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Flashcards in Test 2 Deck (50):
1

What is coronary artery disease?

atherosclerosis: narrowing of arteries leads to deposit of cholesterol & lipid in the artery wall which hardens with age.

2

What is angina?

Chest pain caused from insufficient oxygenated blood to the heart.

3

What are the risk factors for CAD?

Modifiable: elevated serum lipids, HTN, DM, obesity, physical inactivity, tobacco use.

Non-modifiable: age, gender, ethnicity, family hx, genetic predisposition

4

S/S of angina?

sweating, SOB, rapid/weak pulse, Nausea, grey complexion, pain from jaw, neck, arms, back stomach, central chest pain.

5

What are the classes of angina?

I: strenuous activity causes angina.
II: angina occurs w/walking, climbing rapidly uphill
III: limit ordinary daily activity
IV: angina symptoms present @ rest

6

Tx for angina?

Controller drugs: beta blockers, calcium channel blockers, long-acting nitrates

Rescue: SL, trans lingual spray, IV nitroglycerin

7

What is a myocardial infarction?

sustained ischemia to heart muscle results in cell death.

8

Diagnostic studies for CAD?

H&P, 12 lead ECG, cardiac enzymes, troponin levels, Coronary angiography.

9

What is heart failure?

heart unable to pump sufficient amount of blood to meet body's metabolic needs (decreased CO)

10

Risk factors of HF?

Major: chronic HTN, MI

Other: valve deficiency, Afib/flutter, aging myocardium, DM

11

S/S of Right HF

Juglar vein distention, ascites, pedal edema

12

S/S of Left HF

PE, cough, dyspnea

13

FACES

Fatigue, limitation of activities, chest congestion/cough, dependent edema, shortness of breath

14

Diagnostic studies for HF

BNP, Ejection fraction %

15

Drugs that Tx HF

Diuretics, ACEI, ARBs, Beta blcokers, cardiac glycosides, b-type natriuretic peptides, vasodilators

16

What are the components of Cardiac Rehab?

Medical eval, prescribed exercise, nutrition education, counseling of pt w/cardiac disease, emotional support

17

What is Phase I of cardiac rehab?

Initated while pt. still in hospital

18

What is Phase II of cardiac rehab?

A supervised ambulatory outpatient program 3-6 mon

19

What is phase III of cardiac rehab?

Lifetime maintenance where physical fitness & additional risk factor reduction emphasized

20

What are the goals of cardiac rehab?

Prevent disease progression & disability, improve physical functioning, improve quality of life.

21

What is COPD?

irreversible airflow of obstruction that interferes w/normal breathing and gas exchange. Associated with abnormal inflammatory response.

22

What are the two categories of COPD?

chronic bronchitis and emphysema.

23

What does COPD stand for?

Chronic Obstructive Pulmonary Disease

24

What is Chronic Bronchitis?

Cough & sputum production for at least 3 mon, 2 consecutive years w/inflammation & scarring of bronchial tube lining

25

What is emphysema?

enlarged air space as a result to destruction in aveolar walls (reduced surface area of gas exchange)

26

What is the difference between chronic bronchitis and emphysema?

In bronchitis, obstruction is in the brochial tubes and emphysema, obstruction is in the aveolar

27

What are the clinical manifestations of COPD?

dyspnea, chronic cough, chronic sputum production, fatigue, weakness, activity intolerance, changes in appearance (barrel chest, clubbing, tripod w/accessory use of muscles, bluish-red skin), cachexia

PINK PUFFER & BLUE BLOATER

28

What are the lab values that determine COPD?

Hypoxemia: PaO2 <60mmHg (SaO2 <88%)

Hypercapnia: PaCO2>45mmgHg

Labs: Polycythemia: HgB>20g/dL

29

Medical Management for COPD>?

Smokign cessation, medication (long acting beta 2 agonist, anticholinergic, inhaled corticosteroid, phosphodiestease 4 inhibitor), pulmonary rehab, 02 therapy, surgery (lung transplant, LVRS)

30

Pt. Education on COPD?

Smoking cessation, breathing exercises, good nutrition & fluid therapy, promote exercise, teach prevention

31

Why is pursed lip breathing important?

Prolongs exhale, prolonging gas exchange so that the pt. doesn't tire from trying to exchange air too quickly

32

What structures make up the upper airway?

nose, pharynx, larynx

33

What structures make up the lower airway?

trachea, bronchi, bronchioles, alveoli

34

What is the normal lab value for pH?

7.35-7.45

35

What is the normal lab value for PaCO2?

32-48 mm Hg

36

What is the lab value for Bicorbonate (HCO3-)?

22-26 mEq/L

37

What is the normal lab value for PaO2?

80-100 mm Hg

38

What is the normal value for SaO2?

>95%

39

What is considered base excess?

>2.0 mEq/L

40

What is the difference between PaCO2 and PaOC?

PaCO2 meausres CO2 in arterial blood, PaO2 measures pressure of Oxygen in arterial blood

41

What are the steps to reading ABGs?

1. evaluate pH
2. Analyze PaCO2
3. Analyz HCO3-
4. Determin CO2 or HCO3 matches alteration
5. Decide if body attempting to compensate

42

What is dyspnea?

Labored breathing

43

What is tachypnea?

Rapid breathing

44

What is orthopnea?

difficulty breathing laying down

45

What is hypoventilation?

abnormally slow breathing, increased CO2 in blood

46

What is hyperventilation?

abnormally fast and deeper breathing, decrease in CO2 in the blood

47

What is hypoxia?

Not enough oxygen reaching tissues

48

What is hypexemia?

abnormally low concentration of oxygen in blood

49

What is hypercapnia?

Elevated CO2 levels in the blood

50

What is ventilation perfision?

V/Q

Alveolar ventilation/Cardiac output