Flashcards in Test 2 Deck (50):
What is coronary artery disease?
atherosclerosis: narrowing of arteries leads to deposit of cholesterol & lipid in the artery wall which hardens with age.
What is angina?
Chest pain caused from insufficient oxygenated blood to the heart.
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
S/S of angina?
sweating, SOB, rapid/weak pulse, Nausea, grey complexion, pain from jaw, neck, arms, back stomach, central chest pain.
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
Tx for angina?
Controller drugs: beta blockers, calcium channel blockers, long-acting nitrates
Rescue: SL, trans lingual spray, IV nitroglycerin
What is a myocardial infarction?
sustained ischemia to heart muscle results in cell death.
Diagnostic studies for CAD?
H&P, 12 lead ECG, cardiac enzymes, troponin levels, Coronary angiography.
What is heart failure?
heart unable to pump sufficient amount of blood to meet body's metabolic needs (decreased CO)
Risk factors of HF?
Major: chronic HTN, MI
Other: valve deficiency, Afib/flutter, aging myocardium, DM
S/S of Right HF
Juglar vein distention, ascites, pedal edema
S/S of Left HF
PE, cough, dyspnea
Fatigue, limitation of activities, chest congestion/cough, dependent edema, shortness of breath
Diagnostic studies for HF
BNP, Ejection fraction %
Drugs that Tx HF
Diuretics, ACEI, ARBs, Beta blcokers, cardiac glycosides, b-type natriuretic peptides, vasodilators
What are the components of Cardiac Rehab?
Medical eval, prescribed exercise, nutrition education, counseling of pt w/cardiac disease, emotional support
What is Phase I of cardiac rehab?
Initated while pt. still in hospital
What is Phase II of cardiac rehab?
A supervised ambulatory outpatient program 3-6 mon
What is phase III of cardiac rehab?
Lifetime maintenance where physical fitness & additional risk factor reduction emphasized
What are the goals of cardiac rehab?
Prevent disease progression & disability, improve physical functioning, improve quality of life.
What is COPD?
irreversible airflow of obstruction that interferes w/normal breathing and gas exchange. Associated with abnormal inflammatory response.
What are the two categories of COPD?
chronic bronchitis and emphysema.
What does COPD stand for?
Chronic Obstructive Pulmonary Disease
What is Chronic Bronchitis?
Cough & sputum production for at least 3 mon, 2 consecutive years w/inflammation & scarring of bronchial tube lining
What is emphysema?
enlarged air space as a result to destruction in aveolar walls (reduced surface area of gas exchange)
What is the difference between chronic bronchitis and emphysema?
In bronchitis, obstruction is in the brochial tubes and emphysema, obstruction is in the aveolar
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
What are the lab values that determine COPD?
Hypoxemia: PaO2 <60mmHg (SaO2 <88%)
Labs: Polycythemia: HgB>20g/dL
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)
Pt. Education on COPD?
Smoking cessation, breathing exercises, good nutrition & fluid therapy, promote exercise, teach prevention
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
What structures make up the upper airway?
nose, pharynx, larynx
What structures make up the lower airway?
trachea, bronchi, bronchioles, alveoli
What is the normal lab value for pH?
What is the normal lab value for PaCO2?
32-48 mm Hg
What is the lab value for Bicorbonate (HCO3-)?
What is the normal lab value for PaO2?
80-100 mm Hg
What is the normal value for SaO2?
What is considered base excess?
What is the difference between PaCO2 and PaOC?
PaCO2 meausres CO2 in arterial blood, PaO2 measures pressure of Oxygen in arterial blood
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
What is dyspnea?
What is tachypnea?
What is orthopnea?
difficulty breathing laying down
What is hypoventilation?
abnormally slow breathing, increased CO2 in blood
What is hyperventilation?
abnormally fast and deeper breathing, decrease in CO2 in the blood
What is hypoxia?
Not enough oxygen reaching tissues
What is hypexemia?
abnormally low concentration of oxygen in blood
What is hypercapnia?
Elevated CO2 levels in the blood