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Cardiopulm Test 1 > Last Couple Day Studying > Flashcards

Last Couple Day Studying Flashcards

1
Q

What is the biggest problem with valve stenosis

A

Decreased cardiac output, decrease blood pressure will be evident

Note: regurgitation of valve causes decreased cardiac output over time but not immediately

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2
Q

The more stretched the atria and ventricles are, the more _____ levels in the blood

A

BNP

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3
Q

What are the classic symptoms of pericarditis?

A

Chest pain with lying down that is relieved by sitting up and leaning forward

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4
Q

Severe pericarditis that limits cardiac output is called

A

Cardiac tamponade

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5
Q

Endocarditis can cause ____ problems

A

Valve

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6
Q

Dental procedures can cause….

A

Endocarditis

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7
Q

Pulmonary embolus comes from the ____ and gets stuck in the

A

Veins

Pulmonary artery

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8
Q

What side of the heart typically fails if you have a pulmonary embolus

A

Right sided heart failure \ R Side heart hypertrophy

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9
Q

when pulmonary embolus causes R side ventricular heart failure this can be called

A

Cor pulmonale

You’ll see swelling, jugular vein distention, and weight gain

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10
Q

What is a D-dimer test

A

Test for DVT by looking for certain proteins

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11
Q

T or F Pulmonary pressure can normally be 20+ during exercise

A

T

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12
Q

When oxygen levels of the lung decrease you see reflexive ______

A

Vasoconstriction to shunt blood to areas with better ventilation/perfusion ratio

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13
Q

Dehydration increases what electrolyte that can cause arrhythmias

A

Increases sodium

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14
Q

Aldosterone causes retention and excretion of what

A

Retain sodium

Excrete potassium

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15
Q

Patient’s with thoracotomy have a risk of developing ____ in the lung

A

Pneumonia

-bc difficulty clearing phlegm

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16
Q

Why does a patient hold a pillow on their incision when they cough?

A

To provide counterpressure bc of the increased intra-abdominal pressure

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17
Q

With any percutaneous procedure you are concerned about ______ for the first couple days

A

Bleeding

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18
Q

If a patient you’re already seeing is now going for a valve replacement procedure and will be back to your outpatient PT soon, what will you do when they get back?

A

Listen to heart sounds before and after activity

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19
Q

When someone’s light headed/dizzy how can you increase venous return to resolve this?

A

Have them lay down with legs up

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20
Q

If the vascular of the extremities is constricted in order to increase BP during heart failure, what will the patient’s extremities feel like?

A

Cold

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21
Q

Ejection fraction less than _____ indicates heart failure

A

40

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22
Q

-sartan suffix

A

Angiotensin receptor blocker

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23
Q

-ril suffix

A

Ace Inhibitor

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24
Q

What are the effects of angiotension 2

A

Constricts Arterioles

Causes release of ADH (helps to retain water)

INCREASE BLOOD PRESSURE

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25
Q

ACE Inhibitors and angiotensin receptors can affect _________ and cause (hypo/hyper)_____________ which can cause arrythmias

A

electrolytes (potassium)

hyperkalemia

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26
Q

Patient’s on ACE inhibs and ARBs might have (low or high BP) with an (increased/decreased) HR

A

Low BP

Increased HR

might experience orthostasis when standing up

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27
Q

What kind of inotropic medication will be taken in an outpatient setting?

A

Dijoxin/digitalis

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28
Q

Dijoxin makes you feel….

A

SICK

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29
Q

Why is Dijoxin used for Atrial fibrillation

A

Increases PR interval

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30
Q

T or F, a patient with dijoxin needs their heartrate taken for a whole minute

A

T

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31
Q

Angioplasty risks?

A

Arrythmias

No vigorous exercise 5-7 d/t bleeding

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32
Q

How to stop a stent from becoming reoccluded?

A

drug eluting stent

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33
Q

What do you do to help with the healing of an angioplasty

A

10lb sandbag placed over femoral artery puncture site for 6 hours

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34
Q

Arthrectomy vs Angioplasty

A

Arthectomy uses a drill and is typically used for coronary artery stenosis because the blockage is bigger

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35
Q

Typical CABG precautions?

A

Sternal

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36
Q

CABG complications?

A

Arrythmias

MI

Cardiac stunning

Bleeding

Renal Failure

CVA

Infection

MOST COMMON: Pleural effusion due to decreased cardiac output

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37
Q

Should you mobilize a patient after a CABG?

A

Yes it is very important to prevent serious complications

38
Q

How to prevent infection for a CABG patient

A

make sure bandages are clean and dry and check for drainage

39
Q

IABP risks?

A

Could potentially damage kidneys

Stroke

Infection

Ischemia

40
Q

Metal valve replacement complications?

A

Increase risk of stroke

patient needs blood thinners for rest of life

41
Q

Why would a patient be fatigued after a valve replacement?

A

They were temporarily put on a heart/lung machine

42
Q

Patients will typically need _____ after a cardiac ablation procedure

A

4-7 days of rest

43
Q

Bipolar pacemakers are typically used for…

A

Ventricular arrythmias

44
Q

Pacemaker/ICD precautions

A

No lifting arm overhead past 90 degrees for 4 weeks, no shoulder ext or HABD (for ICD or pacemaker)

No lifting 10+ pounds

PT needs to be aware of what rate sets it off and work 10-20 beats below that (for ICD only)

Need to know what kind of pacemaker/ICD it is

45
Q

Carotid endarterectomy is indicated for…

A

symptomatic patients w/ 50% blockage

or

asymptomatic patients w/ 60% blockage

-This procedure is done due to stroke risk.

46
Q

Carotid Endarectomy precautions

A

No aggressive side bending or turning of head

47
Q

Abdominal Aortic Anuerysm repair precautions

A

NO trunk extension, no twisting

Dont encourage flexion either

patient needs to heal in an upright position

-no coughing or huffing early on

-encourage bronchial hygene techniques

-teach patient to logroll

48
Q

Bronchoscopy risks

A

Pain limits breathing -> risk of collapsed lung -> teach patient breathing exercises

49
Q

What are the 3 kinds of lung resection

A

Wedge- piece of lung

Lobectomy- whole lobe

Pneumonectomy - whole 1 lung

50
Q

Thoracotomy precautions

A

-no coughing/huffing early on

-pt needs to be taught breathing exercises, risk of collapsed lung

-shoulder pain is common

-no stretching surgical scar areas

-dont activate the muscles involved in the surgical area too aggressively

51
Q

From what leads is T wave inversion normal?

A

Lead 3, Lead V1, and Lead AVR

(note: children may have inversion in V1, V2, and V3)

52
Q

P wave inversion on a lead that is not lead 3, AVR, or V1 V2 could potentially mean:

A

Heart block with a junctional rhythm

53
Q

A ventricular triplet is also called…..

A

Nonsustained ventricular tachycardia

54
Q

What leads look at the anterior wall of the heart?

A

V3 V4

55
Q

What leads look at the lateral wall of the heart?

A

V5 V6

56
Q

What kind of medication is lasix?

A

Loop diuretic (most potent)

57
Q

Why would a patient present w/ high heartrate after taking a nitrate?

A

Reflexive tachycardia

58
Q

What is orthostatic hypotension

A

drop of SBP 20

DBP drops 10

HR increases 30bpm

59
Q

What is the difference between ACE and ARBs

A

ACE works on the enzymes whereas ARBs works on the receptors

60
Q

What is Entresto/Neprolysin Inhibitor

A

Special kind of ARB

Reduces abnormal remodeling of vasculature

promotes diuresis/ vasodialation/ NA excretion and K retention (opposite of aldosterone)

61
Q

What medicine causes angioedema?

A

ARBs / ACE inhib

62
Q

What are the effects of aldosterone antagonists

A

Mild diuretic

Decreases renal fluid and NA retention (excretes NA)

Side effects: Possible hyperkalemia since aldosterone normally excretes potassium

63
Q

What are the 3 classes of positive inotropes?

A

Cardiac Glyocosides (seen in outpatient)

Sympathomimetics ( Acute care)

Phosphodiasterase inhibitors (Acute care)

64
Q

Dopamine/Inotropin is considered a…..

A

Sympathomimetic

65
Q

Which of the following is NOT a vasodilator:

Ca+ Blocker

ACE inhibitor

Beta Blockers

Nitrates

A

Beta Blockers

66
Q

What is a potential side effect of vasodilators

A

reflexive tachycardia

67
Q

What is Nipride?

A

Arterial and Venous Dilator

Rapid Onside

-effective in treatment of Severe HF

68
Q

What medication is often taken to control the side effects of vasodilators?

A

Beta blockers (to prevent sympathetic compensation)

69
Q

Which of the following is not an antihypertensive:

B blocker

Aldosterone Antagonist

Cardiac Glycoside

Ca+ Blocker

ARB/ACE inhib

Vasodilator

DIuretics

A

Cardiac Glycoside

70
Q

What is Xylocaine and how does it work?

A

Class 1 Antiarythmic medication, reduces influx of Na+ into cell

71
Q

Beta blockers are class ____ antiarythmcis and calcium channel blockers are class ______

A

Beta Blockers: 2

Calcium channel blockers: 4

72
Q

How do calcium channel blockers help arrythmias

A

Blocks Ca+ channels into cells that normally cause excitation

72
Q

How to betablockers help arrhythmias

A

Block sympathetic excitation

73
Q

Why does hyperkalemia cause arrythmias?

A

Because it lowers the threshold required for excitation of the myocardium

(more potassium= easier to excite and cause an AP)

74
Q

How does digitalis/digoxin help arrhythmias

A

Slows HR by extending PR interval (depresses AV node conduction)

75
Q

What is adenosine?

A

Drug given by IV for supraventricular tachycardias

slows conduction pathway through AV node

76
Q

What is Atropine

A

Medicine for bradydysrhythmias

blocks cholinergic receptors on cardiac muscle

77
Q

Why is MMT not reliable in the ICU

A

-Sedation

-Limited Ability to communicate

78
Q

what is considered high PEEP?

A

15+

79
Q

what is considered high pressure support

A

20+

80
Q

What is considered high FiO2?

A

60+

81
Q

What is considered high Rate Pressure Product at rest?

A

10,000

82
Q

What is considered low MAP?

A

below 60

83
Q

What is normal Cardiac ejection fraction and what’s considered heart failure?

A

Normal: 55-70

failure: below 40

84
Q

Which ventilator is not for weaning?

A

Assist-Control

85
Q

On a ventilator, excessive PEEP may ________ cardiac output

A

reduce

86
Q

If a patient has paradoxical breathing, what does this mean?

A

Accessory muscles being used

diaphram is tired

87
Q

what device delivers the fastest flow of oxygen?

A

High Flow Humidification system

88
Q

What is it?

A

Reservoir nasal cannula

89
Q

What is the purpose of this mask?

A

Turns medication into mist for inhalation

90
Q

Bundle branch blocks are a sign of…

A

Worsening condition (not necessarily a fatal problem on their own)

91
Q

What is worse: Ventricular bigemini or trigemini

A

bigemini

Cardiopulm Test 1 (11 decks)

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