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Cardiopulmonary > Midterm > Flashcards

Midterm Flashcards

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1
Q

Heart sounds heard on the left are

A

Where you hear either S1 or S2 the best

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2
Q

S1 is

A

Sound of mitral and tricuspid valve closing

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3
Q

Hear S 1 best at

A

Apex of heart

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4
Q

S2 is

A

Sound of aortic and pulmonary valve closing

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5
Q

S2 best hear at

A

Base of heart

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6
Q

Split S2 normal with

A

Inspiration

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7
Q

S4 is heard when

A

Infidulum is scarred or ischemic or left ventricle wall is stiff

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8
Q

S4 heard best when

A

Pt in partial decubitus position and at the apex

Follow s1

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9
Q

S3 is

A

When ventricles are overloaded and mitral and tricuspid regurgitate or chf or mi

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10
Q

S3 common in

A

Children under five
World class athletes
Trimester of pregnancy

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11
Q

Summation gallop is

A

All four sounds heard together

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12
Q

S4 heard with

A

L vent aneurysm

Idiopathic or ischemic cardiomyopathy or heart block

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13
Q

Systolic murmurs

A

Mitral insufficiency
Aortic stenosis
Mitral valve prolapse

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14
Q

Mitral insufficiency

A

Heard best at apex

Sound like blowing through all of systole

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15
Q

Aortic stenosis

A

Heard at aortic area

Increase afterload can lead to chf, heart hypertrophy

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16
Q

Mitral valve prolapse

A

Heard at apex
When papillary mm break
Hear snapping open between s1&2

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17
Q

Diastole murmurs

A

Mitral stenosis
Aortic stenosis
Pericardial friction rubbing

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18
Q

Mitral stenosis

A

Heard at apex sound like rumble

Lead to R and L CHF

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19
Q

Aortic stenosis

A

Heard at erbs point , sound like blowing

Lead to L CHF

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20
Q

Pericardial friction rub

A

Heard at fourth L ICS

Sounds like crackling

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21
Q

Murmur grade 1

A

Barely audible

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22
Q

Murmur grade 2

A

Med intensity

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23
Q

Murmur grade 3

A

Loud with not thrill (vibration)

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24
Q

Murmur grade 4

A

Loud with thrill

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25
Murmur grade 5
Loud need stethoscope
26
Murmur grade 6
Loud no stethoscope
27
Limb lead I shows
Atrium | RA-> LA
28
Limb lead II shows
Left ventricle | RA to LL
29
Limb lead III shows
Apex | LA to LL
30
Augmented leads top to bottom
AVF(LF)
31
Augmented leads bottom to top
AVR(RA) and AVL( LA)
32
V1 placed
Fourth ICS on r
33
V2 placed
Fourth ICS on l
34
V4 placed.
Fifth ICS at apex
35
V3 placed
Between v2 and v4
36
V6 placed
Sixth ICS at ant axial line
37
V5 placed
Between v4 and v6
38
Why where a holter monitor?
``` Symptoms of arrhythmia Causes of arrhythmia MI Evaluate pacemaker Evaluate change in medication ```
39
Thallium 201 findings
Cold spot = dead tissue | Assess cardiac ischemia and blood flow
40
Sestamibi findings
Hot spot =dead tissue | Assess acute cardiac ischemia and blood flow
41
Pulmonary artery catheter
Measure CO and R atrial pressure | PRoM
42
Centeral venous line
Measure R atrial pressure | PROM and AROM
43
Stable angina
Predictable chest pain | Know when going to get chest pain because reached ischemic threshold
44
Unstable angina
Chest pain occurs whenever | Occurs with less exertion, lasts longer, non responsive to meds
45
Prinzmetal angina
Vasospam of coronary a | Angina occurring at rest
46
Signs of angina
``` Dyspnea Light headed Belching Brought on by exercise Relieved with rest Levines sign Vomiting Denial Diaphoresis Severe weakness Apprehension ```
47
Ischemic MI stage
Reversible
48
Injury MI stage
Occluded vessel but have collateral circulation to help
49
Infarct MI stage
Cell deaths
50
Subendocardial MI( no q wave)
Less intense PT | Eight weeks to form a scar if to high of HR lose wall
51
Full thickness MI (q wave)
Aggressive PT | Try to decrease scar and increase heart mm
52
Heart failure I (mild)
No limitations | Ordinary activity doesn't cause SOB, fatigue, palpation
53
Heart failure II ( mild)
Slight limitations Good at rest Cause SoB, fatigue, palpation
54
Heart failure III (moderate)
Marked limitations Good at rest Less than normal activity cause fatigue, SoB, palpation
55
Heart failure IV ( severe)
Normal activity cause discomfort Cardiac insufficiency at rest Any activity increase discomfort
56
L chf excessive afterload causes
``` Systolic ventricular dysfunction Dec sv/ef Inc lv edv Inc la pressure Inc la/pulm pressure Pulmonary edema ```
57
R chf caused by
L vent failure Mitral valve disease Pulm htn Pulm disease
58
R chf consequences
``` Inc r vent end diastolic Jugular venous dissension Liver enlargement Ascitis (fluid in abs) Peripheral edema ```
59
Systolic hf
Ef less than 55% Pulm/peripheral edema Dyspena
60
Treat for systolic hf
Dec afterload - ace inhobitors - diuretics - digitoxin ( inc contractility)
61
Diastolic hf
Dec sv, dec edv | Dec wall compliance
62
Tx for diastolic hf
Ace inhibitor Diuretic Dec sodium
63
Indications for cabg
Stable angina that is debilitating Initial agnosia Myocardium ischemia Unstable angina
64
Risks of cabg
``` Perioperative mi Aortic stenosis Unstable angina Unstable htn Uncompensated chf Arrhythmia ```
65
Risks of anesthia
``` Intubation Atelectasis Pleural fluid Inc sputum production Arrhythmia Pneumonia ```
66
Post op complications
``` Opening up of wound Pleural effusion Pneumonia Arrhythmia Wound infection Atelectasis Cardiac arrest Chf Cardiac tamponade Hemothorax Hypercapnea Pe Subcutaneous emphysema Brachial plexus / fibularis nerve palsy Compartment syndrome. ```
67
Indications of pacemaker
SA node disorders Av node disorders Tachycardia
68
NBG code 1
Location of pacemaker
69
NBG code 2
What's being paced
70
NBG code 3
How will it respond to problem | Pace out?
71
NBG code 4
Heart rate set?
72
NBG code 5
Pace or shock pt out of arrhythmia
73
PR interval
Time between SA node and av node | .12-.2 seconds 3-5 small boxes
74
RR interval
Rate and rhythm of heart
75
QRS complex
.04-.09 1-2 small boxes >.09 interventicular conduction block >.12 BBB
76
QT interval
Ventricular depolarization and repolarization | .42 sec
77
Contraindications for phase one cardiac rehab
``` Unstable angina Uncontrolled chf Orthopedic problems Uncontrolled arrhythmia Uncontrolled htn Recent pe Severe outflow track obstruction Severe physical or emotional issues Complete heart block Acute infections ```
78
Peripheral line for
Saline lock No food or meds 48-72 hours
79
Swan gnaz cather
Monitor heart function | Measures wedge pressure- inc pressure can cause r chf, co, stroke index
80
Cardiopulmonary monitoring lines for
Draw blood, blood pressure, atrial gases
81
Pacing wires
Pace heart if need be
82
Complications of line s
``` Dislodgement Fracture Irritate phrenic n Tamponade Rhythm disturbances Hospitalized for 24 hours after ```
83
Calcium channel blocker clinical considerations
Watch for s and s on dec co Hypotensive Dec pedal edema Dec contractility
84
Heart sounds heard on the right are
Both S1 and S2 equally

Cardiopulmonary (2 decks)

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