal wedge= ARDS
Fluid overload, hypervolemia, known as flooding will increase? all hemodynamic values, including BP
Dehydration, shock, blood loss, known as drought will decrease? all hemodynamic values including BP
A patient with a lactate greater than 2? not getting enough 02, shock
What is the normal RBC count for males and females? males 5-6 mill, females 4-5 mill
What are the normal HB levels? males 14-17 g/dl, females 12-15 g/dl
What are the normal hematocrit levels? males 40-50%, females 35-45%
What is the normal WBC level? 5000-10,000/mm
Leukocytosis is an icrease in WBC's, this indicates? bacterial infection or inflammatory response
Leukopenia is a decrease in WBC's, this indicates? chemo, radiation, systemic disease
Anemia will? decrease RBC, HB, Hematocrit increased RBC breakdown, or decreased RBC production, blood loss
Polycythemia is increased RBC, HB, and hematocrit, this is seen in patients with? chronic hypoxemic lung/heart disease, can cause rt heart failure, treated with 02 therapy COPD, pulm fibrosis
If eosinophilia is found in the sputum this always indicates? Asthma
Thrombocytopenia is a decrease in clotting cells, this poses a risk of bleeding. What symptoms are seen with this? petechiae(red, purple spots), ecchymosis (blue, black spots) caused by meds like prednisone, heparin
What is SOAP? Subjective- Pt states, Objective- therapist finds (vitals, ABG), Assessment- therapists conclusion based on S and O, Plan-treatment plan
Oxygen therapy protocol is used too? treat hypoxemia, decrease wob, and decrease myocardial workload
Hyperinflation protocol is used to prevent or treat atelectasis and alveolar consolidation, the methods for this are? cough and deep breathing, IS, IPPB, CPAP, PEEP
Bronchial hygiene therpay is used to mobilize secretions, these methods are? increased bronchial hydration, cough and deep breathing, CPT, PD, percussion, suctioning, mucolytic, bronchoscopy,
What is an infiltrate seen on an x-ray? A pulmonary infiltrate is a substance denser than air, such as pus, blood, or protein, which lingers within the parenchyma of the lungs. Pulmonary infiltrates are associated with pneumonia, tuberculosis
What is an air bronchogram seen on an xray? filling of alveoli by fluid or inflammatory exudates.
What vent parameter is most commonly seen in a patient with sepsis? high ve
What are symptoms of DKA? fruity breath, kussmauls, possible coma
What are the clinical indications to provide oxygen therapy? Sp02 <90%, Pa02 <80 Acute Hypoxemia; tachypnea, tachycardia, cyanosis, confusion
What are clinical indications for hyperinflation therapy? atelectasis, consolidation, fibrosis, opacity (white area) seen on xray, bronchial breath sounds, dull percussion note, restrictive pft's
What are clinical indications for bronchial hygiene therapy? excess sputum with a weak or strong cough, consider color of sputum, sputum viscosity, and ronchi breath sounds
What are clinical indications for aerosolized therapy? bronchospasm, airway secretions, relax bronchial smooth muscle, wheezing,
What is transudate sputum? thin and watery, few cells, less protein, CHF, Pulm emboli
What is exudate sputum? thick and opaque, many WBC's, more protein, pneumonia, TB, lung cancer, fungal disease
Created by: juialynn92
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