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Cardiopulmonary > Week 3 > Flashcards

Week 3 Flashcards

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1
Q

cardioversion

A

restores normal sinus rhythm
electrical or pharmacological

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2
Q

PT implication of cardioversion

A

no restrictions or limitations
no immediate bedrest
watch for changes in heart rhythm at rest or activity

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3
Q

what dx can cardioversion be used for

A

A-fib
SVT
stable v-tach

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4
Q

cardiac ablation

A

used to stop or prevent arrhythmias

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5
Q

types of cardiac ablation

A

Atrial fibrillation ablation
Atrial flutter ablation
AV node ablation
SVT ablation
Ventricular tachycardia ablation

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6
Q

PT implications for cardiac ablation

A

bed rest for a few hours if using the femoral artery catheter site
no restrictions/precautions
what for changes in heart rhythm at rest or activity

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7
Q

endarterectomy

A

procedure used to remove plaque from narrowed or blocked arteries

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8
Q

complications for endarterectomy

A

vasospasm
rupture
stroke
peripheral clot in the leg
compartment syndrome

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9
Q

PT implications for endarterectomy

A

neuro– sensation, coordination, cognition
integ check
strength testing

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10
Q

balloon angioplasty

A

tiny balloon deflated and guided through the artery to a blockage
balloon gets inflated to widen the lumen of a vessel and therefore increase blood flow to the heart
stent can be placed during procedure

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11
Q

PT implications for balloon angioplasty

A

bed rest for a few hours if using femoral artery
no restrictions/precautions

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12
Q

percutaneous coronary intervention PCI

A

small, expandable stents used to open up narrowed coronary arteries

stents: drug induced or bare metal

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13
Q

results of percutaneous coronary intervention

A

reduce symptoms
increase blood flow
help keep vessels open to prevent further problems

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14
Q

complications of percutaneous coronary intervention

A

infection or rejection
stent could fail
stroke
risk for bleeding

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15
Q

pacemaker

A

device used to control an irregular heart rhythm

no shock delivered

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16
Q

precautions for pacemaker

A

no e-stim
no reaching OH, pushing, pulling

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17
Q

implantable cardioverter defibrillator

A

delivers an electrical shock to restore a normal heart rhythm

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18
Q

CABG

A

surgical procedure to restore normal blood flow to an obstructed coronary artery

relieves or prevents left ventricular dysfunction

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19
Q

ON PUMP CABG

A

heart is stopped and blood is filtered via machine
utilizes bypass harvesting
2 openings total
commonly from saphenous vein

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20
Q

OFF PUMP CABG

A

performed without the use of a heart-lung machine
allows procedure to be done on a beating heart

associated with decreased post op complications and recovery time

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21
Q

minimally invasive CABG

A

commonly for LAD
preserves the sternum

more painful because ribs are cracked open which makes it harder to breath
no sternal precautions

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22
Q

CABG post op complications

A

post-perfusion syndrome
cardiogenic shock
nonunion of the sternum
acute renal failure
stroke
pneumothorax/hemothorax
bleeding

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23
Q

cardiogenic shock

A

heart cannot pump enough blood and oxygen to vital organs

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24
Q

common medications used during cardiogenic shock

A

levophed
vasopressin
epinephrine
dobutamine and milrinone

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25
cardiac tamponade
reduced cardiac function due to fluid accumulation in the pericardial cavity
26
beck's triad
hypotension jugular vein distention muffled heart sounds
27
3 surgical options for cardiac tamponade
subxiphoid pericardial window medial sternotomy CABG
28
sternal wound complications
dehiscence sternectomy--> debridement to remove infected bone pectoralis flap--> covers where sternum was removed
29
most common A line
radial
30
if transducer is too high _____
it will give a false low BP
31
if transducer is too low _____
it will give a false high BP
32
transducer should be at the ___________ space
4th intercostal
33
annuloplasty
replaces the rim on the mitral or tricuspid valves
34
valve replacement mechanical
metallic or synthetic material highly durable and can last a lifetime BUT requires lifelong anticoagulation to decrease the risk of thromboembolism
35
valve replacement tissue or biologic
human, cow, or pig tissue durability is 10-20 years BUT no lifelong anticoagulation required
36
transcatheter aortic valve replacement
minimally invasive used for aortic valve only NO restrictions or precautions used for patients that are higher risk and cannot undergo heart surgery
37
aneurysm
a localized, blood filled balloon like bulge in the wall of a blood vessel as size increases, risk for rupture increases
38
aneurysm can lead to
bleeding hypovolemic shock death
39
locations for aortic aneurysm
descending thoracic ascending thoracic aortic root aortic arch
40
aortic dissection
tear occurs in the inner layer of the aorta lining
41
endovascular aortic repair
minimally invasive method to manage abdominal or thoracic aortic aneurysms NO PRECAUTIONS **idea procedure
42
pain rating 0-4
0-- no pain 1-- mildly, barely noticeable 2-- moderate, bothersome 3-- moderately severe, very uncomfortable 4-- most severe or intense pain ever experienced
43
metabolic syndrome
high blood glucose high blood pressure high lipid profile large waist size low HDL levels
44
non-modifiable risk factors
Biological sex Family history Age Race
45
modifiable risk factors
HTN High Blood Cholesterol and triglycerides Type II Diabetes Smoking Overweight and obesity Physical inactivity
46
other risk factors than can be changed
stress ETOH diet and nutrition
47
oxygen requirement
Any patient with a resting PO2 of less than 55 mm Hg on room air or an oxygen percentage saturation of less than 88%
48
PaO2 levels (normal, mild, moderate, severe hypoxemic)
normal= 80-100 mild= 60-80 moderate= 40-60 severe= <40
49
body postures/positions that may affect respiration
Kyphosis and scoliosis [limit vital capacity and hence exercise capacity] Assuming the professorial position Often unable to lie in a flat, supine position Typically assume a semi-Fowler's position
50
central cyanosis
caused by diseases of the heart or lungs, or abnormal hemoglobin Discoloration is systemic -- skin would be colored
51
peripheral cyanosis
is caused by decreased local circulation and increased extraction of oxygen in the peripheral tissues. Discoloration is regional
52
First heart sound/S1 Lub
associated with the closure of the mitral and tricuspid valves corresponds with the onset of ventricular systole results from reverberation within the blood associated with the sudden block of flow reversal by the valves Blood blocked from entering ventricles from the atria
53
The second heart sound/S2 Dub
associated with the closure of the aortic and pulmonary valves corresponds with the start of ventricular diastole results from reverberation within the blood associated with the sudden block of flow reversal Blood blocked from the ventricles into the pulmonary artery and aorta
54
Third heart sound/S3 Lub-dub-dub
occurs early in diastole while the ventricle is rapidly filling Normal in healthy children or young adults Abnormal in an older, physically inactive person or in the presence of heart disease it typically indicates a loss of ventricular compliance often called a ventricular gallop (overstretched)
55
Fourth heart sound (S4) La-lub-dub
occurs late in diastole, just before S1 Also known as atrial gallop is not normal and is associated with an increased resistance to ventricular filling hypertensive cardiac disease, coronary artery disease, or pulmonary disease
56
stenosis
Aortic or Pulmonary Valve can’t fully open (Stenosis)
57
regurgitation
Mitral or tricuspid valve can’t fully close (regurgitation/insufficiency) Mitral valve prolapse/regurgitation is the most common valvular condition
58
murmurs result from
turbulent blood flow
59
pitting edema scale 0-4
0 No depression 1+ Barely detectable depression when finger is depressed into the skin 2+ Slight indentation. <15 seconds to rebound 3+ Deeper indentation. 15-30 seconds to rebound 4+ > 30 seconds to rebound
60
oxygen saturation
Should remain unchanged Typically >95%
61
desaturation
Fall below 90% or so Abnormal response
62
rubor dependency test is a good predictor of
PAD Low negative predictive value (Can’t rule out potential PAD if rubor is not present)
63
ABI normal vs low results
An ABI above 0.9 is considered normal An ABI below 0.5 is suggestive of severe arterial occlusive disease
64
ABI >1 symptoms and presentation
no symptoms normal presentation
65
ABO 0.41-0.9 symptoms and presentation
claudication pain in calf with ambulation
66
ABI 0.2-0.4 symptoms and presentation
critical limb ischemia atrophic changes, rest pain, wounds
67
ABI <0.2 symptoms and presentation
severe ischemia gangrene/severe necrosis
68
symptoms of PAD/PVD
Shiny and hairless skin, gangrene, weak pulses, wounds, numbness, intermittent claudication
69
common cause of PAD/PVD
atheroscloreosis which decreases bloof flow to limbs May also be caused by injury to limbs, irregular anatomy, infection
70
HR drops sharply in the 1st minute post-exercise. It should recover by _______ per minute after this.
20 beats
71
s/sx of exercise intolerance
Syncope; dizziness during activity New onset of angina Nausea & vomiting Marked dyspnea (sudden SOB) Unusual or severe fatigue Ataxia, persistent unsteadiness, mental confusion Severe claudication pain Facial expression of severe distress Cyanosis/pallor Cold sweat SBP > 250 mm Hg DBP > 110 mm Hg Drop in DBP > 20 mm Hg = STOP Presence of arrhythmias Excessive fatigue 2 or more hours after exertion– you overdid it
72

Cardiopulmonary (6 decks)

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