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Chapter 12
Ch.12 Cardiopulmonary Procedures
| Question | Answer |
|---|---|
| A disposable electrode is held in place by what? | Adhesive |
| All of the following are characteristics of a low-range peat flow meter except: | It is used for adults |
| All of the following are characteristics of a nasal cannula except: | Patients who need a high flow of oxygen |
| What are the characteristics of asthma? | Recurrent episodes of coughing, chest tightness, shortness of breath, and wheezing |
| What are the electrode guidelines? | Always check the expiration date on electrodes before applying. They must be stored properly to prevent electrolyte drying out. Store in a cool area away from sources of heat. When pouch is open, store in a Ziploc bag to preserve moisture. |
| Examples of pulmonary function tests include: | Spirometry, lung volumes diffusion capacity, arterial blood gas studies, pulse oximetry, and cardiopulmonary exercise test |
| How do you calculate the peak flow meter? | Take the highest reading |
| How do you prepare a patient for a ECG? | Do not apply body lotion, oil, or powder to on the day of the test. Wear comfortable clothing and a shirt or blouse that can be removed easily. Avoid wearing tights since the electrodes need to be placed on lower legs. |
| The following may require home oxygen therapy except: | Someone with hepatitis |
| All of the following result in muscle artifacts except: A) patient discomfort B) an apprehensive patient C)electrodes may have come loose D)patient coughs or talks | C) electrodes may have come loose |
| Electrocardiograph is a recording of what? | Electric activity of the heart |
| Blood enters the right atrium from what? | Superior and inferior vena cava |
| Chest lead V2 is located at? | Fourth intercostal space at left margin of sternum |
| A device placed on the skin that picks up electric impulses by the heart is known as? | Electrode |
| How high is the standardization mark? | 10 mm |
| How many leads are there in a standard ECG? | 12 leads |
| Lead l, ll , and lll are the what leads? | Bipolar leads |
| Oxygen combines with glucose to make what? | Energy |
| Peak flow measurement can be used for all of the following except: A)to monitor a patient's lung flow over time B)to determine if a patient's meds need to be changed C) determine the severity of an asthma attack D)to determine if lung damage has occurred | D) to determine if lung damage has occurred |
| Which heart dysrhythmias is the most dangerous? | Ventricular fibrillation |
| aVR, aVL, and aVF are known as what leads? | Augmented leads |
| The chest lead records the heart voltage from what? | From front to back |
| The left atrium receives what? | Oxygenated blood from the lungs |
| What is the name given to the portion of the ECG between two waves? | Segment |
| What changes can occur on an ECG due to myocardial infarction? | Larger than normal Q wave and an elevated ST segment |
| What is the function of coronary arteries? | To supply the heart itself with oxygen and nutrients |
| What is additional electrical activity picked up by the electrocardiograph that interferes with the normal appearance of an ECG cycle? | Artifact |
| What is buildup of fibrous plaques of fatty deposits and cholesterol on the inner walls of an artery that causes narrowing, obstruction and hardening of the artery? | Arthrosclerosis |
| What is a flat horizontal line that separates the various waves of the ECG cycle? | Baseline |
| What is a cardiac cycle? | One complete heartbeat |
| What is an irregular heart rate or rhythm? | Dysrhythmia |
| What is the graphic representation of the electrical activity of the heart? | Electrocardiogram |
| What is the instrument used to record the electrical activity of the heart? | Electrocardiograph |
| What is a chemical substance that promotes conduction of an electrical current? | Electrolyte |
| What is the number of liters of oxygen per minute that come out of an oxygen delivery system? | Flow rate |
| Where is V5 chest lead located? | Horizontal level of position 4 at left anterior axillary line |
| What is located in the upper portion of the right atrium just below the opening of the superior vena cava and has the ability to send out an electrical impulse without an external nerve stimulus? | Sinoatrial (SA) node |
| The SA node is often referred to as the what of the heart? | Pacemaker |
| What is located at the base of the right atrium and delays the impulses momentarily to allow for complete contraction of the atria and filling of the ventricles with blood from the atria? | Atrioventricular (AV) node |
| The AV node transmits electrical impulse to the what? | Bundle of His |
| The bundle of His divides into right and left branches known as? | Bundle branches |
| What relays the impulse to the Purkinje fibers? | Bundle branches |
| What are some triggers for asthma? | Dust mites, pollens, molds, animal dander, and cockroaches |
| What are the signs and symptoms of myocardial ischemia? | Severe dyspnea, chest discomfort or pain, pallor, weakness, and dizziness |
| What changes can occur on an ECG due to myocardial ischemia? | Depressed ST segment and an inverted T wave |
| What is the purpose of standardizing the electrocardiograph? | Quality control measure that ensures an accurate and reliable recording. Also, means that an ECG run on one electrocardiograph compares in accuracy with a recording run of another machine. |
| What does the P wave represent on the ECG cycle? | Electrical activity associated with the contraction of the atria also known as (atria depolarization) |
| What does the QRS complex represent on the ECG cycle? | Electrical activity associated with the contraction of the ventricles also known as (ventricular depolarization) |
| What does a T wave represent on the ECG cycle? | Electrical recovery of the ventricles also known as (ventricular repolarization) |
| What does the P-R segment represent on the ECG cycle? | Time interval from the end of the atrial depolarization to the beginning of the ventricular depolarization |
| What does the S-T segment represent on the ECG cycle? | Time interval from the end of the ventricular depolarization to the beginning of repolarization of the ventricles |
| What does the P-R interval represent on the ECG cycle? | Beginning of the atrial depolarization to the beginning of the ventricular depolarization |
| What does the Q-T interval represent on the ECG cycle? | Beginning of ventricular depolarization and the end of repolarization of the ventricles |
| What events occur in one cardiac cycle? | Contraction of the atria, the contraction of the ventricles, and the relaxation of the entire heart |
| Why is the impulse initiated by the SA node delayed momentarily by the AV node? | To allow for complete contraction of the atria and filling of the ventricles with blood from the atria |
| Why is the R wave taller than the P wave on the ECG graph cycle? | The ventricles are larger than the atria and therefore require a stronger electrical stimulus to depolarize |
| Why does atrial repolarization not appear as a separate wave on the ECG cycle? | It occurs at the same time as ventricular depolarization so it is hidden by the QRS complex |
| How many "electrical photographs" of the heart are recorded by the electrocardiograph? | 12 electrical photographs |
| What is the purpose of the right leg lead wire? | Known as the ground it is not used for the actual recording but serves as an electrical reference point |
| What is the difference between a single-channel and a three-channel electrocardiograph? | A three-channel electrocardiograph can record the electrical activity of the heart through three leads. Simultaneously. A single-channel can only record one lead at a time. |
| Why should artifacts be eliminated, if they occur in an ECG recording? | Presence of artifacts affects the quality of the recording, making it difficult to manually measure the ECG cycles. Can also cause a false positive result on an ECG that is analyzed by a computer. |
| What causes muscle artifacts on an ECG? | An apprehensive patient. Patient discomfort. Patient movement. A physical condition. |
| What can cause a wandering baseline artifact to appear on the ECG cycle? | Loose electrodes. Dried out electrolyte. Body creams, oils, or lotions on the skin in the area where the electrode is applied. Excessive movement of the chest wall during respiration. |
| What can cause the 60-cycle interference artifact to appear on the ECG cycle? | Lead wires not following body contour. Other electrical equipment in the room. Wiring in the walls, ceilings, or floors. Improper grounding of the electrocardiograph. |
| What can cause an interrupted baseline artifact to appear on the ECG cycle? | Caused by the metal tip of the lead wire becoming detached or by a frayed or broken patient cable |
| What is the purpose of using a Holter monitor electrocardiography? | To assess the right and rhythm of the heart during daily activities. To evaluate patients with unexplained chest pain, dizziness, or syncope. To discover intermediate cardiac dysrhythmias. Detect myocardial ischemia. Assess a pacemaker |
| What are the symptoms of a low oxygen level in the body? | Frequent headaches, anxiety, cyanosis of the lips or fingernails, drowsiness, confusion, restlessness, and slow, shallow, difficult, or irregular breathing. |
| What occurs if oxygen comes in contact with a fire? | It greatly increases the combustion rate of the fire. Oxygen will make the flame hotter and cause it to burn faster and more vigorously. |
| Lead one records the electric current traveling between what? | The right arm and the left arm electrodes |
| Lead two records the electric current traveling between what? | The right arm and the left leg electrodes |
| Lead three records the electric current traveling between what? | The left arm and the left leg electrodes |
| Which lead shows the heart's rhythm more clearly than the other leads, also known as a rhythm strip? | Lead ll |
| To reduce artifacts during the recording period with the Holter monitor, the electrodes are typically placed where? | Over bone such as on the sternum or ribs |
| A rate slower than 60 beats per minute is what? | Sinus bradycardia |
| A rate faster than 100 beats per minute is what? | Sinus tachycardia |
| Is characterized by a beat that comes before the next normal beat is due, the most distinguishing feature is the P wave of the premature beat has a different shape from the P wave of the normal beat: | Premature atrial contraction |
| Is characterized by a rhythm that has a sudden onset and termination. The sudden increase in rate occurs in short burst and lasts only a few seconds, after which the rate returns to what it was before: | Paroxysmal supraventricular tachycardia |
| What happens during an angina episode? | Severe indigestion, tightness or burning, heaviness, ache, and squeezing or crushing pressure in the center of the chest. Other symptoms include: shortness of breath, sweating, nausea, weakness, fatigue, heart palpitations and dizziness |
| What is one of the most common rhythm disorders often occurring in healthy patients with no underlying heart disease and young adults with normal hearts? | Paroxysmal supraventricular tachycardia (PSVT) |
| Is a rapid, regular fluttering of the atrium in which the heart falls between 250 and 350 beats per minute. P waves appear as saw-tooth spikes between the QRS complexes. | Atrial flutter |
| Is characterized by an ECG in which the P waves have no definite pattern or shape. The P waves appear as irregular wavy undulations between the QRS complexes. | Atrial fibrillation |
| What dysrhythmia can cause blood to pool in the atrium of the heart? | Atrial fibrillation |
| Is characterized by a beat that comes early in the cycle, is not proceeded by a P wave, has a wide and distorted QRS complex, and has a T wave opposite in direction of the R wave of the QRS complex. | Premature ventricular contraction |
| Consist of a series of three or more executive PVCs that occur at a rate of 150 to 300 per minute. May occur paroxysmally and last only a short time, or it may persist for a long time. The QRS complexes are bizarre and widened and no P waves are present. | Ventricular tachycardia |
| Is the most serious dysrhythmia. The ventricles do not beat in a coordinated manner but instead they quiver or fibrillate. No recognizable P waves, QRS complexes, or T waves in the irregular line of jagged spikes. | Ventricular fibrillation |
| The purpose of a pulmonary function test (PFT) is to? | Assess lung functioning, assisting in the detection and evaluation of pulmonary disease |
| Is the maximum volume of air (measured in liters) that can be expired when the patient exhales as forcefully and rapidly as possible and for as long as possible? | Forced vital capacity (FVC) |
| Is the volume of air (in liters) that is forcefully exhaled during the first second of the FVC breathing maneuver. | Forced expiratory volume after one second (FEV1) |
| In patients with chronic obstructive pulmonary disease, the FEV1/ FVC ratio is? | Less than 70% to 75% |
| To evaluate the spirometry test results fully, certain demographic factors must be taken into consideration including? | Patient's age, sex, weight, and height |
| Patient preparation for a spirometry test includes: | Do not eat a heavy meal for 8 hours before the test. Stop smoking at least 8 hours before the test. Do not take bronchodilators for 4 hours before the test. Do not engage in strenuous activity for 4 hours before the test. Wear loose clothing |
| Helps to relieve bronchial inflammation and prevent symptoms from occurring. Helps the patient have fewer and milder attacks. Examples include corticosteroids like Flovent, Pulmicort, Asmanex, Qvar, AeroBid, Singular,Accolate, Serevent, Zyflo, and Advair | Long-Term control medication |
| Opens the airways quickly by dilating the bronchial tubes. It is taken when the patient is experiencing symptoms to prevent or control an asthma attack. Examples include Proventil, Ventolin, and Xopenex | Quick-relief medication |
| Is a portable handheld device used to measure a breathing maneuver performed by a patient? | Peak flow meter |
| Has a range from 0 to 300 and is used by young children and some older adults | Low-range meter |
| Has a range from 0 to 800 and is used by older children, teenagers, and adults | Full-range meter |
| The peak flow measurement obtained from the breathing maneuver is known as the? | Peak expiratory flow rate |
| Is a written individualized management plan developed jointly by the provider and the patient? | Asthma action plan (AAP) |
| An asthma action plan typically includes the following information: | A list of possible asthma triggers that should be avoided, instructions for taking asthma medications, guidelines for determining the severity of an asthma attack based on the symptoms and peak flow measurements, what to do during an asthma attack |
| Is the highest peak flow measurement a patient can achieve over a 2 to 3 week when under good asthma control? | Personal best measurement |
| What is the asthma green zone? | Peak flow measurement is 80%- 100% of the patient's personal best measurement. No asthma symptoms are present. The patient is doing well and under reasonably good control. The patient should take their daily control medication as usual. |
| What is the asthma yellow zone? | Peak flow measurement is 50%-79% of the patient's personal best measurement. Asthma symptoms may not be present. If symptoms are present, they are mild to moderate. Patient should take their quick relief medication in addition to their daily control meds |
| What is the asthma red zone? | Peak flow measurement is less than 50% of the patient's personal best measurement. Asthma symptoms are severe resulting in extreme breathing difficulties. Asthma medication is not working. Signals a medical emergency. Call 911 |
| Is a colorless, odorless, and tasteless gas that is vital to the human body? | Oxygen |
| Oxygen combines with what to produce energy? | Glucose |
| Clinical signs of hypoxemia include: | Cyanosis, dyspnea, tachypnea, tachycardia, and anxiety |
| The amount of supplemental oxygen prescribed to a patient is known as the? | Flow rate |
| The goal of oxygen therapy is to maintain a blood oxygen level of _________measured through ABG analysis and _________ measured through pulse oximetry. | 65 mmHg, 90% to 93% |
| What refers to the use of oxygen for more than 15 hours a day? | Continuous oxygen therapy |
| What are the three common delivery systems for providing supplemental oxygen to a patient? | Compressed oxygen gas, liquid oxygen, and an oxygen concentrator |
Created by:
Diamond87