Elements of Patient Management a. Decision to reexamine b. Process of reexamination 1. May also identify the need for consultation with or referral to another provider 2. Based on new clinical findings or on lack of patient progress

1. B (Process of Reexamination) 2. A (Decision to Reexamine)

S1 L1.1: Subjective Assessment Flashcards by Mind Med

T/F: PPTA still has no special interest group for cardiopulmonary PTs

False
Currently, there is currently a subgroup specialization for Cardiopulmonary PTs in PPTA.

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Elements of Patient Management

The process of obtaining a history, performing a systems review, and selecting and administering tests and measures to gather data about the patient/client.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

a. Examination

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Elements of Patient Management

Determination of the level of optimal improvement that may be attained through intervention and the amount of time required to reach that level.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

d. Prognosis (c Plan of Care)

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Elements of Patient Management

Results of patient/client management, which include the impact of physical therapy interventions to the patient.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

f. Outcomes

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Elements of Patient Management

Both the process and the end result of evaluating examination data, which the physical therapist organizaes into defined clusters, syndromes, or categories to help determine the prognosis and the most appropriate intervention strategies.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

c. Diagnosis

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Elements of Patient Management

Purposeful and skilled interaction of the physical therapist with the pt/client using various physical therapy methods and techniques to produce changes in the condition that are consistent with the diagnosis and prognosis.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

e. Intervention

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Elements of Patient Management

A dynamic process in which the physical therapist makes clinical judgements based on data gatehred during the examination.

a. Examination
b. Evaluation
c. Diagnosis
d. Prognosis ( c Plan of Care)
e. Intervention
f. Outcomes

b. Evaluation

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Elements of Patient Management

The _____ is a comprehensive screening and specific testing process that leads to a diagnostic classification.

Initial Examination

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Elements of Patient Management

T/F: Examination includes subjective and objective assessment

True

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Elements of Patient Management

The _ specifies the interventions to be used and their timing and frequency.

Plan of Care

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Elements of Patient Management

a. Decision to reexamine
b. Process of reexamination

May also identify the need for consultation with or referral to another provider
Based on new clinical findings or on lack of patient progress

B (Process of Reexamination)
A (Decision to Reexamine)

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4 Sources of History Taking

Patient/Family/Caregiver Interview
History & Data Forms
Medical Chart Review
Information from Other Health Care Providers

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What do you do if the patient is not viable to answer the question during the interview?

a. Wait until the patient can answer
b. Interview the family/caregiver
c. Proceed with the other patient examinations

b. Interview the family/caregiver

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Questions to probe when a pt has Hypertension in their medical history?

Clinically diagnosed?
Controlled/uncontrolled type?
Given medications and respective intake

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Questions to probe when a pt has Diabetes in their medical history?

Clinically diagnosed?
Type 1 or 2?

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Questions to probe when a pt has Asthma in their medical history?

Was it aquired since birth or when only triggered?

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Chief Complaint

This is aso known as “Air Hunger” and is considered as one of the most common symptoms of cardiac and pulmonary diseases.

Dyspnea

(Shorttness of Breath)

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Chief Complaint

Which of the ff are TRUE regarding Dyspnea:
a. Occurs when the body’s requirement for breathing is less than the body’s capacity to provide it
b. Gas exchange is compromised
c. Unconsious breathing.

Only B is correct.
The body’s requirement for breathing exceeds the body’s capacity to provide it thus having the pt be conscious of their breathing.

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Chief Complaint

T/F: An affectation in the phrenic nerve can cause Dyspnea

True.
Phrenic Nerve innervates the diaphragm (C3-C5)

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Chief Complaint

Possible locations that can cause abnormalities in the ventilatory system?

Thoracic Cage
Lungs
Heart
Kidneys

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Chief Complaint

Dyspnea should be assessed based on _ of the appearance and progression

Time course

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Chief Complaint

a. Acute Dyspnea
b. Dyspnea on Exertion (DOE)
c. Paroxysmal Nocturnal Dyspnea (PND)
d. Functional Dyspnea

Dyspnea during functional (extreme) exercises (aggravating factor and subsides during rest

Dyspnea on Exertion (DOE)

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Chief Complaint

a. Acute Dyspnea
b. Dyspnea on Exertion (DOE)
c. Paroxysmal Nocturnal Dyspnea (PND)
d. Functional Dyspnea

Inability to breath/SOB when pt is sleeping. Onset of dyspnea 2-3 hours after the onset of sleep

Paroxysmal Nocturnal Dyspnea

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Chief Complaint

What position relieves Paroxysmal Nocturnal Dyspnea?

Upright position (Which is why pt often wakes up in the middle of the night.

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# Chief Complaint Paroxysmal Nocturnal Dyspnea (PND) is d/t _

Pulmonary Congestion

# Chief Complaint a. Acute Dyspnea b. Dyspnea on Exertion (DOE) c. Paroxysmal Nocturnal Dyspnea (PND) d. Functional Dyspnea Associated chest pain (which can be d/t spontaneous pneumothorax or embolism), chest trauma, decompensating left ventricle, possible heart failure. SOB is even present during rest.

Acute Dyspnea

# Chief Complaint a. Acute Dyspnea b. Dyspnea on Exertion (DOE) c. Paroxysmal Nocturnal Dyspnea (PND) d. Functional Dyspnea Present at rest but absent during exertion/exercise. It is short-term and more common in women.

Functional Dyspnea

# Chief Complaint Assessed based on Body Position; a. Orthopnea b. Platypnea c. Trepopnea SOB in one lateral position (in side lying position). This is common for pt c unilateral lung problem and mitra stenosis.

c. Trepopnea

# Chief Complaint Assessed based on Body Position; a. Orthopnea b. Platypnea c. Trepopnea SOB in recumbent (supine) position and is relieved when backrest is elevated.

a. Orthopnea | Congestive heart failure, Chronic pulmonary diseases

# Chief Complaint Document; "I cannot sleep well lying flat on bed but I can sleep well if I have 3 pillows."

3-pillow orthopnea

# Chief Complaint Assessed based on Body Position; a. Orthopnea b. Platypnea c. Trepopnea SOB when assuming sitting from supine. Happens with pts with pulmonary fibrosis, hypoxemia, and ventilation-perfusion mismatch (less O2/Hemoglobin=mismatch)

b. Platypnea

DYSPNEA SCALE (Grade 0-4) Walks slower than people of the same age on level ground d/t SOB or has to stop for breath when walking at own pace on level ground

GRADE 2

DYSPNEA SCALE (0-4) Too breathless to leave the house or during dressing or undressing

GRADE 4

DYSPNEA SCALE (0-4) Not troubled by breathlessness except with strenuous exercise

GRADE 0

DYSPNEA SCALE (0-4) Stops for breath after walking 100m or after few mins on level ground

GRADE 3

DYSPNEA SCALE (0-4) Troubled by SOB when hurrying on level ground or walking up a slight hill

GRADE 1

Another way to measure the SOB where O2 and HR are directly proportional with one another (6-20)

Borg RPE

As PTs settle at the yellow score (__) while avoid red scale (__) when doing exercises.

1. 12-16 2. 17-20

2nd most common symptom/CC

Chest Pain

T/F: Not all chest pain is related to angina

TRUE Differential diagnosis should be precise and done well to make sure it is not just traumatic pain on the chest instead of an actual angina

For CP pts, there is a greater chance that the chest pain is brought by ___ which may lead to ____ which may lead to ____.

Ischemia > Chest Pain > Myocardial Ischemia > Myocardial Infarction

TYPES OF CHEST PAIN a. Ischemic Chest Pain b. Stable Angina c. Unstable Angina d. Prinzmetal Angina e. Microvascular Angina Less serious type of angina where the heart must work harder during physical exertion but lasts a short time ( >5mins). May feel like gas or indigestion.

b. Stable Angina

TYPES OF CHEST PAIN a. Ischemic Chest Pain b. Stable Angina c. Unstable Angina d. Prinzmetal Angina e. Microvascular Angina Due to coronary microvascular disease at the distal segments or spasms on the walls of small arteries

e. Microvascular Angina

TYPES OF CHEST PAIN a. Ischemic Chest Pain b. Stable Angina c. Unstable Angina d. Prinzmetal Angina e. Microvascular Angina A diffuse retrosternal pain that immediately needs to be resolved. It presents (+) Levine Sign and discomfort or heaviness in the shoulder, jaw, arm, elbow, and upper back

a. Ischemic Chest Pain

TYPES OF CHEST PAIN a. Ischemic Chest Pain b. Stable Angina c. Unstable Angina d. Prinzmetal Angina e. Microvascular Angina A more serious type of angina that occurs during acute coronary syndrome. This causes a blot clot on heart artery which may lead to a heart attack

c. Unstable Angina

TYPES OF CHEST PAIN a. Ischemic Chest Pain b. Stable Angina c. Unstable Angina d. Prinzmetal Angina e. Microvascular Angina Occurs at rest and observed on younger pts.It is caused by spasms in the coronary arteries.

d. Prinzmetal Angina

What is the positive presentation of the Levine Sign

Fist close to the heart because of chest pain

TYPES OF CHEST PAIN a. Ischemic Chest Pain b. Stable Angina c. Unstable Angina d. Prinzmetal Angina e. Microvascular Angina Sx can be associated with dyspnea, sweating, indigestion, dizziness, syncope, and anxiety

a. Ischemic Chest Pain

What occurs when oxygenation is problematic to a patient

The body will not be able to supply an adequate amount of oxygen anymore

T/F: The heart muscle does not require its own supply of oxygen.

False. It requires it own supply of oxygen. Once deprived, it willnow result in angina.

What can relieve a stable angina? a. Rest b. Nitroglycerin c. Both d. None

c. Both

How can chest pain be relieved with the use of nitroglycerin?

Placed under the tongue (sublingual)

How can you determine that the type of angina is stable using nitroglycerin?

When the reaction to the medication is immediate.

T/F: Smoking is a very strong risk factor in triggering a stable angina

True. It can also be triggered by emotional stress, extremes of temp, and a heavy meal

Which of the ff is an indication of an unstable angina? 1. Occurs when a awake 2. Lasts longer than a stable angina 3. Rests and medicine (nitrates) relieve the pain 4. Pain usually lasts for 30mins

2 and 4 1. It occurs when resting or sleeping 3. Rests and medicine do not relieve pain

This artery is the blood vessel that supplies O2 and nutrients to the heart muscle

Coronary Artery

What occurs when there are spasms in the coronary artery?

It impedes the delivery of O2 and nutrients to the heart muscle

Diff Diagnosis of Chest Pain a. Pleuritic Chest Pain b. Pulmonary Hypertension c. Pericardial Chest Pain d. Esophageal Chest Pain e. Chest Wall Pain Substernal pain radiating on one or both arms and is relieved by sublingual nitroglycerin and antacids

d. Esophageal Chest Pain

Diff Diagnosis of Chest Pain a. Pleuritic Chest Pain b. Pulmonary Hypertension c. Pericardial Chest Pain d. Esophageal Chest Pain e. Chest Wall Pain Pain close to thoracic cage (superficial) and worsens sharply with inspiration, coughing, or laughing (Pain comes from the pleura and felt during the inflation of lungs)

a. Pleuritic Chest Pain

Diff Diagnosis of Chest Pain a. Pleuritic Chest Pain b. Pulmonary Hypertension c. Pericardial Chest Pain d. Esophageal Chest Pain e. Chest Wall Pain Midline pain felt from each heartbeat (pericardium) and is aggravated by deep inspiration, coughing, swallowing, or lying down. The pain is relieved by sitting up, leaning forward or lying on right side

c. Pericardial Chest Pain

Diff Diagnosis of Chest Pain a. Pleuritic Chest Pain b. Pulmonary Hypertension c. Pericardial Chest Pain d. Esophageal Chest Pain e. Chest Wall Pain This may mimic angina pectoris and occurs during exertion. This is associated with dyspnea and not relieved by nitrates.

b. Pulmonary Hypertension

T/F: Not all chest pain that does not react to nitrates is unstable angina

True. Look at other symptoms of unstable angina

T/F: Pulmonary Hypertension is similar to stable angina

False. It is similar to both stable and unstable angina

Diff Diagnosis of Chest Pain a. Pleuritic Chest Pain b. Pulmonary Hypertension c. Pericardial Chest Pain d. Esophageal Chest Pain e. Chest Wall Pain This is an intermittent type with variable intensity. It may have a traumatic history on the chest wall

e. Chest Wall Pain

Syndrome that has chest wall pain that presents with local tenderness and costochondral of the 2nd-4th costochondral junction

Tietze Syndrome

This syndrome is a tumor on superior sulcus that compresses brachial plexus. It also presents with radiating pain in the shoulder, scapular or medial aspect of arm and hand

Pancoast Syndrome

Angina Rating Scale (1-4) Moderately severe, very uncomfortable

Grade 3

Angina Rating Scale (1-4) Moderate, bothersome

Grade 2

Angina Rating Scale (1-4) Most severe or intense pain ever experienced

Grade 4

Angina Rating Scale (1-4) Mild, barely noticeable

Grade 1

Type of cough that expels sputum

Productive cough

No sputum is expelled but may sometimes contain saliva

Non-productive

T/F: Cough may only be due to acute infections of the lungs

False. It may be due to acute or chronic infection of the lungs.

# Acute Infection of the Lungs Cough associated with sore throat, runny nose & eyes

Tracheobronchitis

# Acute Infection of the Lungs Cough preceded by Sx of upper respiratory infection; dry cough → productive

Lobar Pneumonia

# Acute Infection of the Lungs Starts as acute bronchitis; dry or productive cough

Bronchopneumonia

# Acute Infection of the Lungs Paroxysmal cough (sudden increase or occurrence of symptoms)

Viral Pneumonia

# Acute Infection of the Lungs Chronic productive cough; mucoid sputum → purulent (greenish or yellowsih sputum)

Exacerbation of Chronic Bronchitis

# Chronic Infections of the Lungs Chronic productive cough for more than 3 consecutive months for 2 successive years; mucoid → mucopurulent sputum

Chronic Bronchitis

# Chronic Infections of the Lungs Cough copious; foul smell; purulent

Bronchiectasis

# Chronic Infections of Lungs Persistent cough for weeks to months; often with blood-tinged sputum

Tuebrculosis

Non-productive to productive cough for weeks or months; recurrent small hemoptysis

Tumoris

Upper airway: cough with sign of asphyxiation (nasamid) Lower airway: non-productive cough, persistent, associated with localizing wheeze

Foreign Bodies

Cough most marked in morning; slightly productive is due to?

Smoking

Often initiated by postural changes & relieved by assuming an upright position; non-productive; nocturnal and episodic

Cardiac

T/F: If wheezing is associated with dyspnea, then the condition may be a pulmonary or cardiac disease.

True

Manifestation of a narrowed airway and thickened bronchial walls d/t pulmonary edema

Wheezing in cardiac patients | Whistling or sumisipol

Wheezing or Stridor? Laryngotracheal narrowing

Stridor

Wheezing or Stidor? Thickened bronchial walls d/t pulmonary edema

Wheezing | Not in the larynx and trachea

This chief complaint is the awareness by patient of heart rhythm abnormalities such as pounding, fluttering, racing heartbeat. It can be triggered by stress, exercise, or medications

Palpitation

What are the different causes of palpitation?

1. Lack of sleep 2. Caffeinated drinks 3. Medication that is related to heart rhythm 4. Alcoholic drinks 5. Stress and some diseases

This chief complaint may be d/t reduced cardiopulmonary endurance and/or physical inactivity, antihypertensive medication, hypokalemia, and other mental health problems (depression, anixiety, emotional stress)

Fatigue

What does hypokalemia do to the body

Potassium is depleted -> absence of potassium - muscles will be weak

This type of edema is d/t congestive heart failure

Pedal/bipedal edema

How does edema form d/t congestion on the heart?

Congestion on the heart → blood can no longer go back → accumulation of blood that retains in the LE/UE → forming edema

Accumulation of fluid inside the abdominal area

Ascites

T/F: Weight gain is an earlier indication of fluid retention d/t CHF

True. I.e. ascites- increased abdominal girth

What can be other causes of edema?

Lymphatic obstruction, localized trauma (e.g. on the hand)

# HPI Patterns of Sx that must be taken note of:

1. Sudden/gradual onset 2. Constant/intermittent sx 3. Sx during at rest/exertion 4. Sx reaction to medication 5. Time of day the sx is present

What is the primary goal of PTs for pts within the ICU?

Achieve hemodynamic stability tability and optimal oxygen transport for each patient who is critically ill → optimal function

Since PTs also treat pts in the ICU, implication must be considered like:

1. Monitoring the patient (ECG, arterial and venous lines, ICP) 2. Making sure drainage (thoracostomy) is upright and is lower than point of insertion 3. Careful that attached IV lines might get disloge 4. Assess fluid and electrolyte imbalance 5. Check for sx of acid-base imbalances

Fluid & Electrolyte Imbalance: Head and Neck

Fluid Excess: Distended neck veins; facial edema Fluid Loss: Thirst, dry mucous membranes

Fluid & Electrolyte Imbalance: Extermities

Fluid Excess: Dependent “pitting” edema Fluid Loss: Muscle weakness, tingling, tetany

Fluid & Electrolyte Imbalance: Respiration

Fluid Excess: Dyspnea, orthopnea, productive cough, moist breath sounds Fluid Loss: Changes in rate and depth of breathing

Fluid & Electrolyte Imbalance: Circulation

Fluid Excess: Htn, visible jugular pulse at 45° sitting angle, atrial dysrhythmias Fluid Loss: Irregular pulse rate, dysrhythmia, postural hypotension, sinus tachycardia

Fluid & Electrolyte Imbalance: Skin

Fluid Excess: Warm, moist, taut, cool feeling when edematous Fluid Loss: Dry, decreased turgor (skin elasticity)

Fluid & Electrolyte Imbalance: Abdomen

Fluid Excess: Increased girth, fluid wave Fluid Loss: Abdominal cramps

Acidosis or Alkalosis (Respiratory Disturbances) Hypercapnia

Acidosis

Acidosis or Alkalosis (Respiratory Disturbances) Lightheadedness

Alkalosis

Acidosis or Alkalosis (Respiratory Disturbances) Convulsions

Alkalosis

Acidosis or Alkalosis (Respiratory Disturbances) Comatose

Acidosis

Acidosis or Alkalosis (Respiratory Disturbances) Headache

Acidosis

Acidosis or Alkalosis (Respiratory Disturbances) Numbness of digits

Alkalosis

Acidosis or Alkalosis (Respiratory Disturbances) Tetany

Alkalosis

Acidosis or Alkalosis (Respiratory Disturbances) Drowsiness

Acidosis

Acidosis or Alkalosis (Respiratory Disturbances) Hypocapnia

Alkalosis

Acidosis or Alkalosis (Respiratory Disturbances) Tetany

Alkalosis

Acidosis or Alkalosis (Respiratory Disturbances) DTR

Acidosis

Acidosis or Alkalosis (Respiratory Disturbances) Hypoventilation

Acidosis

Acidosis or Alkalosis (Respiratory Disturbances) Comatose

Acidosis

Acidosis or Alkalosis (Respiratory Disturbances) Hyperkalemia

Acidosis

Acidosis or Alkalosis (Respiratory Disturbances) Hypokalemia

Alkalosis

Acidosis or Alkalosis (Respiratory Disturbances) Visual Disturbances

Acidosis

Acidosis or Alkalosis (Metabolic Disturbances) Hypokalemia

Alkalosis

Acidosis or Alkalosis (Metabolic Disturbances) Bicarbondate deficit

Acidosis

Acidosis or Alkalosis (Metabolic Disturbances) Hyperventilation

Acidosis

Acidosis or Alkalosis (Metabolic Disturbances) Convolusions

Alkalosis

Acidosis or Alkalosis (Metabolic Disturbances) Headache

Acidosis

Acidosis or Alkalosis (Metabolic Disturbances) Tetany

Aklalosis

Acidosis or Alkalosis (Metabolic Disturbances) Muscle Twitching

Aklalosis

Acidosis or Alkalosis (Metabolic Disturbances) Numbness of digits

Alkalosis

Acidosis or Alkalosis (Metabolic Disturbances) Mental dullness

Acidosis

Acidosis or Alkalosis (Metabolic Disturbances) Dizziness

Alkalosis

Acidosis or Alkalosis (Metabolic Disturbances) Deep Respirations

Acidosis

Acidosis or Alkalosis (Metabolic Disturbances) Mental confusion

Alkalosis

Acidosis or Alkalosis (Metabolic Disturbances) Depressed respirations

Alkalosis

Acidosis or Alkalosis (Metabolic Disturbances) Stupor

Acidosis

Acidosis or Alkalosis (Metabolic Disturbances) Comatose

Acidosis

Acidosis or Alkalosis (Metabolic Disturbances) Bicarbonate excess

Alkalosis

Acidosis or Alkalosis (Metabolic Disturbances) Hyperkalemia

Acidosis

T/F: Cardiopulmonary system works alone. Once it becomes problematic, it is the only system affected.

False It works with the renal system and kidney. Once the cardiopulmonary system is problematic, the kidney will adapt and compensate and vice versa.

PT Implication: What to do when sx arise during the PT session?

1. Stop the PT session first 2. Check Blood Gasses 3. Assess Arousal and Brain Activity

Blood Gasses: measures function and non-functional hemoglobin; measured by extracting blood and analyzing it

Arterial Blood Oxygen Saturation

Blood Gasses: only measures functional hemoglobin; measured with the pulse oximeter

Peripheral Oxygen Saturation

What scale can be used to assess arousal and brain activity

Glasgow Coma Scale

Other scale used to assess the arousal state

Richmond Agitation-Sedation Scale

May also provide information about cerebral functioning

Electroencephalogram

PT Implication: Thorasis Surgery a. Muscle is cut b. Tissue is cut 1. result to pain 2. result to weakness

1. b 2. a

In CABG, why must not be the arms be raised beyond 90deg?

To give time for the wound to heal so it won't open | Results to LOM

This type of thoracotomy may possibly cut these muscles: pectoralis major, pectoralis minor, serratus anterior, intercostals

Anterolateral Thoracotomy

This apporach is when only a few muscles will be cut

Muscle Sparing approach

This type of thoracotomy uses the muscle-sparing approach (only intercostals) where the muscles that are possibly cut arelatissimus dorsi, serratus anterior, lower trapezius, intercostals, and sometimes could reach the rhomboids and middle trapezius

Posterolateral thoracotomy

Thoracotomy that cuts pectoralis major or linea alba of rectus abdominis

Median Sternotomy

A process of inserting a tube after surgery for drainage to evacuate excessive air and fluid

Thoracostomy

a. Vasodilators b. NSAIDS + ACE inhibitors c. NSAIDS + Digitalis d. Diuretics e. Beta-blockers f. Alpha-1 Blockers g. ACE Inhibitors h. Calcium Channel Blockers Monitored during physical exertion for elevated BP

b. NSAIDS + Ace Inhibitors

a. Vasodilators b. NSAIDS + ACE inhibitors c. NSAIDS + Digitalis d. Diuretics e. Beta-blockers f. Alpha-1 Blockers g. ACE Inhibitors h. Calcium Channel Blockers close monitoring of RPE and bradycardia; cautious when using HR in monitoring pt

e. Beta-blockers

a. Vasodilators b. NSAIDS + ACE inhibitors c. NSAIDS + Digitalis d. Diuretics e. Beta-blockers f. Alpha-1 Blockers g. ACE Inhibitors h. Calcium Channel Blockers hypotension, reflex tachycardia (medicines that end in "zosin")

f. Alpha-1 Blockers

a. Vasodilators b. NSAIDS + ACE inhibitors c. NSAIDS + Digitalis d. Diuretics e. Beta-blockers f. Alpha-1 Blockers g. ACE Inhibitors h. Calcium Channel Blockers muscle weakness & spasms, dizziness, headache, incoordination, nausea

d. Diuretics

a. Vasodilators b. NSAIDS + ACE inhibitors c. NSAIDS + Digitalis d. Diuretics e. Beta-blockers f. Alpha-1 Blockers g. ACE Inhibitors h. Calcium Channel Blockers rash, persistent dry cough (Medicines that end in “pril”)

g. ACE Inhibitors

a. Vasodilators b. NSAIDS + ACE inhibitors c. NSAIDS + Digitalis d. Diuretics e. Beta-blockers f. Alpha-1 Blockers g. ACE Inhibitors h. Calcium Channel Blockers fatigue, confusion, arrhythmias

c. NSAIDS + Digitalis

a. Vasodilators b. NSAIDS + ACE inhibitors c. NSAIDS + Digitalis d. Diuretics e. Beta-blockers f. Alpha-1 Blockers g. ACE Inhibitors h. Calcium Channel Blockers swelling on feet and ankles, hypotension, headache, nausea (Due to excessive vasodilation)

h. Calcium Channel Blockers

a. Vasodilators b. NSAIDS + ACE inhibitors c. NSAIDS + Digitalis d. Diuretics e. Beta-blockers f. Alpha-1 Blockers g. ACE Inhibitors h. Calcium Channel Blockers may produce hypotension, dizziness and syncope (loss of consciousness)

a. Vasodilators

a. Nitrates b. Anticoagulants c. Thrombolytic Drugs d. Beta-2 receptor agonists e. Theophylline and Aminophylline f. Corticosteriods Clearance if DVT resolves (If a clot is present, these drugs are used).

c. Thrombolytic Drugs

a. Nitrates b. Anticoagulants c. Thromolytic Drugs d. Beta-2 receptor agonists e. Theophylline and Aminophylline f. Corticosteriods Can also lead to osteoporosis, growth degradation, cushing's syndrome

f. Corticosteriods

a. Nitrates b. Anticoagulants c. Thromolytic Drugs d. Beta-2 receptor agonists e. Theophylline and Aminophylline f. Corticosteriods headache, dizziness, tachycardia, OH

a. Nitrates

a. Nitrates b. Anticoagulants c. Thromolytic Drugs d. Beta-2 receptor agonists e. Theophylline and Aminophylline f. Corticosteriods for asthma attacks (albuterol, formoterol, salmeterol, etc)

d. Beta-2 receptor agonists

a. Nitrates b. Anticoagulants c. Thromolytic Drugs d. Beta-2 receptor agonists e. Theophylline and Aminophylline f. Corticosteriods hematoma, nose-bleeding (heparin or warfarin, prevent clot formation)

b. Anticoagulants

a. Nitrates b. Anticoagulants c. Thromolytic Drugs d. Beta-2 receptor agonists e. Theophylline and Aminophylline f. Corticosteriods Monitoring because of toxic effects. Advanced asthma but has toxic effects on body

e. Theophylline and Aminophylline

Chest X-Rays: a. Air b. Fats c. Muscle, other soft tissues d. Bone/metals Light Gray

c. Muscle, other soft tissues

Chest X-Rays: a. Air b. Fats c. Muscle, other soft tissues d. Bone/metals Dark

a. Air

Chest X-Rays: a. Air b. Fats c. Muscle, other soft tissues d. Bone/metals White

d. Bone/metals

Chest X-Rays: a. Air b. Fats c. Muscle, other soft tissues d. Bone/metals Dark Gray

b. Fats

T/F: Advnace CT Scans and MRI's were discovered in the 1980's-1990's

False 1970's-1980's

Provide excellent images of heart, lungs and vascular tissues; more precise; ionizing effect (drawback)

Computed Tomography (CT Scan)

Higher-quality views of soft tissues. It is more expensive and non-ionizing (takes an hour to complete)

Magnetic Resonance Imaging (MRI)

Checks the heart’s rhythm and its electrical activity (Usually use 12 leads)

Electrocardiogram (ECG / EKG)

Laboratory procedure that includes RBC count, variety of RBC indices, differential WBC count, hematocrit (Hct), hemoglobin (Hgb), and platelet count.

Complete Blood Count (CBC)

What needs to be assessed under the Lvl of Physical Activity (3)

1. Including exercises and sport activities 2. Current vs. prior lifestyle 3. Active vs. sedentary lifestyle

Need to be taken into account under Functional Status (2)

1. Work/School (Current vs. Prior) 2. Occupational History

Formula in getting the BMC Public Health Classification (Pack-years)

(No. of packs a day) x (Current age - Age first started smoking)

A.F. is a 55 yrs old smoker who smokes 1 pack a day. He started smoking at the age of 25. Document the pack years.

Lifestyle > pt is a moderate smoker c Hx of 30 pack-years

BMC Public Health Classification a. Non-smoker b. Light smoker c. Moderate smoker d. Heavy smoker 21-40 pack years

c. Moderate smoker

BMC Public Health Classification a. Non-smoker b. Light smoker c. Moderate smoker d. Heavy smoker 0 pack years

a. Non-smoker

BMC Public Health Classification a. Non-smoker b. Light smoker c. Moderate smoker d. Heavy smoker >40 pack years

d. Heavy smoker

BMC Public Health Classification a. Non-smoker b. Light smoker c. Moderate smoker d. Heavy smoker 1-20 pack years

b. Light smoker

Categories of Alcoholic Beverage a. Social b. Conformity c. Enhancement d. Coping e. Alcohol Abuser f. Alcoholic Drink to fit in, not necessarily because they would normally drink in the situation

b. Conformity

Categories of Alcoholic Beverage a. Social b. Conformity c. Enhancement d. Coping e. Alcohol Abuser f. Alcoholic Extreme consumption (Considered as a psychological disorder)

e. Alcohol Abuser

Categories of Alcoholic Beverage a. Social b. Conformity c. Enhancement d. Coping e. Alcohol Abuser f. Alcoholic Drink to celebrate; pastime

a. Social

Categories of Alcoholic Beverage a. Social b. Conformity c. Enhancement d. Coping e. Alcohol Abuser f. Alcoholic Drink because it is exciting; likely to actively seek to get drunk

c. Enhancement

Categories of Alcoholic Beverage a. Social b. Conformity c. Enhancement d. Coping e. Alcohol Abuser f. Alcoholic Addiction to alcohol - Excessive alcohol consumption is related to heart diseases, heart failure, atrial fibrillation, even hemorrhagic stroke

f. Alcoholic

Categories of Alcoholic Beverage a. Social b. Conformity c. Enhancement d. Coping e. Alcohol Abuser f. Alcoholic Drink to forget about their worries, may lead to worse long-term consequences

d. Coping

Type of Alcoholic Beverage Drinker: ● 1 drink/day (women); 1-2 drinks/day (men) ● Beer: 12 fluid ounces (355 milliliters) ● Wine: 5 fluid ounces (148 milliliters) ● Distilled spirits (80 proof): 1.5 fluid ounces (44 milliliters)

Moderate Drinker

Type of Alcoholic Beverage Drinker: High-risk drinking; >3 drinks on any day or >7 drinks/week (>65 y/o), and >4 four drinks on any day or >14 drinks/week for men (65 y/o)

Heavy Drinker

Type of Alcoholic Beverage Drinker: 4 drinks within 2 hours for women and 5 drinks within 2 hours for men

Binge Drinker

Drug Abuse: What can opoid use cause?

arrhythmias, stroke, endocarditis

Drug Abuse: What can Methamphetamine (shabu) cause?

congestive heart failure, arrhythmia, and damage to heart muscles and blood vessels via inflammation

Nutritional Intake through providing food through tube in nose, stomach, or intestine

Enteral

Nutritional Intake through providing food intravenously; bypassing eating and digestion

Parenteral

Which of the ff statements are true about the Pt's Goal? a. Allows the clinician to align the care provided with what is most important to the patient b. Establishes the most medically appropriate, realistic, and agreed goal of patient care c. Both d. None

c. Both

S1 L1.1: Subjective Assessment Flashcards

(199 cards)