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Acute > Week 3 > Flashcards

Week 3 Flashcards

1
Q

Automaticity

A

the heart has the ability to initiate its own electrical impulse

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2
Q

Excitability

A

heart’s ability to respond to electrical stimulus

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3
Q

Conductivity

A

allows the heart to transmit electrical impulse from cell to cell of the myocardium

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4
Q

Contractility

A

heart needs to function as one unit, so contractility allows the heart to stretch as a single unit, then passively recoil while actively contracting – ability to function as a whole unit

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5
Q

Rhythmicity

A

the heart needs to repeat is cycle in synchrony and with regularity – will have issues getting enough blood down to the heart (arrythmia) – treatment is medication or pacemaker

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6
Q

Which side of the heart is a low pressure system? high pressure system?

A

Right side of heart: low pressure system

Left side of heart: high pressure system

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7
Q

atrial systole

A

period of atrial emptying, includes atrial kick – try to make sure atrium is completely empty

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8
Q

atrial diastole

A

period of atrial filling

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9
Q

What is the 1st reading of BP?

A

ventricular systole - period of ventricular contraction

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10
Q

What is the 2nd reading of BP?

A

ventricular diastole - period of ventricular filling

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11
Q

What is heart pump dysfunction?

A

congestive heart failure

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12
Q

What is container dysfunction?

A

dysfunction of blood vessels

- HTN will cause vasoconstriction and ischemia

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13
Q

What does anaphylaxis and septic shock cause and lead to?

A

causes massive vasodilation leading to lethal hypotension

- also known as distributive shock

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14
Q

What is content dysfunction?

A

dysfunction of blood

- any kind of sustained bleeding or hemorrhaging will cause a loss of blood content

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15
Q

What is mean arterial pressure and what should it be?

A

measure of tissue perfusion - > 75 mmHg

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16
Q

P wave

A

atrial depolarization

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17
Q

PR interval

A

elapsed time between atrial depolarization and ventricular depolarization

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18
Q

QRS complex

A

ventricular depolarization and atrial repolarization

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19
Q

ST segment

A

elapsed time between end of ventricular depolarization and beginning of repolarization

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20
Q

QT interval

A

elapsed time between beginning of ventricular repolarization and end of repolarization

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21
Q

T wave

A

ventricular repolarization

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22
Q

What does ST depression of 1-2 mm mean?

A

ischemia

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23
Q

What does ST elevation mean?

A

MI

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24
Q

What does T wave inversion mean?

A

MI

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25
What does prominent Q wave mean?
MI
26
What does a wide QRS mean?
bundle branch block
27
A-fib EKG
QRS wave is down
28
V-fib EKG
squiggly mountains | - would need AED to shock rhythm back into rhythm
29
V-tack EKG
sharp QRS wave up
30
More than ______ PVS in a minute – stop exercising! Why?
6 | - ventricles are not filling all the way and less blood is getting to the tissues
31
What lab value is used to ID congestive heart failure? What is the cutoff value?
Brain natriuretic peptide (BNP) | - anything under 100 is normal
32
SaO2 vs PaO2
SaO2 - saturation of peripheral O2 - percentage of available binding sites on hemoglobin that are bound with oxygen in arterial blood PaO2 - partial pressure of O2 - amount of O2 in arterial blood
33
What is normal PaO2 and PaCO2?
PaO2 - > 80 mmHg PaCO2 - 35-45 mmHg
34
What happens during carbon monoxide poisoning? What device shouldn't be used and why?
CO bumps O2 off hemoglobin and using a pulse ox will give you a false thinking that the person has O2 in blood
35
Agonal rhythm
irregular, < 20bpm, near death
36
Atrial fibrillation - what does it lead to?
most common arrhythmia - can lead to syncope due to no atrial kick - found w/ CHF, CAD, HTN, and other cardiac conditions
37
Ventricular tachycardia
rate > 100 bpm, usually regular rhythm, most common after acute MI
38
Ventricular fibrillation
chaotic rate and rhythm, will lead to death if untreated | - need shock from AED
39
Multifocal VT (torsades de pointes)
irregular rhythm and rate > 150 bpm
40
AV block
rhythm disturbance where electrical conduction from atria to ventricles is partially or completely blocked
41
What type of tachycardia is a product of exertion and which one is pathological after MI?
exertion - Atrial tachycardia pathological - V-tach
42
What position should be avoided with CHF?
supine
43
What precautions are used after a CABG?
sternal precautions for 8 weeks
44
What are PT considerations after cardioversion/pacemaker?
closely monitor activity response w/ HR and BP | - know if device has rate modulation
45
What is AICD/ICD? What are precautions?
automatic cardiac defibrillator | - patient can't use that arm that pacemaker is on for 1-3 days post surgery
46
What type of patient uses a life vest? What should you do if walking and it notifies it will apply a shock?
- patient who is high risk for cardiac arrest - awaiting heart transplant or not a candidate for a heart transplant - If walking a patient and it alerts, sit them down and figure out if shock is necessary or not – can manual override
47
What is VAD? What are rehab and precautions?
ventricular assist device - rehab - phase 1-2 cardiac rehab - precautions - know emergency procedures in case of battery failure, maintain patency of drive lines w/ external pump, monitor hemodynamics
48
What predicts likelihood of discharge of CAD?
Marburg Heart Score ``` 55+ in men, 65+ in women Known CAD or cardiovascular disease Pain not reproducible by palpation Pain worse with exercise Patient’s assumption that pain is cardiogenic in origin ```
49
Cardiac PT Interventions goals
- assess hemodynamic response - maximize activity tolerance - patient/caregiver education for activity/behavior modification
50
Absolute Indications and withhold treatment
- decompensated CHF - 2nd degree heart block w/ PVC - 3rd degree heart block - > 10 PVC/min at rest - chest pain w/ new ST segment changes - New onset A-fib w/ rapid ventricular response at rest (HR > 100 bpm)
51
Relative Indications to modify or withhold treatment
resting HR > 100 bpm resting HTN > 160 systolic and > 90 diastolic hypotension at rest (<80 systolic) ventricular ectopy at rest A-fib w/ rapid ventricular response at rest (HR > 100 bpm) psychosis/unstable psych condition
52
How many beats over resting HR is generally safe intensity level?
20-30 bpm
53
Patients on beta-blockers: do not exceed____ beats above resting HR
20
54
AICD: target HR ______ beats below threshold rate on defibrillator
20-30
55
T/F: You can use HR to prescribe exercise post-heart transplant
False - You CANNOT use HR to prescribe exercise after heart transplant
56
What is HHR (HR recovery)?
difference between peak HR w/ exercise minus HR at 60 seconds
57
What is an abnormal response to BP?
- systolic decrease of 10 mmHg below resting - systolic response >180 mmHg - diastolic response > 110 mmHg
58
What is goal of phase 1 cardiac rehab? When does it start?
starts as soon as patient is stable goal is to tolerate ADL's, walking functional distances, climbing stairs - education is essential
59
What is goal of phase 2 cardiac rehab? When does it start?
starts about 2 weeks after cardiac event continue patient education and progresses exercises and activities
60
When does phase 3 of cardiac rehab begin?
usually begins 2-3 months after cardiac event
61
As O2 stats drop, the patient becomes more what?
acidotic

Acute (14 decks)

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