509 - 2 - Activity Eval & Response

Front 1

What info is already available?

Back 1

* Chart review (cause of admission, medical history, medication)
* Patient interview (PLOF, goals, home environment, signs/symptoms)
* Other healthcare team members

Front 2

Dynamic Assessment examines:

Back 2

position changes
ADL
monitored ambulation

Front 3

What do you measure?

Back 3

* Functional mobility
(OOB to chair, tubes, surgical wounds)
* Vital signs
(in different positions)
(examine if stop is needed)

Front 4

How much HR increase per MET of activity?

Back 4

7-10 beats / MET

Front 5

How much SBP increase per MET of activity?

Back 5

7-10 mmHg / MET

Front 6

Biilat leg (peripheral) pain and fatigue with exercise suggests:

(CP signs normal)

Back 6

Claudication with peripheral arterial disease

Front 7

Claudication pain comes on when during exercise?

Back 7

Always at the same time

Front 8

How much CP sign increase with ADL?

Back 8

5-10 bpm & mmHg

Front 9

How much CP sign increase with monitored ambulation?

Back 9

10-20 bpm & mmHg

Front 10

What is the exception to having to take vital signs during monitored ambulation?

Back 10

Patient safety comes first, such as if patient needs constant max assist.

Front 11

Rapid rise with increased workload suggests

Back 11

Severe deconditioning
CV abnormality

Front 12

Flat response indicates

Back 12

High probably of CV disease
chronotropic incompetence

Front 13

Hypertensive SBP responese:

Back 13

Higher than expected response

at risk for developing resting HTN

Front 14

Hypertensive SBP response due to:

Back 14

1) increased catecholamines
2) increased resistance from PVD
3) abnormally centrally-mediated vasomotor tone

Front 15

Blunted/Flat SBP response

Back 15

failure to increase with workload
if can't reach 130mmHg, high risk for future sudden death

Front 16

Hypotensive/hypoadaptive SBP response:

Back 16

increases but drops with increasing workload (>10-20 mmHg)
High correlation with pathological cardiac condition

Front 17

Hypotensive/hypoadaptive SBP response due to

Back 17

severe multi-vessel CAD
LV function is poor or in acute fair
Severe AS or HCM

Front 18

3 Abnormal DBP responses

Back 18

an increase of 10mmHg
sustained elevated BP in recovery phase
likely to have or high risk for CAD

Front 19

Normal O2 sat range

Back 19

94-100%

Front 20

Crackles sound like, & indicate:

Back 20

popping sounds, like vecro

indicates fluid or collapsed airways

Front 21

Wheezes sound like, & indicate

Back 21

high pitched whining

indicate narrowed airways

Front 22

Pleural rubs sound like, & indicate

Back 22

rubbing sounds,

indicating rubbing between lung and lining due to infection or inflammation

Front 23

Pericardial rub sounds like, & indicate

Back 23

tumbling thumping,

indicate pericardial sac inflammation

Front 24

Pleural rub vs Pericardial rub, if you hold your breath:

Back 24

Pleural stops

Pericardial continues

Front 25

What is egophony

Back 25

ask patient to say "E"

normal: muffled "EEEE"
positive: hard "AAAA"
suggests: consolidation

Front 26

What is bronchophony

Back 26

ask patient to say 99

normal: indistinguishable muffled
postiive: 99 clearly heard
suggests: increased lung density

Front 27

what is whispered pectriloquy

Back 27

ask patient to whisper 1,2,3

normal: faint/indistinct
positive: 1-2-3 clearly heard
suggests: consolidation

Front 28

Kentucky

Back 28

S3

Front 29

Tennessee

Back 29

S4

Front 30

Split S2

Back 30

High pitched sound, can be heard with diaphragm (unlike S3 & S4)

Front 31

S3 heard during

Back 31

Diastole after S2

Front 32

S3 indicates

Back 32

rapid filling in early diastole

Front 33

S3 causes

Back 33

heart failure
mitral/tricuspid incompetence
pregnancy / pill
PE / pericarditis
youth/athlete

Front 34

S4 heard during

Back 34

Diastole before S1

Front 35

S4 indicate

Back 35

Atrial contribution to late diastolic filling

Front 36

S4 caused by

Back 36

Tamponade
Hypertension/ Heart block
Ischemic heart disease CAD/MI
Stenosis (aortic/pulm)

Front 37

Murmurs are dysfunction of:

Back 37

valves

Front 38

Regurgitant murmurs

Back 38

loose leaflet that allows backflow through the valve

a valve that should be closed is open

Front 39

Stenotic murmurs

Back 39

stiffened valve that does not open all the way

a valve that should be open is closed

Front 40

S1 occur during

Back 40

start of systole

closing of mitral and tricupspid valves

Front 41

S2 occur during

Back 41

start of diastole

closing of pulmonary and aortic valves