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IER Chapter 3
Cardiovascular PT (IER Chapter 3)
| Question | Answer |
|---|---|
| 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
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