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Cardio-Pulmonary > Pathological Vital Signs > Flashcards

Pathological Vital Signs Flashcards

(48 cards)

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1
Q

what are the categories of acute coronary syndrome

A

unstable angina
MI
- STEMI
- NSTEMI

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2
Q

explain difference between STEMI and NSTEMI in relation to location/degree of infarct

A

ST = st elevation MI resultant from total occlusion thrombus

NST - non-st elevation resultant from partial occlusion with or w/o collateral circulation

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3
Q

if ventricular chamber dilates, what occurs to
- heart wall
- blood pressure
- vasomotor tone

A

wall thins and systolic function decreases

decreased CO = hypotension

vasoconstriction and afterload increase = greater ischmemia

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4
Q

what does nitroglycerin act as?

A

vasodilator

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5
Q

why may tachycardia occur during acute coronary syndrome

A

vasoconstriction
decreased CO
HR increases as a response

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6
Q

what is the associated elevation of ST segment during STEMI

A

1 mm

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7
Q

what elevated markers indicate necrosis

A

troponin I
troponin T
creatine-kinase MB

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8
Q

for patients with stable ACS/MI patients, what values indicate ability to do PT

A

RR <30 breaths per minute
<120 RHR
MAP of at least 60
SpO2 >90%
SBP <110 mmHg

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9
Q

indication to stop PT intervention in those with ACS / MI

A

unable to comfortably speak
RR >40 breath/min
onset of S3 heart sound
HR decrease of >10bpm
SBP decrease of >10mmHg
MAP increase >10mmHg
SpO2 <90% of decrease greater than 4% from baseline

return of pre-MI angina pain

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10
Q

HFpEF
- value
- indicates which dysfunction

A

55-75% ejection fraction

diastolic dysfunction

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11
Q

HFrEF
- value
- indicates which dysfunction

A

EF <40%
systolic dysfunction

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12
Q

BP equation

A

CO x TPR

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13
Q

what may increase in those with HFrEF

A

increased RR due to pulmonary edema

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14
Q

for those with stable HF, what vitals indicate PT

A

RR <30 breath/min
crackles below rib 5 posteriorly
resting HR <120
MAP >60mmHg
minimal/no weight gain in 24 hours

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15
Q

for those with stable HF, what vitals during PT indicate stoppage

A

unable to comfortably speak
RR >40
S3 heart sound onset
pulmonary crackles above rib5 posteriorly
HR decrease >10
SBP decrease >10mmHg
MAP increase > 10 mmHg
new onset/worsening cardiac arryhtmia

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16
Q

what can be visually monitored in those with Right Sided HF

A

jugular vein distension
peripheral edema

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17
Q

what can cause claudication

A

O2 demand > O2 availability in periphery

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18
Q

what is the measure of ABI? what values indicate what?

A

ankle SBP / arm SBP

<0.9 suggests PAD
>1.1 suggests atherosclerosis / DM2

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19
Q

what is commonly found in those with PAD

A

other CVD

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20
Q

what can be important to screen for in those with PAD? why these things?

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A

fall risk / integ changes
- blood obstruction can lead to muscle atrophy/decreased endurance

s/s of CVD (50% of those with PAD have a form of another CVD)

21
Q

what commonly causes aorta aneurysms

Study These Flashcards
A

atherosclerosis and systolic HTN

22
Q

what defines an aortic aneurysm

Study These Flashcards
A

dilation of aorta
>50% of orignal size
or
> 3 cm

23
Q

what are the common vital sign indicators of aortic aneurysms

Study These Flashcards
A

tachycardia
decrease BP
– especially with complain of sudden abdominal pain

24
Q

DVT s/s

Study These Flashcards
A

pain
ipsilateral swelling
warmth or redness

– most common in the LE

25
pulmonary embolism s/s
unexplained shortness of breath decreased SpO2 pleuritic chest pain cough tachycardia
26
what are marked in both types of lung disorders
progressive dyspnea hypoxia decline FEV1
27
what is the diagnostic threshold for RLD
FEV1/FVC = >85%
28
explain difference between primary and secondary RLD
primary = within the lung, issue that is specific to lung tissue secondary = condition that could limit thoracic expansion
29
what is under the umbrella of primary RLD
pneumonia interstitial lung disease acute lung injury acute respiratory distress syndrome
30
what is the appearence of those with RLD
emaciated kyphoscolosis tachypnea/tachycardia
31
explain minute ventilation changes in those with RLD? any considerations?
will decrease to 1:1 - more so RR than tidal vol reserve will need supplemental O2
32
for those with RLD, what vitals indicate PT
RR <40 breath/min HR: 60-120 SpO2: >90%
33
what vitals indicate stoppage/modification of PT in those with RLD
unable to comfortably speak SpO2 <85%, especially if on O2 decrease in HR and SBP by >10 units
34
what can be helpful early on in RLD intervention vs what is not?
inspiratory muscle training "deep slow breaths" -- need to increase RR because they are limited in thoracic expansion ability
35
what is the diagnostic threshold for OLD
FEV1/FVC <70%
36
what is under the umbrella of COPD
chronic bronchitis emphysema bronchiectasis asthma cystic fibrosis
37
explain respiration ratio in those with OLD
will move closer to 1:3 or 1:5 - normal is 1:2
38
explain oxygen supplmentation in those with COPD
it is something to be careful of in chronic patients - those with COPD rely on hypoxic drive for breathing, therefore more O2 in the system can disrupt that
39
what vital signs indicate PT in those with OLD
RR <30 breath/min, speaking comfortable SpO2: >90% at rest (+/- O2 supplement) HR: 60-120 bpm
40
what vital signs indicate PT stoppage/modification in those with OLD
inability to comfortably speak SpO2: <85%, especially with O2 supplement HR and/or SBP: decrease of >10 units
41
what level on the BORG are we looking to get pts with RLD/OLD to in treatment
11-13 on 6-20 scale
42
for those with DM, what is important to monitor in relation to HR
dysrhythmias / atrial fibrillation
43
for those with DM, what is important to monitor in relation to BP
orthostatic hypotension
44
explain pulse oximetry measurements in those with DM
may overestimate O2 saturation in those with poorly managed DM2 - ABG may be needed
45
level of pre-exercise blood glucose
90-250 mg/dL
46
what symptoms may indicate silent ischemia in those with DM
fatigue nausea / vomiting sweating dyspnea arrythmia
47
what to do if pre-exercise blood glucose is: low (<90 mg/dL) vs elevated (250-350 mg/dL) vs high (>350 mg/dL)
low: ingest 15-30g of carbohydrate elevated: test for ketones - if negative, low mild to moderate is indicated - if positive (mod to large amounts) no exercise high: no exercise
47
in those with chronic DM, what is often found? how can this affect vital signs?
autonomic neuropathy increased resting HR (early stages) then fixed and unresponsive during exercise

Cardio-Pulmonary (22 decks)

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