Cardiovascular / Pulmonary Care in the Acute Setting Flashcards
(34 cards)
Vital signs tell us about the patient’s?
Vital signs tell us about the patient’s baseline health status.
- Objective measures used throughout course of intervention to determine improvement or decline in the health status.
Core Vital Signs
- Heart Rate
- Respiratory Rate
- Blood Pressure (30 mmHg over occlusion test)
- Edema
(The Guide to PT practice states that recording the core vital signs is the very minimum assessment of the cardiovascular/pulmonary system on Every New Patient.)
Normal blood pressure
Systolic = less that 120
and
Diastolic = less than 80
Elevated blood pressure
Systolic = 120-129
and
Diastolic = less than 80
High Blood Pressure blood pressure (Hypertension) Stage 1
Systolic = 130-139
or
Diastolic = less than 80-89
High Blood Pressure blood pressure (Hypertension) Stage 2
Systolic = 140 or higher
or
Diastolic = 90 or higher
Hypertension Crisis
(Consult doctor immediately)
Systolic = Higher than 180
and/or
Diastolic = Higher than 120
Orthostatic hypotension is?
- Orthostatic hypotension is a condition in which your blood pressure suddenly drops when you stand up from a seated or lying position.
- An important part of fall risk assessments.
Orthostatic Hypotension
3 positive for Orthostatic Hypotension, supine to sitting/standing:
- Positive: SBP decrease of 20 mmHg or more.
- Positive: DBP decrease of 10 mmHg or more.
- Positive: HR increase of 10 bpm or more.
1 min and 5 min
Pitting Edema?
PT systems review
Pitting Edema:
Descriptor = Trace 1+
Depth of Indentation = ?
Description/rebound time = ?
Descriptor = Trace 1+
Depth of Indentation = Slight
Description/rebound time = Barely perceptible indentation, Quick rebound
Pitting Edema:
Descriptor = Mild 2+
Depth of Indentation = ?
Description/rebound time = ?
Descriptor = Mild 2+
Depth of Indentation = 0.0-0.6 cm
Description/rebound time = Easily identifiable indentation, skin rebounds <15 seconds.
Other than the core vital signs, what are some of the screening tests (Cardiovascular & Pulmonary Systems).
- Temperature
- Oxygen saturation
- Peripheral arterial blood flow (pulse)
- Perceived exertional effort
- Walking effort/speed
- Pain
Taken in a relaxed envirment
Pitting Edema:
Descriptor = Moderate 3+
Depth of Indentation = ?
Description/rebound time = ?
Descriptor = Moderate 3+
Depth of Indentation = 0.6-1.3 cm
Description/rebound time = Easily identifiable indentation, skin rebounds in 15-30 seconds.
Pitting Edema:
Descriptor = Severe 4+
Depth of Indentation = ?
Description/rebound time = ?
Descriptor = Severe 4+
Depth of Indentation = 1.3-2.5 cm
Description/rebound time = Easily identifiable indentation, skin rebounds in>30 seconds
Describe the 4-Point Pulse Scale.
3+ and 4+ = abnormal
Common cardiovascular/pulmonary health conditions requiring hospitalization?
- Acute Coronary Syndrome
- Rhythm and Conduction Disturbances
- Valve Disease
- Congestive Heart Failure
- Obstructive & Restrictive Pulmonary Conditions
Acute Coronary Syndrome?
and common treatments.
- Myocardial oxygen deprivation causing angina (reported chest pain) and potentially tissue ischemia (.
- CAD (coronary artery disease)
- MI (myocardial infarction)
Common treatments:
PTCA = Percutaneous transluminal coronary angioplasty
stent =
CABG = Coronary artery bypass grafting
What are some rhythm and conduction disturbances, and treatments.
- **Atrial fibrillation/flutter **= A-fib happens when the SA node isn’t functioning properly and instead, multiple electrical impulses are firing in a disorganized manner, throughout the atria. The problem is that most of these impulses are not strong enough to create an effective contraction to shunt blood to the ventricles.
- Arrhythmia = Irregular heartbeat, is a problem with the rate or rhythm of your heartbeat.
- Ventricular Tachycardia = Abnormal heart rhythm, or arrhythmia. It occurs when the ventricles beats too fast to pump well and the body doesn’t receive enough oxygenated blood.
- AV block = Electrical signal that controls your heartbeat is partially or completely blocked. This makes your heart beat slowly or skip beats and your heart can’t pump blood effectively.
- BBB =
Treatments:
* Pharmaceutical
* Pacemaker (PPM)
* Mobilize?
* DME?
* Defibrillator (ICD)
Stenosis, regurgitation, and prolapse are related to?
Valve Disease
- Over time, pumping dysfunction
can cause heart failure - Valve Replacement Surgery =
- Sternotomy Precautions = If they had open heart surgery
Congestive Heart Failure
Decrease in Cardiac Output (CO) usually caused by?
Cardiomyopathy
