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Licensure Prep > Cardiopulmonary > Flashcards

Cardiopulmonary Flashcards

1
Q

Target heart rate using percent max HR

A

lower: HRmax x 55%
upper: HRmax x 90%

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2
Q

Heart rate reserve

A

lower: [(HRmax - HRrest) x 40%] + HRrest
Upper: x 85%

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3
Q

Normal CP response to acute aerobic exercise

A
  • increased oxygen consumption
  • increased CO
  • increased blood flow
  • linear increase in SBP with increasing workload
  • no change or decrease in DBP
  • increased respiratory rate and tidal volume
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4
Q

Precautions/Contraindications to postural drainage

A
  1. IC pressure >20 mmHG
  2. head and neck injury (until stabilized)
  3. active hemorrhage with hemodynamic instability
  4. recent spinal surgery or acute spinal injury
  5. active hemoptysis
  6. empyma
  7. bronchopleural fistula
  8. pulm. edema associated with CHF
  9. large pleural effusion
  10. PE
  11. confused or anxious patients
  12. rib fracture
  13. surgical wound or healing tissue
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5
Q

Contraindications to trendelenburg position

A
  1. uncontrolled HTN
  2. distended abdomen
  3. esophageal surgery
  4. recent gross hemoptysis related to lung carcinoma treated surgically or with radiation
  5. uncontrolled airway at risk for aspiration (feeding tube, recent meal)
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6
Q

Autogenic drainage

A
  • controlled breathing to mobilize secretions by varying expiratory airflow without using postural drainage or coughing
  • requires patience to learn
  • not suitable for young children or patient who are not motivated or easily distracted
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7
Q

Active Cycle of Breathing

A
  • always couples breathing exercise with the huff cough

- 3 phases: breathing control, thoracic expansion, forced expiratory technique

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8
Q

Bullectomy

A

surgical procedure that removes large air spaces (“bullae” that form when alveoli are destroyed by emphysema.

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9
Q

Bullectomy

A

surgical procedure that removes large air spaces (“bullae” that form when alveoli are destroyed by emphysema.

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10
Q

ABI procedure and scoring

A
  • take SBP in (B) UE and (B) LE
  • divide higher of 2 BPs in the ankles by the higher of rht 2 in the arms
  • > 1.3 - rigid arteries, check for PAD
  • 1.0-1.3 = normal
  • 0.8-0.99 - mild blockage, beginning PAD
  • 0.4-0.79 - moderate blockage, may have intermittent claudication
  • > 0.4 - severe blockage, severe PAD, may have claudication at rest
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11
Q

BP procedure

A
  • cuff should encircle 80% of the arm in adults and 100% in children
  • cuts off brachial artery
  • deflate cuff no more than 2-3mmHG per second
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12
Q

Hypertension classifications

A

Normal: 160/>100

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13
Q

Borg RPE

A 
7 - very, very light
9-very light
11-fairly light
13-somewhat hard
15-hard
17-very hard
19-very, very hard
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14
Q

Modified BORG RPE

A 
0-nothing
1-very weak
3-moderate
5-strong
7-very strong
10-maximal
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15
Q

Expected outcomes with diaphragmatic breathing

A
  1. decrease RR
  2. decrease use of accessory muscles
  3. increase tidal volume
  4. decrease respiratory flow rate
  5. subjective improvement of dyspnea
  6. improve tolerance for activity
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16
Q

Pursed lip breathing

A
  • helps prevent airway collapse in patient’s with emphysema
  • decreases RR
  • reduces dyspnea
  • maintains a small positive pressure in the bronchioles
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17
Q

Expected outcomes with pursed lip breathing

A
  1. decrease RR
  2. relieve dyspnea
  3. reduce arterial PaCO2
  4. improve tidal volume
  5. improve o2 sats
  6. prevent airway collapse
  7. improve activity tolerance
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18
Q

Positioning for segmental breathing

A
  • sitting for basal atelectasis
  • sidelying with affected lung uppermost
  • postural drainage positions with affected lung uppermost to assist with secretion removal
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19
Q

Expected outcomes of segmental breathing

A
  1. increase chest wall mobility
  2. expand collapsed alveoli via airflow through collateral channels
  3. assist with secretion removal
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20
Q

Expected outcomes of sustained maximal inhalation with incentive spirometer

A
  1. absence of or improvement in signs of atelectasis
  2. decreased RR
  3. resolution of fever
  4. normal pulse rate
  5. normal chest Xray
  6. improved paCo2
  7. increased forced vital capacity and peak expiratory flows
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21
Q

Atrial systole

A

-contraction of (R) and 9l) atria pushing blood into ventricles

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22
Q

Atrial diastole

A

-period between atrial contractions and atria repolarizing

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23
Q

Ventricular systole

A

-contraction of (R) and (L) ventricles

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24
Q

Ventricular diastole

A

-period of repolarization

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25
Q

Normal stroke volume

A

60-80ml

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26
Q

Normal CO

A

4.5-5.0 L/min. can increase up to 25L/min during exercise

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27
Q

Left sided CHF

A

-associated with S/S pulmonary venous congestion

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28
Q

Left sided CHF

A

-associated with S/S pulmonary venous congestion

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29
Q

Right sided CHF

A

-associated with S/S systemic venous congestion

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30
Q

CHF compensatory changes

A
  • due to decreased CO
  • increase in blood volume
  • increase in cardiac filling pressure
  • increase in HR
  • increase in cardiac muscle mass
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31
Q

MI risk factors

A
  • family history
  • smoking
  • physical inactivity
  • stress
  • HTN
  • elevated cholesterol
  • diabetes mellitus
  • obesity
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32
Q

ACE inhibitors

A

-HTN, CHF
Side effects: dizziness, hypotension, dry cough
-“pril”

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33
Q

Antiarrythmic agents

A

Side effects: : dizziness, hypotension

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34
Q

Antihyperlipidemia agents

A

side effects: headache, GI distress, myalgia, rash

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35
Q

calcium channel blockers

A

Side effects: dizziness, headache, hypotension, peripheral edema
HR and BP response to exercise will be diminished

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36
Q

calcium channel blockers

A

Side effects: dizziness, headache, hypotension, peripheral edema
HR and BP response to exercise will be diminished

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37
Q

Nitrates

A

Side effects: headache, dizziness, orthostatic hypotnesion, reflex tachycardia, nausea, vomiting

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38
Q

Positive iontropic agents

A

Side effects: arrythmias, GI distress, diziness, blurred vision

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39
Q

CPR -adults

A
  • compression - airway - breathing
  • rate: 100/min
  • depth: 2 inches (5cm)
  • 30: 2
  • 1 breath every 6-8sec, 8-10 breaths/min
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40
Q

CPR - children

A
  • depth: 1/3 AP depth, 2 inches (5 cm)
  • single rescuer 30:2
  • 2 rescuers: 15:2
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41
Q

CPR - infants

A
  • depth: atleast 1/3 AP (40%), 1.5 inches (4cm)

- 30: 2 if single, 15:2 if 2

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42
Q

P wave

A

-atrial depolarization

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43
Q

PR interval

A

-conduction from SA node to AV node (normal=0.12-0.2 seconds)

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44
Q

QRS

A

-ventricular depolarization and atrial repolarization (normal 0.06-0.1 seconds)

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45
Q

QT interval

A

-time for both ventricular depolarization and repolarization (0.2-04 seconds)

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46
Q

ST segment

A

-isoelectric period

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47
Q

T-wave

A

-ventricular repolarization

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48
Q

PACs

A
  • premature atrial contraction
  • normally benign
  • p wave is premature and abnormal
  • may progress to atrial flutter, tachycardia or fibrillation
  • may occur with a normal heart and any type of heart disease
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49
Q

A-fib clinical significance

A

-S/S include palpitations, fatigue, dyspnea, lighteheadedness, syncope, chest pain

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50
Q

PVC

A
  • unifocal or multifocal
  • bigemeny: normal sinus impulse followed by a PVC
  • trigeminy- PVC occurs after every 2 normal sinus impulses
  • common arrythmia that occurs in healthy and diseased hearts
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51
Q

V-tach

A
  • 3 or more consecutive PVCS at a ventricular rate of .150beats/min
  • P waves are absent and QRS is wide
  • longer than 30 seconds is life threatening
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52
Q

V-fib

A

-no cardiac output

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53
Q

Signs of MI

A

ST segment depresion and elevation

54
Q

Absolute indications to stop exercise testing

A
  • drop in SBP >10 from baseline despite increase in work load
  • moderately severe angina
  • increases nervous system symptoms
  • signs of poor perfusion
  • sustained v-tach
  • 1.0 mm ST elevation without q-waves
55
Q

Relative indications to stop exercise testing

A
  • drop in SBP >10 from baseline without other evidence of ischemia
  • > 2mm ST segment depression
  • arrhythmias other than sustained v-tach (including multifocal PVCs, supraventricular tachycardia, heart block, bradyarrhtyhmias)
  • fatigue, SOB, wheezing, leg cramps, claudication
  • development of bundle branch block
  • increasing chest pain
  • hypertensive response
56
Q

Ventricular systole

A

-contraction of (R) and (L) ventricles. S1

57
Q

Ventricular diastole

A

-period of repolarization. S2

58
Q

Relative indications to stop exercise testing

A
  • drop in SBP >10 from baseline without other evidence of ischemia
  • > 2mm ST segment depression
  • arrhythmias other than sustained v-tach (including multifocal PVCs, supraventricular tachycardia, heart block, bradyarrhtyhmias)
  • fatigue, SOB, wheezing, leg cramps, claudication
  • development of bundle branch block
  • increasing chest pain
  • hypertensive response
59
Q

Tricuspid valve

A

-prevents backflow into right atrium

60
Q

Pulmonary valve

A

-prevents back flow into right ventricle

61
Q

Mitral valve

A

-prevents back flow into left atrium

62
Q

Aortic valve

A

-prevents backflow into left ventricle

63
Q

S3

A

-vibrations of teh distended ventricle walls due to passive flow of blood from the atria during rapid filling phase of diastole

64
Q

S4

A

-pathological sound with ventricular filling and atrial contraction

65
Q

Metabolic alkalosis

A
  • increased pH
  • PaCo2 WNL
  • increased HCO3
  • S/S weakness, lethargy, early tetany
66
Q

Metabolic acidosis

A
  • decreased pH
  • PaCO2 WNL
  • decreased HCO3
  • S/S secondary hyperventilation, N/V, lethargy, coma
67
Q

Respiratory alkalosis

A
  • increased pH
  • decreased PaCO2
  • HCO3 WNL
  • caused by alveolar hyperventilation
  • s/s dizziness, syncope, tingling, numbness, confusion, cramping
68
Q

Respiratory acidosis

A
  • decreased PH
  • increased PACO2
  • HCO3 WNL
  • caused by alveolar hypoventilation
  • s/s anxiety, restlessness, dyspnea, headache, confusion, coma
69
Q

Expiratory reserve volume

A
  • max volume of air that can be exhaled after normal tidal exhalation
  • 15% of total lung volume
70
Q

-Forced expiratory volume

A
  • max volume exhaled in a specified period of time

- usually 1st, 2nd and 3rd second of forced vital capacity

71
Q

Functional residual capacity

A
  • volume of air in lungs after normal exhalation
  • ERV + RV
  • 40% of total lung volume
72
Q

Inspiratory capacity

A
  • max volume of air that can be inspired after normal tidal exhalation
  • TV +IRV
  • 60% of total lung volume
73
Q

Inspiratory reserve volume

A
  • max volume of air that can be inspired after normal tidal volume inspiration
  • 50% total lung volume
74
Q

Peak expiratory flow

A

-max flow of air during teh beginning of a forced expiratory maneuver

75
Q

Residual volume

A
  • volume of gas remaining in teh lungs at the end of a maximal expiration
  • 25% of total lung volume
76
Q

Tidal volume

A
  • total volume inspired and expired with each breath during quiet breathing
  • 10% of total lung volume
77
Q

Total lung capacity

A
  • volume of air in lungs after maximal inspiration
  • RV + VC
  • FRC + IC
78
Q

Vital capacity

A
  • volume change that occurs between maximal inspiration and maximal expiration
  • TV + IRV + ERV
  • 75% of total lung volume
79
Q

Vital capacity

A
  • volume change that occurs between maximal inspiration and maximal expiration
  • TV + IRV + ERV
  • 75% of total lung volume
80
Q

Apical segment drainage

A

-sitting position, leaning back 30-40 degrees

81
Q

Posterior segment (R) UL

A
  • turned 1/4 from prone on (L) side with bed horizontal and head/shoulders raised on a pillow
82
Q

Post. segment (L) UL

A

-1/4 from prone on the (R) with head of bed elevated 45 degrees and head and shoulders raised on pillow

83
Q

Lingula (L) UL

A

-turned 1/4 from supine on the (R) with foot of bed elevated 12 inches

84
Q

Anterior segment (R) and (L) UL

A

-supine with bed horizontal

85
Q

(R) middle lobe

A

-turned 1/4 from supine on (L) with foot of bed elevated 12 inches

86
Q

Superior segments (L) and (R) LL

A

-prone with bed horizontal

87
Q

Anterior basal segment ((L) and (R ) LL

A

-patient supine with foot of bed elevated 18 inches

88
Q

Posterior basal segment (L) and (R) LL

A

-prone with foot of bed elevated 18 inches

89
Q

Lateral basal segments lower lobes

A

-SL with foot of bed elevated 18 inches

90
Q

RR adult

A

12-20

91
Q

RR newborn

A

33-45

92
Q

RR 1 year

A

25-35

93
Q

RR 10 years

A

15-20

94
Q

Normal respiratory rhythm

A

Inspiration: Expiration = 1:2

For COPD its 1:3 or 1:4

95
Q

Heart apex

A

-5th intercostal space and (L) midclavicular line

96
Q

Normal CO

A

4.5-5.0 L/min. can increase up to 25L/min during exercise

HRxSV

97
Q

Left sided CHF

A
  • associated with S/S pulmonary venous congestion
  • edema
  • low CO
98
Q

Right sided CHF

A
  • associated with S/S systemic venous congestion

- jugular vein distention and peripheral edema

99
Q

Heart apex

A

-5th intercostal space and (L) midclavicular line

100
Q

HR pacing

A
  • SA node: 60-100bpm
  • AV node: 40-60bpm
  • purkinje tissue: 20-40bpm
101
Q

frank starling

A

-the greater the diastolic filling (pre-load), the greater the quantity of blood pumped

102
Q

Non-modifiable CVD risk factors

A
  • age (men>45, women>55)

- family history (1st degree male relative women until menopause)

103
Q

Modifiable CVD risk factors

A
  • total cholesterol (40)

- HGA1c

104
Q

Postural tachycardia syndrome

A

-sustained HR increase >30 bpm within 10 mins of standing

105
Q

Auscultation (aortic valve)

A

2nd right intercostal space at sternal border

106
Q

Auscultation (pulmonic valve)

A

2nd left intercostal space at sternal border

107
Q

Auscultation (tricuspid valve)

A

4th left intercostal space at sternal border

108
Q

Auscultation (mitral valve)

A

5th left intercostal space at midclavical area

109
Q

Stable angina

A
  • exertional angina

- relieved with rest or nitroglycerin

110
Q

Unstable angina

A
  • chest pain increases in severity, frequency, duration

- any time without precipitating factors

111
Q

Transmural MI

A
  • full thickness

- ST elevated (STEMI)

112
Q

Nontransmural MI

A
  • partial thickness

- non-ST elevated (NSTEMI)

113
Q

Left sided CHF

A
  • associated with S/S pulmonary venous congestion
  • edema
  • low CO
  • dry cough, dyspnea
  • orthopnea
  • rales/wheezing
114
Q

Right sided CHF

A
  • associated with S/S systemic venous congestion
  • jugular vein distention and peripheral edema
  • weight gain
  • ascites
  • liver engorgement
  • S3 heart sounds
115
Q

Nontransmural MI

A
  • partial thickness

- non-ST elevated (NSTEMI)

116
Q

Arm ergometry

A
  • HR higher
  • stroke volume lower
  • SBP/DBP higher
117
Q

Post-MI early rehab

A

-70% max HR until 6 weeks post MI

118
Q

REad through pulmonary disease

A

ok

119
Q

Glucose

A

under 70, over 300

120
Q

Bicarbonate

A

22-26

121
Q

Hemoglobin

A
122
Q

Platelets

A

less than 10,000

123
Q

WBC

A
124
Q

Hematocrit

A
125
Q

Right sided CHF

A
  • associated with S/S systemic venous congestion
  • jugular vein distention and peripheral edema
  • cor pulmonale
  • weight gain
  • ascites
  • liver engorgement
  • S3 heart sounds
126
Q

Hemoglo

A
127
Q

Hematocrit

A
128
Q

Auscultate the apex of the heart in…

A

(L) sidelying

129
Q

phase 2 cardiac rehab HR

A

45-65% calculated HRreserve

130
Q

Avoid valsalva maneuver because…

A

slowing of pulse and risk of fainting

Licensure Prep (7 decks)

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