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Semester 5 PMCP Exam 3 > Exam and Eval 1 > Flashcards

Exam and Eval 1 Flashcards

1
Q

Review their medical history - includes what

A 
Hx of present illness
PMH
Lab values and tests
Medications
Contraindications for exercise
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2
Q

Hx of present illness includes

A 
Diagnosis
Date of admit
Date of event or course of events
Current medical status
Hx of present illness
Surgical procedures
Medications
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3
Q

PMH - prior cardiovascular or pulmonary disease - primary risk factors for pulmonary disease

A

Smoking, environmental exposure, family history of asthma, alpha 1 antitrypsin deficiency

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4
Q

PMH - prior cardiovascular or pulmonary disease - primary risk factors for cardiovascular disease

A

Obestiy, HPTN, Smoking, Sedentary lifestyle, family hx, cholesterol over 200 alone and especially if combined with family hx

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5
Q

Social history - what are we looking for to progress our treatment

A

their goals, their previous function, where they are going after, will they have help, are they a caregiver for anyone

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6
Q

Purpose of lab tests

A 
Complete risk factor profile
Presence of illness 
Diagnosis of event
Determine cardiac anatomy
Assess LV function
Evaluate success of intervention
Preoperative risk profile
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7
Q

Red blood cells
Male
Female

A

Male 25-35 ml/kg

Female 20-30 ml/kg

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8
Q

COPD, altitude, anemia - high or low RBCs

A

COPD, altitude = higher

Anemia = lower

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9
Q

Hemoglobin
Males
Females

A 
Males = 14-17 gm/dl
Female = 12-16 gm/dl
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10
Q

COPD high or low hemoglobin

A

higher

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11
Q

Hemoglobin - when do we not treat (for heart patients)

A

If not surgical patient, don’t treat under 8

If surgical, don’t treat under 7

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12
Q

Hematrocrit
M
F

A 
male = 41-51%
female = 36-44%
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13
Q

Hematocrit - COPD

A

higher

Also with other lung disease

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14
Q

WBC count norm

A

3,900 - 10, 700 cells/mm

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15
Q

What would make WBC count higher

A

infection

internal injury

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16
Q

Platelets - norm

A

150,000 to 400,000 (avg 300,000)

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17
Q

Platelets - chemo

A

lower

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18
Q

Arterial blood gas analysis - pH

A

7.35 - 7.45

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19
Q

Arterial blood gas analysis - PaO2

A

80-100 mmHg

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20
Q

Arterial blood gas analysis - PaCO2

A

35-45 mmHg

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21
Q

Arterial blood gas analysis - HCO3

A

22-26 MEq/l

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22
Q

Arterial blood gas analysis - SpO2

A

over 90%

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23
Q 
Respiratory acidosis -
pH
PaCO2
HCO3
Disease
A

Low pH
inc PaCO2
normal HCO3
Hypoventilating?, lung disease like COPD

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24
Q 
Respiratory alkalosis - 
pH
PaCO2
HCO3
Disease
A

high pH
low PaCO2
little high HCO3
Fever

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25
Q 
Metabolic acidosis -
pH
PaCO2
HCO3
Disease
A

low pH
normal PaCO2
dec HCO3
dec CO and renal failure

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26
Q 
Metabolic alkalosis 
pH
PaCO2
HCO3
Disease
A

high pH
norm/high PaCO2
greater than 27 HCO3
Respirator insufficiency

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27
Q

How will pt present if CO2 is high

A

confused

resp acidosis

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28
Q

Cultures

A

Strep
Staph
TB

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29
Q

acute stage of metabolic acidosis - we will not work with - T or F

A

TRUE

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30
Q

Cultures - strep can lead to pt becoming

A

resistant to medications that they are taking for these

Need to put on isolation equipment

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31
Q

Cultures - TB - you need to get what before entering the room

A

fit mask!

they need 9 FULL months of medication

32
Q

Cultures - TB - usually located where

A

lower lobes - unless has reoccurred then will be in different place (upper lobe)

33
Q

Coagulation studies - PT

A

11-12.5 sec

over 36 is critical

34
Q

Coagulation studies - what is PT looking at

A

how long it takes the blood to clot

35
Q

Coagulation studies - PTT

A

30-40 sec

critical is over 100

36
Q

Coagulation studies - fibrinogen

A

150-400 mg/dl

Less than 100 is critical

37
Q

Coagulation studies - fibrinogen - is what

A

the ability to clot

38
Q

Coagulation studies - INR (international normalization ratio)

A
  1. 9 - 1.1

2. 5 to 3.5 for prosthetic heart valves (they are already on anticoagulants)

39
Q

Coagulation studies - INR - when are we not working with them

A

5 - you are absolutely not working with them
We can work with people up into 3 range even if they dont have the prosthetic valve, 4 you need to be cautious and consider the whole picture

40
Q

Electrolyte studies - Na

A

136-145 mEq/l

41
Q

If high Na - how will they present

A

swelling, HR inc, might be confused

42
Q

Electrolyte studies - K

A

3.5 - 5 Meq/l

43
Q

If high K how will they present

A

inc in dysrhythmias, they wont tolerate long bouts of treatment (could be high or low K)

44
Q

Electrolyte studies - BUN

A

10-20 mg/dl

45
Q

BUN tells you

A

how well their kidneys are working or ig they are in kidney failure

46
Q

Electrolyte studies - creatinine

A

0.6 - 1.2 mg/dl

47
Q

Creatinine - what is it telling you

A

breakdown of proteins

48
Q

Electrolyte studies - glucose

A

70-110 mg/dl

49
Q

Glucose - what if it is too low - how will patient present

A

Confused, fatigued

50
Q

Glucose - what if it is too high - how will patient present

A

fatigued and confused - maybe HA

51
Q

Electrolyte studies - Albumin

A

more than 2.5 g

52
Q

Albumin is telling you

A

it is a protein and is giving you info about the hydration status of the patient
Dehydrated = low albumin

53
Q

Electrolyte studies - prealbumin

A

18-32 mg/l

54
Q

Prealbumin - what is it

A

not impacted by hydration

is another protein factor

55
Q

electrolyte studies - HgA1C

A

4.8 - 6.0%

56
Q

HgA1C - tells you what

A

blood glucose over 90 days
Indicates how their blood sugar is doing
Higher - indicates diabetes

57
Q

Cardiac enzymes - Troponin 1

A

0.0 to 0.1 ng/ml

58
Q

Cardiac enzymes - troponin 2

A

less than 0.18 ng/ml

59
Q

Cardiac enzymes - Troponin 1 and 2 - what is important to note

A

They start to rise within 3-4 hrs of having MI but dont peak until 12-24 hours -
Could take up to 2 wks for troponins to come back to normal levels

60
Q

Cardiac enzymes - Total CPK

A

30-170 uL/L

61
Q

Cardiac enzymes CPK - MB

A

less than 3%

62
Q

CPK - MB - what to take note of

A

what they look at for MI

4 hrs to onset, peaks at 12 hrs, comes back down to normal in shorter time

63
Q

Cardiac enzymes - LDH

A

70-180 U/L

takes 12-48 hours to peak

64
Q

Cardiac enzymes - myoglobin - males and females

A

males - 10-95 ng/ml

females - 10-65 ng/ml

65
Q

Blood lipids - total cholesterol

Adults and children

A

less than 200 mg/dl adults

less than 125-200 children

66
Q

Blood lipids - HDL males and females

A

m - more than 33

f - more than 43

67
Q

Blood lipids - LDL

A

less than 100 mg/dl

68
Q

Blood lipids - Triglycerides

A

less than 140 mg/dl

69
Q

Blood lipids - total/HDL ratio

A

less than 4:1 ratio

for CP patients - for non they will look at total to LDL ratio

70
Q

Cardiac cath, coronary angiogram - are looking at what

A

arteries
cath - taking picture
angio - inserting dye

71
Q

Ventriculography is looking at what

A

ventricles

72
Q

Cardiac cath, coronary angiogram, ventriculography provides valuable incuding what

A

establish or confirm a dx
severity of dx
guidelines for optimal management of the patient including medical and surgical management

73
Q

what is protocol after cath, angiography, ventrculography

A

best rest for 4-6 hrs after

74
Q

Data obtained from cath, angiogram, ventric

A 
CO
shunt detection
L and R heart pressure
Ventricular EF
Presence/severity of CAD
Presence of L vent dysfun and aneurysm
Presence of pericardial disease
Presence of valvular disease
75
Q

Indication for cath

A

cardiac arrest or primary v fib
pulm edema
intolerance or noncompliance to cardiac drugs
job mandate
sig dec in exercise duration with stress test
vent tachycardia with exercise
ST depression
prolonged chest pain that is not responsive to nitro

Semester 5 PMCP Exam 3 (6 decks)

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