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DPT 629: Cardio > PT Exam and Assessment of the Pulmonary System > Flashcards

PT Exam and Assessment of the Pulmonary System Flashcards

(92 cards)

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1
Q

what are the elements of pt/client management

A

exam, eval, dx, prognosis, and intervention

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2
Q

what are the components of the examination?

A

pt hx, systems review, tests and measures

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3
Q

what is the purpose of the evaluation?

A

to evaluate data to make a clinical judgement

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4
Q

what is the purpose of the diagnosis?

A

to classify a pt w/in a specific practice pattern and indicates the primary dysfunctions

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5
Q

what is the purpose of the prognosis?

A

to determine the predicted level of optimal function

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6
Q

what is included in the pt/client hx?

A

info on their current symptoms and medical problems

PMH

initial info on impairments and functional limitations

other sources of info beyond the chart from the pt/family/nurses

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7
Q

what is the difference bw aerobic capacity and fatiguability?

A

aerobic activity is specific to exercise, fatiguability can be any level of exertion w/SOB

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8
Q

is dyspnea a function change or a description of a change in function?

A

a description of a change in function

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9
Q

what info is included in the medical chart review?

A

dx and date of event

symptoms

other medical problems and PMH

relevant social hx

meds

clinical lab data

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10
Q

the date of the event determines the ___

A

acuteness

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11
Q

what are the classic pulmonary symptoms?

A

SOB, dyspnea, increased work of breathing, sputum, wheezing, coughing

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12
Q

what is dyspnea?

A

SELF REPORTED difficulty breathing

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13
Q

what is SOB?

A

OBSERVABLE increased RR, shallow quick breathing

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14
Q

what is the normal range of pH?

A

7.35-7.45

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15
Q

if the pH is low (<7.35) is this acidosis or alkalosis?

A

acidosis

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16
Q

if the pH is high (>7.45) is this acidosis or alkalosis?

A

alkalosis

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17
Q

is PCO2 the respiratory or metabolic component of ABGs?

A

respiratory

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18
Q

is HCO3 the respiratory or metabolic component of ABGs?

A

metabolic

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19
Q

what is the key indicator of alveolar ventilation?

A

PaCO2

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20
Q

what is normal PaCO2?

A

40 mmHg

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21
Q

if PaCO2 is <40mmHg, what is this indicative of?

A

HYPERventilation

respiratory alkalosis

rapid shallow breathing

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22
Q

what are some s/s of hyperventilation?

A

rapid, shallow breathing

anxiety

irritability

respiratory alkalosis

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23
Q

if PaCO2 is >40mmHg, what is this indicative of?

A

HYPOventilation

respiratory acidosis

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24
Q

what is a key sign of hypoventilation?

A

drowsiness

loss of consciousness even

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25
what is ventilatory failure?
PaCO2>50mmHg
26
if HCO3 is low, is this acidosis or alkalosis?
acidosis
27
if HCO3 is high, is this acidosis or alkalosis?
alkalosis
28
what can cause low HCO3?
increased production from ketoacidosis failure to remove from kidney failure medical condition
29
what can cause high HCO3?
overuse of antacids vomiting potassium wasting diuretics
30
if the pH is low, and PaCO2 is high, what is this?
respiratory acidosis
31
if the pH is low, and HCO3 is low, what is this?
metabolic acidosis
32
if the body is in respiratory alkalosis, what may the body do to create equilibrium?
create a metabolic acidosis
33
what is partial compensation in ABGs?
the pH remains out of range, CO2 and HCO3 are out of range
34
what is full compensation in ABGs?
the pH is in normal range, but PaCO2 and HCO3 are both out of range
35
what is normal PaCO2?
80-100 mmHg
36
what is SpO2?
% hemoglobin oxygenated
37
what are the S/S of hypoxemia?
headache, breathlessess, dyspnea, palpitations, angina, restlessness, tremors if severe: impaired judgement, progressive loss of cognitive fxn, loss of consciousness
38
what is O2 therapy?
the use of supplemental O2
39
what things should be noted about O2 therapy?
use of O2 and the delivery method amount of O2 delivered correlate to ABGs any other respiratory treatments
40
t/f: supplemental O2 is registered as a drug by the FDA
true
41
t/f: oxygen requires a physician order or prescription that is flexible
true
42
an O2 prescription should specify ___ not ____
an SpO2 goal, amount O2
43
why should O2 prescriptions be flexible?
to allow practitioners to adjust the dose according to pt presentation
44
what is FiO2?
fraction of inspired O2 the fraction of O2 in the atmosphere
45
what is normal FiO2?
0.21 or 21% (room air)
46
does supplemental O2 increase or decrease FiO2?
increase
47
what is the flow rate?
the amount of O2 delivered to the pt per minute
48
what are the supplemental O2 delivery options from least to most potent?
nasal cannula (NC) oxidizer simple face mask venturi face mask non-rebreather mask high flow nasal cannula tracheostomy collar
49
what is the nasal cannula delivery method of O2?
varying FiO2 by varying the flow rate suitable for flow rates 0.25-6L/min
50
what is the oxidizer delivery method of O2?
specialized nasal cannula w/an oxygen reservoir that provides greater FiO2 at lower flow rates up to 12 L/min flow up to FiO2 of .82/82%
51
what is a simple face mask delivery of O2?
for pts who need flow >6-10 L/min OR can be useful instead of NC for pts who mouth breathe
52
what is the venturi face mask delivery of O2?
face mask that provides more specific FiO2 at a specified flow rate varied orifice size to deliver specified FiO2 may have interchangeable inlets or may alter orifice size using a dial tells the liters needed to reach a certain %
53
what is humidification?
wetness that can added to O2 delivery methods bc O2 has a drying effect on mucus membranes
54
the higher the O2, the ___ the need for humidification
higher
55
what is a non-rebreather mask for O2 delivery?
delivery of higher FiO2 at lower flow rates by preventing rebreathing of CO2 FiO2 up to .90/90% (closest to 100% you can get w/o an invasive vent)
56
what are some precautions to be aware of with a non-rebreather mask?
the mask must fit tightly to the face the reservoir bag should remain 1/3 to 1/2 full w/inspiration it is uncomfortable for pts it is not for long term use
57
what is a high flow nasal cannula for O2 delivery?
for flows >6L/min can adjust to FiO2 and flow rate independently FiO2 up to 1.0 or 100% flows up to 60L/min heated and humidified circuit
58
what are some precautions to be aware of with a high flow nasal cannula?
it should fit tightly to the face and nostrils you will likely need an aid to handle to device setup to mobilize pts
59
what is a tracheostomy collar for O2 delivery?
for pts with an open tracheostomy to deliver O2 straight to it
60
what is included in radiological studies of the medical chart?
chest radiographs, CT scans, MRIs, and scintigraphy
61
t/f: the extent of a pt's surgery predicts the activity performance impairments
true
62
what are the incisions related to pulmonary surgery?
video-assisted thoracic surgery (VATS) thoracotomy sternotomy clamshell
63
what is a VATS incision?
small incision in the chest from scopes
64
what is a thoracotomy incision?
extensive incision from the axilla back around the scapulae tends to cause the most pain with mobility
65
what is a sternotomy incision?
the typical incision for open heart surgery straight down the sternum
66
what is a clamshell incision?
not commonly seen outside of lung transplant lift up the chest to access the lungs
67
what are the precautions post VATS?
typically none
68
what are the precautions post-thoracotomy?
no lifting>10lbs on the ipsi side
69
what are the precautions post-clamshell?
no lifting >10 lbs on the ipsi side sternal precautions
70
what are the PT considerations with VATS?
pain and guarding
71
what are the PT considerations with thoracotomy?
pain and guarding scar tissue if chronic posture
72
what are the PT considerations with clamshell incisions?
pain and guarding scar tissue if chronic posture
73
where do chest tubes get placed?
in the pleural space or mediastenum
74
what is the purpose of chest tubes?
to evacuate air or fluid to prevent or correct lung collapse
75
what are chest tubes connected to?
suction device or water seal
76
check that what are intact b4 mobilizing with chest tubes?
sutures holding the tubes in place
77
what are the PT implications of chest tubes?
pain asking if suction needs to be maintained with mobilization checking tubing b4 moving bed rails and recliner parts maintaining the collector below the level of insertion to maintain gravity effects avoid kinking tubes avoid tipping collector may have to wait for chest x-ray after removal before mobilizing
78
what is obstructive disease?
can't get air out
79
what are the characteristics of obstructive disease PFTs?
decreased FEV1 decreased FEV1/FVC normal FVC less steep slope
80
what does 65-80% predicted FEV1 mean?
mild obstruction
81
what does 50-65% predicted FEV1 mean?
moderate obstruction
82
what does <50% predicted FEV1 mean?
severe obstruction
83
what is normal FEV1/FVC?
75%
84
what is considered a significant change in FVC or FEV1 post bronchodilators?
12% increase
85
what does a change post bronchodilators mean?
reversible obstruction
86
what may complete return to normal after bronchodilators therapy indicate?
asthma
87
what is restrictive disease?
can't get air in
88
what are the characteristics of restrictive disease PFTs?
decreased FEV1, FVC, TLC normal FEV1/FVC (>80%)
89
what does 65-80% predicted TLC mean?
mild restriction
90
what does 50-65% predicted TLC mean?
moderate restriction
91
what does <50% predicted TLC mean?
severe restriction
92
what are the vital signs?
RR, temp, BP, HR, and pain

DPT 629: Cardio (12 decks)

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