Cardiopulmonary System

Question 1

standard vital signs

Answer 1

hear rate
respiratory rate
blood pressure
temperature

Question 2

normal range of heart rate

Answer 2

60-100 bpm

Question 3

normal range of respiratory rate

Answer 3

12-20 breaths per min

Question 4

normal blood pressure

Answer 4

systemic <120

diastolic <80

Question 5

take observations of these before vital signs

Answer 5

signs of distress
seated posture
overall nutritional status 
skin color
- cyanosis (blue)
- jaundice (yellow)
- bruising
- petechia (purple marks)
diaphoresis (excessive sweating)
peripheral observation of extremities
- edema 
- clubbing of digits

Question 6

clinical indicators that warrant VS testing

Answer 6

dyspnea- difficulty breathing
fatigue
chest pain/discomfort
irregular heart beat- palpitations
cyanosis- blue fingertips or lips
intermittent claudication- leg pain with activity or rest
pedal edema- swelling of feet and lower legs

Question 7

pulse

Answer 7

wave of blood in artery created by contraction of left ventricle during ventricular systole

Question 8

three aspects of HR

Answer 8

rates, rhythm, quality

Question 9

rate of HR

Answer 9

normal range= 60-100 bpm
bradycardia= < 60 bpm
tachycardia= >100 bpm

Question 10

palpitation

Answer 10

sensation of one or more irregular heart beats- feels like heart skips a beat or flutters

Question 11

rhythm of HR

Answer 11

arrhythmia or dysrhythmia= irregular rhythm

• premature or mission beats
• typically caused by conduction abnormalities

Question 12

HR quality

Answer 12

related to blood volume
- larger volume= stronger pulse
- smaller volume= weaker pulse
weak or “thready”= difficult to detect and easy to eliminate
strong or “bounding”= difficult to eliminate

Question 13

factors affecting HR

Answer 13

age/gender
fitness level
emotional status
exercise
medications
temperature (external and internal)

Question 14

methods of assessing HR

Answer 14

arterial palpation
auscultation of heart apex
electrocardiogram (EKG or ECG)
electronic devices

Question 15

palpation points

Answer 15

temporal
external carotid 
brachial
radial
femoral
popliteal (behind knee) 
dorsal peds

Question 16

diaphragm innervation

Answer 16

C3,4,5

Question 17

supper respiratory tract

Answer 17

noce, mouth, pharynx, larynx

Question 18

conducting zone

Answer 18

trachea, primary bronchus, bronchioles, terminal bronchioles

Question 19

respiratory zone

Answer 19

respiratory bronchioles, alveolar duct, alveolar sac

Question 20

ventilation

Answer 20

mechanical process of breathing

can have voluntary control but usually involuntary

Question 21

respiration

Answer 21

gas exchange in alveolar sacs to bloodstream

involuntary

Question 22

inspiration/inhalation

Answer 22

diaphragm, intercostal muscles, accessory muscles (scalenes, SCM)

Question 23

expiration/exhalation

Answer 23

passive elastic recoil of diaphragm and lung parenchyma abdominals

Question 24

regulatory mechanisms

Answer 24

respiratory center (pon, medulla) control rate and depth of breath
central and peripheral chemoreceptors monitor PaCO2/pH, PaO2

Question 25

factors affecting RR

Answer 25

``` metabolic rate/demand age (higher in kids) body size body position (lower laying) environment emotion/stres medications disease ```

Question 26

RR parameters

Answer 26

``` 12-20 br/min ("eupnea") tachypnea (>24 br/min) bradypnea (<10 br/min) apnea= absence of breathing normal tidal volume= 0.5L/br ```

Question 27

sounds of RR

Answer 27

``` normally smooth and soft usually requires stethoscope wheezing= narrow airway stridor= upper airway obstruction crackles= secretions in air passages ```

Question 28

ventilation is controlled voluntarily by

Answer 28

cortex

Question 29

ventilation is controlled involuntarily by

Answer 29

pons and medulla

Question 30

blood pressure definition

Answer 30

force exerted agains arterial walls, measure in mmHG (millimeters of mercury) BP= cardiac output x total peripheral resistance

Question 31

systolic BP

Answer 31

highest pressure exerted on arteries during cardiac systole

Question 32

diastolic BP

Answer 32

lowest pressure recorded within arteries during cardiac diastole

Question 33

modifiable risk factors or hypertension

Answer 33

``` current cigarette smoking diabetes mellitus dyslipidemia/hypercholesterolemia overweight/obesity physical inactivity/low fitness unhealthy diet ```

Question 34

factors that affect BP

Answer 34

``` blood volume elasticity of arteries exercise valsalva maneuver body position arm position ```

Question 35

arm position affect

Answer 35

1-2 mm Hg for every 2.5 cm above or below level of the heart above- BP reading is too low below- BP reading too high

Question 36

orthostatis hypotension

Answer 36

precipitous drop in BP of more tan 20 mmHg (systolic) when moving from supine/seated to standing can lead to loss of consciousness gradual acclimatization can restore baroreceptor reflex function - compression stockings, tolt tables, repetition

Question 37

elevated BP

Answer 37

120-129/ <80

Question 38

stage 1 hypertension

Answer 38

130-139/ 80-89

Question 39

stage 2 hypertension

Answer 39

>140/>90

Question 40

temperature regulation center

Answer 40

hypothalamus

Question 41

fever vs. hyperthermia

Answer 41

fever - never exceed 104*F - associated with change to hypothalamic set point - respond to medication - some diurnal variation hyperthermia - exceeds 104*F - does not respond to medication, needs whole body cooling - no diurnal variation - extremely dangerous an requires intensive care

Question 42

signs and symptoms of hyperthermia

Answer 42

``` mental statu change strong rapid pulse lack of sweating dry flushed skin faintness staggering coma ```

Question 43

health related factors of hyperthermia

Answer 43

``` dehydration impaired blood circulation inefficient sweat glands hear, lung, kidney diseases high BP reduced sweating from diuretic medication, sedatives, tranquilizers, heart or BP medication being substantially over or underweight drinking alcohol ```

Question 44

hypothermia

Answer 44

drop in core body temperature below 95*F (35*C)

Question 45

stages of hypothermia

Answer 45

1. shivering 2. slow, weak pulse, slow breathing, lack of coordination, irritability, confusion, sleepiness 3. slow, weak, or absent respiration and pulse, loss of consciousness

Question 46

factors raising core body temperature

Answer 46

``` later in the day (4-8pm_ children exercise menstrual cycle pregnancy environment ingestion of hot things ```

Question 47

factors lowering core body temperature

Answer 47

mornings (4-6am) elderly people environment ingestion of cold things

Question 48

signs nd symptoms of infectious disease

Answer 48

``` chills vomiting sweating fatigue nausea change in blood composition enlarged lymph nodes inc. HR inc. RR loss of appetite dec. urine output ```

Question 49

common causes of fever

Answer 49

``` blood infection UTI lung infection gastrointestinal infection skin infection ```

Question 50

cause of LE edema

Answer 50

excessive buildup of fluid in tissues - prolonged standing/sitting - pregnancy - injury/trauma/infection/surgery in LE - venous insufficiency - heart, kidney, liver failure

Question 51

edema grade

Answer 51

1. mild, moderate, sever 2. pitting edema scale - 0+ no pitting edema - 1+ mild pitting, barely perceptible depression - 2+ moderate pitting, easily identifies depression (skin rebound within 15 seconds) - 3+ moderately severe pitting edema, easily identifies depression (skin rebound in 15-30 seconds) - 4+ severe pitting edema, easily identifies depression (skin rebounds >30 seconds)