CV Conditions

Question 1

agonal rhythm

Answer 1

• irregular heartbeat
• below 20 bpm
• near death

Question 2

atrial tachycardia

Answer 2

• HR > 100 bpm

- usually associated w increased HR or product of exertion

Question 3

ventricular tachycardia

Answer 3

• HR > 100 bpm

- usually a regular rhythm

Question 4

when is ventricular tachycardia most common?

Answer 4

after acute MI

Question 5

which tachycardia is more pathologic?

Answer 5

ventricular

Question 6

atrial fibrillation (a-fib)

Answer 6

• most common arrhythmia

- can lead to syncope bc no atrial kick

Question 7

ventricular fibrillation (v-fib)

Answer 7

chaotic rate and rhythm, will lead to death if not treated

Question 8

multifocal VT (torsades de pointes)

Answer 8

irregular rhythm and rate > 150 bpm

Question 9

AV blocks

Answer 9

rhythm disturbance where electrical conduction from atria to ventricles is partially or completely blocked

Question 10

what amount of ST depression indicates ischemia?

Answer 10

1-2 mm

Question 11

ST elevation indicates what?

Answer 11

MI

Question 12

T-wave inversion indicates what?

Answer 12

MI

Question 13

prominent Q-wave indicates what?

Answer 13

MI

Question 14

wide QRS indicates what?

Answer 14

bundle branch block

Question 15

what is normal PaO2?

Answer 15

> 80 mm Hg

Question 16

what is normal PaCO2?

Answer 16

35-45 mm Hg

Question 17

what are 3 good functional outcome measures to assess endurance?

Answer 17

• chair rise
• 2MWT
• 6MWT

Question 18

how many PVCs should you see to stop and reassess vitals?

Answer 18

> 6/min

Question 19

what type of heart disease is cardiac tamponade?

Answer 19

pericardial

Question 20

what is an acute management strategy for pts experiencing MI?

Answer 20

thrombolytics

Question 21

what are 3 indications for thrombolytic therapy?

Answer 21

• chest pain suggesting an MI
• elevated ST segment
• bundle branch block

Question 22

what is the timing of administration for thrombolytics?

Answer 22

• within 3 hrs of onset of chest pain

- within 6-24 hrs of onset of symptoms

Question 23

what is a PTCA?

Answer 23

• percutaneous transluminal coronary angioplasty

- endoluminal stent to open up occluded artery

Question 24

what is a CABG?

Answer 24

• coronary artery bypass graft

- used to revascularize the myocardium when a coronary artery is occluded

Question 25

what are the 3 vascular structures used for a CABG? (SIR)

Answer 25

- saphenous veins - internal mammary artery - radial artery

Question 26

what is the standard approach for a CABG?

Answer 26

median sternotomy

Question 27

what are 3 post-op possibilities to be seen with a CABG?

Answer 27

- mediastinal chest tube - external pacemaker - intravascular catheters

Question 28

what 6 factors put a pt at risk for experiencing dehiscence after a median sternotomy?

Answer 28

- obestity - COPD - DM - smoking - PVD - repeat thoracotomy - pendulous breasts

Question 29

what is the purpose of an ablation procedure?

Answer 29

to remove or isolate ectopic foci (abnormal pacemakers) in order to reduce rhythm disturbance

Question 30

maze procedures are used to ablate ____ fibrillation

Answer 30

atrial

Question 31

the leg used in an ablation procedure must remain straight and immobile for how many hours?

Answer 31

3-4

Question 32

what is the purpose of cardioversion?

Answer 32

to restore normal heart rhythm in tachycardia arrhythmic conditions

Question 33

what are the 2 types of cardioversion procedures?

Answer 33

- cardiac pacemaker implantation | - automatic implantable cardiac defibrillator (AICD)

Question 34

what kind of arrhythmia does the AICD help with?

Answer 34

ventricular

Question 35

what are 3 PT considerations for pts with pacemakers or AICDs?

Answer 35

- closely monitor activity response w HR and BP - know if device has rate modulation - pts can't do any lifting or resistive exercise on L side post-op

Question 36

what type of pts would wear a life vest external defibrillator?

Answer 36

- high risk of sudden cardiac arrest | - need a heart transplant

Question 37

what are 3 precautions for someone with an LVAD/RVAD?

Answer 37

- know emergency procedures in case battery dies - maintain patency of drive lines w external pump - monitor hemodynamics

Question 38

what are the complications with LVAD/RVAD? (5)

Answer 38

- thrombus formation - CVA - hemorrhage - line infections - renal or hepatic insufficiency

Question 39

what phase should a pt with an LVAD/RVAD be at in order for you to refer them to cardiac rehab to initiate exercise?

Answer 39

phase I-II

Question 40

why would a pt have an LVAD/RVAD?

Answer 40

- if they need a heart transplant | - can also be a terminal treatment

Question 41

what does the Marburg Heart Score predict?

Answer 41

likelihood of dx of CAD

Question 42

what are the 3 goals for cardiac PT interventions?

Answer 42

- asses hemodynamic response during self-care and functional mobility - maximize activity tolerance - pt/caregiver edu for activity or behavior modifications

Question 43

what are the 6 absolute indications to withhold tx for an unstable cardiac pt?

Answer 43

- decompensated CHF - 2nd degree heart block with PVCs - 3rd degree heart block - >10 PVCs/min at rest - chest pain w new ST segment changes - new onset of A-fib w rapid ventricular response at rest (HR > 100 bpm)

Question 44

what are the 6 precautions to modify or withhold tx for an unstable cardiac pt?

Answer 44

- RHR > 100 - resting HTN > 160/90 - hypotension at rest (systolic < 80) - ventricular ectopy at rest - A-fib w rapid ventricular response at rest (HR > 100) - psychosis/unstable psych condition

Question 45

if pt is on beta blockers, do not exceed ___ beats above their normal RHR

Answer 45

20

Question 46

what is the target HR for someone with an AICD?

Answer 46

20-30 beats below threshold rate on defibrillator

Question 47

if someone has had a heart transplant, can you use their HR to prescribe exercise?

Answer 47

no bc the nerves aren't connected the way they used to be

Question 48

what should the HR recovery be with a cool down?

Answer 48

greater than 12 bpm

Question 49

what is the normal systolic BP response to activity?

Answer 49

increase by 5-12 mm Hg

Question 50

what are the 3 abnormal BP responses you might see during activity?

Answer 50

- systolic dec of 10 mm Hg below resting - systolic > 180 - diastolic > 110

Question 51

use BP to gauge activity intensity for pts who have what?

Answer 51

pacemakers without rate modulation

Question 52

what is the general guideline for mRPE and RPE when monitoring activity tolerance?

Answer 52

- mRPE: 5 or less | - RPE: 13 or less