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-cardiopulm Npte > cp exam 1/20 > Flashcards

cp exam 1/20 Flashcards

1
Q

what age child treat BP same as adult?

A

13

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2
Q

what is mean arterial pressure?

Normal values?

A

arterial pressure in large arteries over time,

  • depends on mean blood flow and arterial compliance
  • normal 70-110mmHg
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3
Q

normal RR

  • adult
  • child
  • newborn
A

adult 12-20 breaths/min

  • child 20-30 breaths/min
  • newborn 30-40 breaths/min
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4
Q

tachypnea

A

RR >=22 breaths/min

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5
Q

bradypnea

A

<=10 breaths/min

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6
Q

hyperpnea

A

increased depth and rate of breath

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7
Q

dyspnea

- on exertion

A

SOB

- SOB brought on by exercise or activity

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8
Q

dyspnea

- orthopnea

A

SOB i reclining or supine position

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9
Q

dyspnea

- paroxysmal nocturnal dyspnea

A

sudden inability breath during sleep

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10
Q

how to rate dyspnea?
lowest?
highest?
severe?

A

Borg dyspnea scale
low 0-10 highest
severe 5

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11
Q

normal O2 sat

A

95-100%

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12
Q

hypoxemia O2

A

<90%,

PaO2 60 mmHg

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13
Q

hypoxia

anoxia

A

low O2 level in tissue

no oxygen in O2

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14
Q

symptoms:
- diffuse, retrosternal pain
sensation tightness, achiness in chest
dyspnea
sweating
indigestion
dizziness, syncope
anxiety

A

ischemic cardiac pain - angina or MI

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15
Q

symptoms in women

  • indegestion or gaslike pain
  • dizziness, nausea
  • unexplained weakness, fatigue
  • discomfort or pain between shoulder blades
  • recurring chest discomfot
  • sense impending doom
A

ischemic cardiac pain - angina or MI

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16
Q

how to rate angina pain

  • light, barely noticeable
  • moderate bothersome
  • most severe pain ever
A

1+
2+
4+

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17
Q

where can cardiac pain refer?

A
  • shoulders
    back
    arm
    neck, jaw
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18
Q

where can dissecting aortic aneurysm pain refer?

A
  • back
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19
Q

diaphoresis associated with

+/- CO?

A

decreased CO

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20
Q

PAD associated with
+/- arterial pulses?
where to start exam?

A

decreased or absent pulse

examine bilateral start most distal

21
Q

dependent rubor with what condition?

A

PAD

22
Q

nail clubbing associated with what conditions?

A
  • enlarged soft tissue at base of nails

- chronic O2 deficiency, chronic pulmonary disease, heart failure

23
Q

PAD trophic changes

A

pale, shiny, dry skin loss of hair

decreased temp

24
Q 
what pathology associated with?
abnormal pigmentation 
ulceration
dermatitis
gangrene
A

PAD

25
Q

what pathology?
pain, cramping, LE fatigue during exercise
relieved by rest
- can occur in calf, thigh, hip, buttock
- can have pain at rest w less arterial blood supply, typically forefoot at night

A

intermittent claudication associated w PAD

26
Q

how to measure change in volume of irregular body parts (can’t use measuring tape)

A

volumeter

27
Q

edema grade?
mild, barely perceptible
<1/4 inch pitting

A

1+

28
Q

edema grade?
moderate, easily identified depression
returns within 15 sec
1/4-1/2in

A

2+

29
Q

edema grade?
very severe depression lasts >30 sec
>1 inch pitting

A

4+

30
Q

causes of peripheral edema?

A

chronic venous insufficiecy
lymphedema
bilateral - CHF

31
Q

which to test first - venous or arterial circulation?

A

venous, may invalidate some arterial tests

32
Q

what test is this? why?

  • pt standing, palpate one segment vein while percussing vein 20 cm higher
  • if pulse wave felt by lower hand then intervening valves are incompetent
A

percussion test

competence of greater saphenous vein

33
Q

what test is this? why?

  • pt supine with legs elevated 60deg to empty venous blood
  • tourniquet placed proximal thigh, occludes venous flow in superficial vein
  • patient stands
  • note if vein fill in normal pattern, approx 30 sec
A

trendelenburg test, retrograde filling test

- competence of communicating veins, saphenous system

34
Q

what test is this? why?

  • pt supine, passively elevate LE 45deg for 1 min
  • place in dependent position
  • observe time for veins to refill
  • if >15sec then what?
A

venous filling time

  • time to refill veins after emptying
  • > 15 sec refill indicates venous insufficiency
35
Q

what test is this? why?

  • pneumatic device cuff placed around calf, attached to pressure transducer and microprocessor
  • occlude venous return, allow arterial inflow
  • record increasing volume w cuff and time to return to baseline w cuff delflation
  • compare times in sitting, standing, up on toes
A

air plethysmography APG

  • measure patency of venous system (open, unobstructed)
  • measure volume
36
Q

ABI test- measure what arteries

A

brachial, post tib, dorsalis pedis

37
Q

ABI normal value?

borderline?

A

1-1.40

0.91-0.99 borderline

38
Q

ABI - clinically sig change?

A

clin sig change >0.15 or

>0.1 in pt with symptoms

39
Q

ABI <=0.5 means

A

severe arterial disease
risk for critical limb ischemia
may have pain at rest

40
Q

what test? why?
elevate foot, then sit with foot hanging (dependent position)
observe chnage in skin color

A

rubor of dependency

  • > 30sec for change indicates arterial insufficiency
  • insufficiency - pallor when elevated, reactive hyperemia in dependent position
41
Q

possible causes of leg cramps?

A

intermittent claudications, PAD
diuretic use
hypokalemia

42
Q

what imaging to get info about lymph flow?

A 
lymphangiography
lymphoscintigraphy (xray)
43
Q 
what diagnostic imaging?
show abnormalities of lung fluid
overall cardiac shape and size 
possible cardiomegaly
aneurysm
A

chest xray

44
Q

what diagnostic imaging?

  • diagnose, evaluate ischemic heart disease
  • myocardial infarction
  • identify myocardial blood flow, areas of stress-inducted ischemia, old infarcts
A

myocardial perfusion imaging

45
Q

what diagnostic imaging?
non invasive test uses ultrasound
assess internal structures- size of chambers, wall thickness, EF, valve movement, septum, abnormal wall movement

A

echocardiogram

46
Q

what diagnostic test?
insert catheter through vessels to R side heart
measures ventral venous pressure, pulmonary artery pressure, pulmonary capillary wedge pressure

A

swan ganz catheter

central line

47
Q

what diagnostic test?
3D image of heart to examine
coronary arteris, aorta, pericardium, myocardium

A

cardiac MRI

48
Q

what enzyme test for myocardial infarction

A
  • troponin I or T along with symptom
    (ischemia, new ST change on ECG, pathological Q waves on ECG, myocardial wall motion abnormality on imaging, intracoronary thrombus)
  • elevated CK (serum creatine kinase) or CPK (creatine phosphokinase)

-cardiopulm Npte (17 decks)

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