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475 Cards in this Set

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GETTING O2 FROM THE AIR TO THE BODY TISSUE CELLS.
LIFE FUNCTIONS
BREATHING AIR IN AND OUT OF THE LUNGS
VENTILATION
MOVING THE BLOOD THROUGH THE BODY
CIRCULATION
GETTING BLOOD AND O2 INTO THE TISSUE
PERFUSION
HOW TO MEASURE VENTILATION
RR, VT, CHEST MOVEMENT, BS
HOW TO MEASURE OXYGENATION
HR, COLOR SENSORIUM
HOW TO MEASURE CIRCULATION
PULSE/HR AND STRENGTH, C.O.
HOW TO MEASURE PERFUSION
BP, SENSORIUM, TEMP, U.O., HEMODYNAMICS
FIRST (LIFE FUNCTION) PRIORITY WHEN YOU HAVE AN EMERGENGY
VENTILATION- ESTABLISH AN OPEN AIRWAY AND BREATHE
2ND (LIFE FUNCTION) PRIORITY
OXYGENATION- INCREASE FIO2
3RD LIFE FUNCTION PRIORIY
CIRCULATION- CHEST COMPRESSION, DEFIBRILLATE, HEART DRUGS
4TH LIFE FUNCTION PRIORITY
PERFUSION- INCREASE BLOOD PRESSURE
MOST COMMON PROBLEM OF ALL THE LIFE FUNCTIONS IS
OXYGENATION
THOSE THINGS THAT YOU CAN SEE OR MEASURE IN A PATIENT.
EX. COLOR, PULSE, EDEMA, BP
SIGNS/OBJECTIVE INFORMATION
THOSE THINGS THAT A PT. MUST TELL YOU.
EX. DYSPNEA, PAIN, NAUSEA
SYMPTOMS/SUBJECTIVE INFORMATION
HOW TO COMPUTE SMOKING HISTORY
IN PACK YEARS.
PACK YRS= # OF PACK/DAY X # OF YRS. SMOKED.
EX. 4 PACKS/DAY X 10 YRS.= 40 PACK YEAR
NORMAL URINE OUTPUT
40 CC/HR
SENSIBLE H2O LOSS
URINE, VOMITING
INSENSIBLE H20 LOSS
LUNGS AND SKIN
IF INTAKE EXCEEDS OUTPUT, THIS COULD RESULT IN?
WEIGHT GAIN
ELECTROLYTE IMBALANCE
INCRESED HEMODYNAMIC PRESSURES
DECREASED LUNG COMPLIANCE
NORMAL FOR LEVEL OF CONCIOUSNESS
PT IS ALERT AND RESPONSIVE
LEVEL OF CONCIOUSNESS FOR A PT. WHO RESPONDS INAPPROPRIATELY, HAVE DRUG OVERDOSE OR INTOXICATION
STUPOROUS OR CONFUSED.
LEVEL OF CONCIOUSNESS FOR A COPD OR O2 OVERDOSE PT.
LETHARGIC, SOMLOLENT OR SLEEPY
LEVEL OF CONCIOUSNESS FOR A PT. WHO RESPONDS ONLY TO PAINFUL STIMULI
SEMICOMATOSE
LEVEL OF CONCIOUSNESS FOR A PT. WHO DOES NOT RESPOND TO PAINFUL STIMULI
COMATOSE
LEVEL OF CONCIOUSNESS FOR A PT. IN DROWSY STATE AND MAY HAVE A DECREASED COUGH OR GAG REFLEX.
OBTUNDED
DIFFICULTY BREATHING WHILE LAYING DOWN EXCEPT IN THE UPRIGHT POSITION
ORTHOPNEA
PTS WITH HEART PROBLEM
CHF
RUN DOWN FEELING, NAUSEA, WEAKNESS, FATIGUE, HEADACHE
GENERAL MALAISE
MAYBE DUE TO ELECTROLYTE IMBALANCE
A FEELING OF SHORTNESS OF BREATH OR DIFFICULTY BREATHING
DYSPNEA
GRADE FOE NORMAL DYSPNEA THAT OCCURS AFTER UNUSUAL EXERTION
GRADE 1
GRADE OF DYSPNEA WHEN PT. IS BREATHLESS AFTER GOING UP HILLS OR STAIRS
GRADE 2
GRADE OF DYSPNEA WHEN PT. HAS DYSPNEA WHILE WALKING AT NORMAL SPEED
GRADE 3
GRADE OF DYSPNEA WHEN PT. HAS DYSPNEA WHILE SLOWLY WALKING SHORT DISTANCES
GRADE 4
GRADE OF DYSPNEA WHEN PT. HAS DYSPNEA AT REST, SHAVING, DRESSING
GRADE 5
A REACTION OF A SPECIFIC NERVOUS TISSUE.
MAY INCREASE BP AND HR.
PAIN
DIFFICULTY SWALLOWING
DYSPHAGIA
PRESENCE OF EXCESSIVE FLUID IN THE TISSUE
PITTING EDEMA
*FLUID THAT OCCURS PRIMARILY IN ARMS AND ANKLES.
*CAUSED FROM CHF AND RENAL FAILURE
*RATED +1, +2, +3, ETC. THE HIGHER THE NUMBER THE GREATER THE SWELLING
PERPHERAL EDEMA
*PRESENCE OF THIS IS SUGGESTIVE OF PULMONARY DISEASE.
*CAUSED BY CHRONIC HYPOXEMIA
*THE THUMB AND FINGERS ARE AFFECTED.
*TOES ARE ALSO AFFECTED
*THE CONDITION IS PRESENT WHEN THE ANGLE OF THE NAIL BED AND SKIN INCREASES
CLUBBING OF FINGERS.
SEEN DURING EXPIRATION BECAUSE OF THE OBSTRUCTIVE COMPONENT(LUNG DISEASE).
OCCURS WITH CHF
INCREASED VENOUS DISTENSION
INDICATION OF PERIPHERAL CIRCULATION.
BLANCHING THE HAND AND WATCH THE BLOOD RETURN.
COMMONLY DONE FOR THE ALLEN'S TEST BEFORE DRAWING ABG'S
CAPILLARY REFILL
A STATE OF PROFUSE/HEAVY SWEATING (NIGHT SWEATS).
DIAPHORESIS
PT'S SKIN COLOR IS PINK, TAN, BROWN, BLACK. THIS INDICATES THAT THE PT'S SKIN COLOR IS...
NORMAL
DECREASE IN PT'S SKIN COLOR (ASHEN, PALLOR) MAYBE DUE TO:
ANEMIA OR BLOOD LOSS WHICH IS ABNORMAL
DIAPHORESIS MAY BE DUE TO:
HEART FAILURE
FEVER, INFECTION
ANXIETY, NERVOUSNESS.
COLOR CHANGE BY REDUCING BLOOD FLOW IS CAUSED BY:
VASOCONSTRICTION
INCREASE IN BILIRUBIN IN BLOOD AND TISSUE WHICH APPEARS MOSTLY IN THE FACE AND TRUNK.
JAUNDICE
REDNESS OF THE SKIN THAT MAYBE DUE TO CAPILLARY CONGESTION, INFLAMATION OR INFECTION
ERYTHEMA
BLUE OR BLUE-GRAY DISCOLORATION OF SKIN AND MUCOUS MEMBRANES.
CAUSED BY HYPOXIA FROM INCREASED AMOUNT OF REDUCED HEMOGLOBIN.(5G OF REDUCED HG)
CYANOSIS
*STRAIGHT SPINE, NO ALTERATIONS IN CHEST SIZE.
*NO LEANING FORWARD OR SIDE TO SIDE.
NORMAL A-P DIAMETER
ANTERIOR POTRUSION OF THE STERNUM
PECTUS CARINATUM
DEPRESSION OF PART OR ALL OF THE STERNUM
PECTUS EXCAVATUM
HUNCHBACK OR CONVEX SPINAL CURVE
KYPHOSIS
LATERAL CURVATURE OF THE SPINE
SCOLIOSIS
IS A COMBINATION OF BOTH KYPHOSIS AND SCOLIOSIS AND CAUSES SEVERE RESTRICTIVE IMPAIRMENT.
KYPHOSCOLIOSIS
*A RESULT OF AIR TRAPPING IN THE LUNGS FOR A LONG PERIOD OF TIME.
*GENERALLY DUE TO COPD
*INCREASE IN A-P DIAMETER
BARREL CHEST
INCREASE IN A-P DIAMETER/BARREL CHEST IS DUE TO...
COPD
BOTH SIDES OF THE CHEST MOVE AT THE SAME TIME
SYMMETRICAL CHEST MOVEMENT
UNEQUAL MOVEMENT OF THE CHEST/DIAPHRAGM
ASYMMETRICAL
ASYMMETRICAL MOVEMENT MAY SHOW UNDERLYING PATHOLOGY SUCH AS:
CHRONIC LUNG DISEASE
ATELECTASIS
PNEUMOTHORAX
FLAIL CHEST-PARADOXICAL
INTUBATED PT'S WITHH ETT IN ONE LUNG
NORMAL RESPIRATORY RATE, DEPTH AND RHYTHM
EUPNEA
INCREASED RR (OVER 20 BPM)
TACHYPNEA
TACHYPNEA IS CAUSED BY:
FEVER
HYPOXIA
PAIN
CNS PROBLEM
OTHER NAME FOR BRADYPNEA
OLIGOPNEA
DECREASED RR(<8 BPM)
VARIABLE DEPTH
IRREGULAR RHYTHM
BRADYPNEA
BRADYPNEA IS CAUSED BY...
SLEEP(NORMAL)
DRUGS
ALCOHOL
METABOLIC DISORDERS
CESSATION OF BREATHING
APNEA
INCREASED RR
INCREASED DEPTH
REGULAR RHYTHM
HYPERPNEA
HYPERPNEA IS CAUSED BY...
METABOLIC DISORDERS
CNS DISORDERS
GRADUALLY INCREASING THEN DECREASING RATE AND DEPTH IN A CYCLE LASTING FROM 30-180 SECONDS, WITH PERIODS OF APNEA LASTING UP TO 60 SECONDS
CHEYNE-STOKES
CHEYNE-STOKES IS CAUSED BY...
INCRESED ICP
MENINGITIS
DRUG OVERDOSE
INCREASED RR
INCREASED DEPTH
IRREGULAR PERIODS OF APNEA
EACH BREATH HAS THE SAME DEPTH
BIOTS
BIOTS IS CAUSED BY...
CNS PROBLEM
INCREASED RR(USUALLY >20BPM)
INCREASED DEPTH
IRREGULAR RHYTHM
BREATHING SOUNDS LABORED
KUSSMAUL'S
KUSSMAUL'S IS CAUSED BY...
METABOLIC ACIDOSIS
RENAL FAILURE
DIABETIC KETOACIDOSIS
PROLONGED GASPING INSPIRATION FOLLOWED BY EXTREMELY SHORT, INSUFFICIENT EXPIRATION
APNEUSTIC
APNEUSTIC IS CAUSED BY...
*PROBLEM WITH RESPIRATORY CENTER
*TRAUMA
*TUMOR
NORMAL VENTILATION MUSCLES USED DURING INSPIRATION
DIAPHRAGM
EXTERNAL INTERCOSTALS
EXHALATION IS NORMALLY
PASSIVE
MUSCLES USED TO INCREASE VENTILATION(ACCESSORY MUSCLES)
ARE
1. MUSCLES OF NORMAL VENTILATION PLUS.
2.INTERCOSTAL, SCALENE, STERNOCLEIDOMASTOID, PLUS
3. ABDOMINAL MUSCLES
HYPERTROPHY OF ACCESSORY MUSCLES OCCURS IN WHICH PT.?
COPD
MUSCLE WASTING OR LOSS OF MUSCLE TONE IS CALLED
ATROPHY
ATROPHY OCCURS IN PT'S WITH
PARALYSIS
INCREASE IN MUSCLE SIZE DUE TO COPD IS CALLED
HYPERTROPHY
WHEN THE CHEST MOVES INWARD DURING INSPIRATORY EFFORTS INSTEAD OF OUTWARD IS CALLED
INTERCOSTAL AND/OR STERNAL RETRACTIONS
INTERCOSTAL AND/OR STERNAL RETRACTIONS IS DUE TO A
BLOCKED (OBSTRUCTED) AIRWAY
INTERCOSTAL AND/OR STERNAL RETRACTIONS IS A SIGN OF RESPIRATORY DISTRESS IN
INFANTS
NASAL FLARING IS A SIGN OF RESPIRATORY DISTRESS IN
INFANTS
EXPIRATORY GRUNTING AND RETRACTIONS OCCUR IN NEWBORNS TO PREVENT
ATELECTASIS
A DRY OR NON-PRODUCTIVE COUGH MAY INDICATE
TUMOR IN THE LUNGS
A PRODUCTIVE COUGH MAY INDICATE
INFECTION
NORMAL ADULT PULSE RATE
60-100 BEATS/MIN
ADULT PULSE RATE >100
TACHYCARDIA
ADULT PULSE RATE >100 INDICATES
HYPOXEMIA
ANXIETY
STRESS
ADULT PULSE RATE <60
BRADYCARDIA
ADULT PULSE RATE <60 INDICATES
HEART FAILURE
SHOCK
CODE EMERGENCY
IF HR INCREASED TO 20 BPM DURING TREATMENT YOU SHOULD
STOP THERAPY
NOTIFY NURSE/DOCTOR
DUE TO ADVERSE REACTION
ANY CHANGE IN RHYTHM IS INDICATION FOR
FURTHER MONITORING
PULSE/BLOOD PRESSURE VARIES WITH RESPIRATION IS CALLED
PARADOXICAL PULSE/PULSUS PARADOXUS
PARADOXICAL PULSE/PULSUS PARADOXUS MAY INDICATE
SEVERE AIR TRAPPING AS IN STATUS ASTHMATICUS
TO DETERMINE PROPER TRACHEAL POSITIONING YOU SHOULD
1. PLACE INDEX FINGER THRU SUPRA STERNAL NOTCH
2. COMPARE THE SPACE BETWEEN THE CLAVICLE AND LEFT BORDER OF THE TRACHEA
CAUSES OF TRACHEAL DEVIATION WHEN PULLED TOWARD THE AFFECTED SIDE
PULMONARY ATELECTASIS
PULMONARY FIBROSIS
PNEUMONECTOMY
DIAPHRAGNATIC PARALYSIS
CAUSES OF TRACHEAL DEVIATION WHEN PUSHED AWAY FROM AFFECTED SIDE
MASSIVE PLEURAL EFFUSION
TENSION PNEUMOTHORAX
ENLARGED LYMPH NODES
LARGE MEDIASTINAL MASS
NECK OR THYROID TUMORS
THIS IS VIBRATIONS THAT ARE FELT BY THE HAND ON THE CHEST WALL
TACTILE FREMITUS
VOICE VIBRATIONS ON THE CHEST WALL
VOICE FREMITUS
A GRATING SENSATION FELT ON THE CHEST WALL DUE TO ROUGHENED PLEURAL SURFACES RUBBING TOGETHER
PLEURAL RUB FREMITUS
PALPABLE RONCHI/SECRETIONS IN AIRWAY
RHONCHIAL FREMITUS
NORMAL AIR FILLED LUNGS.
THIS GIVES A HOLLOW SOUND
RESONANCE
AREAS OVER THE STERNUM, MUSCLE OF AREAS OF ATELECTASIS GIVE A FULL SOUND.
FLATNESS
AREAS OVER FLUID FILLED ORGANS SUCH AS THE HEART OR LIVER.
PNEUMONIA AND PLEURAL EFFUSION WILL GIVE THIS THUDDING SOUND.
DULLNESS
AREA OVER AIR-FILLED STOMACH.
THIS IS A DRUM-LIKE SOUND AND WHEN HEARD OVER THE LUNGS INDICATES INCREASED VOLUME.
TYMPANY
FOUND IN AREAS OF THE LUNG WHERE PNEUMOTHORAX OR EMPHYSEMA ARE PRESENT.
THIS IS A BOOMING SOUND
HYPERRESONANCE
DIAPHRAGMATIC EXCURSION IS MEASURED...
3 TO 5 CM
NORMAL BREATH SOUNDS
VESICULAR
NORMAL SOUNDS IN BOTH LUNGS
BILATERAL VESICULAR SOUNDS
NORMAL SOUNDS OVER THE TRACHEA OR BRONCHI.
THESE BREATH SOUNDS OVER THE LUNG PERIPHERY WOULD INDICATE LUNG CONSOLIDATION
BRONCHIAL BREATH SOUNDS
THE PT. IS INSTRUCTED TO SAY "E" AND IT SOUNDS LIKE AN "A".
EGOPHONY
EGOPHONY WOULD INDICATE...
CONSOLIDATION OF THE LUNG TISSUE AS WITH A PNEUMONIA LIKE CONDITION.
ARE TERMS THAT INDICATE INCREASED INTENSITY OR TRANSMISSION OF THE SPOKEN VOICE AND INDICATE CONSOLIDATION AND PNEUMONIA.
BRONCHOPHONY AND WHISPERED PECTORILOQUY
FLATNESS WOULD INDICATE...
ATELECTASIS
DULLNESS WOULD INDICATE...
PNEUMONIA AND PLEURAL EFFUSION
BRONCHOPHONY AND WHISPERED PECTORILOQUY WOULD INDICATE...
CONSOLIDATION AND PNEUMONIA
TYMPANY WOULD INDICATE...
INCREASED VOLUME IN THE LUNGS
HYPERRESONANCE WOULD INDICATE...
PNEUMOTHORAX OR EMPHYSEMA ARE PRESENT
ANY INCREASE ABNORMALITY IN THE SPOKEN VOICE INDICATES...
CONSOLIDATION
ANY DECREASE ABNORMALITY IN THE SPOKEN VOICE WOULD INDICATE...
OBSTRUCTED BRONCHI
PNEUMOTHORAX
EMPHYSEMA
ABNORAL BREATH SOUNDS
ADVENTITIOUS
ANOTHER TERM FOR CRACKLES
RALES
ANOTHER TERM FOR RALES
CRACKLES
ANOTHER TERM FOR RONCHI
COARSE RALES
ANOTHER TERM FOR COARSE RALES
RONCHI
RALES/CRACKLES ARE HEARD DUE TO
SECRETION/FLUID
LARGE AIR WAY SECRETION
COARSE RALES/RONCHI
MIDDLE AIR WAY SECRETION
MEDIUM RALES
IF A PT HAS COARSE RALES/RONCHI WHAT SHOULD YOU DO?
PATIENT NEEDS SUCTIONING
IF A PT HAS MEDIUM RALES WHAT SHOULD YOU DO?
PT NEEDS CPT
FINE RALES IS ALSO CALLED
MOIST CREPITANT RALES
FINE RALES WOULD INDICATE...
FLUID IN THE ALVEOLI
THEREFORE PT. HAS CHF/PULMONARY EDEMA
TX FOR PT. WITH FINE RALES
PT. NEEDS IPPB
HEART DRUGS
DIURETICS
O2
WHEEZE IS DUE TO
BRONCHOSPASM
TX FOR WHEEZE
BRONCHODILATOR
TX FOR BRONCHOSPASM
BRONCHODILATOR
A UNILATERAL WHEEZE WOULD INDICATE...
FOREIGN BODY OBSTRUCTION
STRIDOR IS DUE TO....
UPPER AIRWAY OBSTRUCTION
UPPER AIRWAY OBSTRUCTION IS CAUSED BY...
1. SUPRAGLOTTIC SWELLING (EPIGLOTTITIS)
2. SUBGLOTTIC SWELLING (CROUP, POST EXTUBATION)
3. FOREIGN BODY ASPIRATION(SOLIDS OR FLUIDS)
SUPRAGLOTTIC SWELLING IS CAUSED BY...
EPIGLOTTITIS
SUBGLOTTIC SWELLING IS CAUSED BY...
CROUP
POST EXTUBATION
FOREIGN BODY ASPIRATION IS CAUSED BY...
SOLIDS OR FLUIDS
SPECIFIC TX FOR STRIDOR
1. TOPICAL DECONGESTANT (RACEMIC EPINEPHRINE) FOR SWELLING AND EDEMA.
2. SUCTIONING AND/OR BRONCHOSCOPY FOR SECRETIONS AND FOREIGN BODY ASPIRATION.
3. INTUBATION FOR SEVERE SWELLING AND EPIGLOTTITIS.
A COURSE GRATING OR CRUNCHING SOUND
PLEURAL FRICTION RUB
PLEURAL FRICTION RUB IS DUE TO....
INFLAMED SURFACE OF THE VISCERAL AND PARIETAL PLEURA RUBBING TOGETHER
PLEURAL FRICTION RUB MAY BE ASSOCIATED WITH
PLEURISY
TB
PNEUMONIA
PULMONARY INFRACTION
CANCER
DRUGS USED FOR PLEURAL FRICTION RUB
STEROIS
ANTIBIOTICS
SOUNDS CREATED BY THE CLOSURE OF THE HEART VALVES
HEART SOUNDS
IS HEARD BY THE CLOSURE OF THE MITRAL AND TRICUSPID VALVES DURING CONTRACTION OF THE VENTRICLES.
FIRST SOUND(S1)
OCCURS WHEN SYSTOLE ENDS, THE VENTRICLES RELAX AND THE PULMONIC AND AORTIC VALVES CLOSE
SECOND SOUND (S2)
IS HEARD DURING EARLY DIASTOLE AND IS PRODUCED BY RAPID VENTRICULAR FILLING IMMEDIATELY AFTER SYSTOLE.
THIRD SOUND (S3)
S3 SOUND IS NORMAL IN
YOUNG HEALTHY CHILDREN ONLY
S3 SOUND IS ABNORMAL IN
ADULTS
OCCURS LATE IN DIASTOLE AND IS PRODUCED BY ACTIVE FILLING OF THE VENTRICLES
FOURTH SOUND (S4)
FOURTH SOUND (S4) MAY OCCUR IN
NORMAL INDIVIDUALS OR CAN BE CONSIDERED A SIGN OF HEART DISEASE
OCCURS WHENEVER THE HEART VALVES ARE STENOTIC OR INCOMPETENT
MURMURS
MURMURS ARE USUALLY CLASSIFIED AS
SYSTOLIC OR DIASTOLIC
AN INCOMPETENT ATRIOVENTRICULAR VALVE OR STENOTIC SEMILUNAR VALVE WOULD CAUSE...
SYSTOLIC MURMURS
AN INCOMPETENT SEMILUNAR VALVE OR A STENOTIC ATRIOVENTRICULAR VALVE WOULD CAUSE...
DIASTOLIC MURMURS
A SOUND HEARD ON AUSCULTATION CAUSED BY TURBULENT BLOOD FLOW.
SIMILAR TO A MURMUR
BRUITS
NORMAL BP
120/80
INCREASED BP INDICATES
CARDIAC STRESS-HYPOXEMIA
DECREASED BP INDICATES
POOR PERFUSION-SHOCK
PROPER ETT PLACEMENT
THE TIP OF THE ETT SHOULD BE POSITIONED BELOW THE VOCAL CORDS AND NO CLOSER THAN 2CM ABOVE THE CARINA, APPROXIMATELY AT THE SAME LEVEL OF THE AORTIC KNOB OR AORTIC ARCH; THIS WILL ENSURE BILATERAL VENTILATION (CLAVICLE IS TOO HIGH)
WILL QUICKLY DETERMINE ADEQUATE VENTILATION BEFORE CXR IS DONE
OBSERVATION AND AUSCULTATION
SEEN AS A DARK AREA MIDLINE ON CXR
TRACHEA
TRACHEA SHOULD BE THE SAME SIZE AS THE_____ON CXR
VERTEBRAL COLUMN
IF NARROWING OF THE MAJOR BRONCHI AT THE CARINA OR AT THE DISTAL END MAY INDICATE
BRONCHOGENIC CARCINOMA
THE AREA BETWEEN THE LUNGS WHERE THE HEART, LYPHATICS, BLOOD VESSELS AND MAJOR BRONCHI ARE FOUND
MEDIASTINUM
MEDIASTINUM MAY SHIFT IN PT'S WITH.....
PLEURAL EFFUSION OR
PNEUMOTHORAX
A-P DIAMETER IS INCREASED IN PT'S WITH......
COPD
BARREL CHEST
HYPERINFLATION
ANGLE MADE BY THE OUTER CURVE OF THE DIAPHRAGM AND THE CHEST WALL
COSTOPHRENIC ANGLES
COSTOPHRENIC ANGLES ARE OBLITERATED BY
PLEURAL EFFUSIONS
DOME SHAPED NORMALLY
DIAPHRAGM
DIAPHRAGM IS FLATTENED WITH...
COPD
LEFT OR RIGHT HEMIDIAPHRAGMS MAY SHIFT DOWNWARD WITH; APPEARING FLATTENED ON ONE SIDE
LEFT OR RIGHT PNEUMOTHORAX
VASCULAR MARKINGS ON CXR WOULD SHOW
BLOOD VESSELS
LYMPHATICS
LUNG TISSUE
LEFT VENTRICLE NORMALLY SEEN
HEART SHADOW
ENLARGED HEART
CARDIOMEGALY
CARDIOMEGALY IS SEEN IN PT'S WITH
COPD
TISSUE SURROUNDING THE CHEST AND ABOVE IN THE NECK AREA
SOFT TISSUE
WHEN AIR (HYPERLUCENCY) IS SEEN IN THE SURROUNDING SOFT TISSUE ON CXR. THIS INDICATES
SUBCUTANEOUS EMPHYSEMA
CXR FILM BEHIND BACK
USED WITH BEDRIDDEN PT'S
AP POSITION
FILM TOUCHING THE CHEST WITH BACK TO X-RAYS
USED WITH NORMAL PT'S
PA POSITION
PROJECTION FROM EITHER THE RIGHT OR LEFT SIDE
ADDS A 3RD DIMENSION TO STRUCTURES VIEWED ON AP OR PA FILMS
LATERAL POSITION
LATERAL NECK XRAY IS DONE TO DETERMINE
EPIGLOTTITIS-SWOLLEN EPIGLOTTIS (SUPRAGLOTIC)
CROUP-SUBGLOTTIC EDEMA
FOREIGN BODIES-PRESENCE OR POSITION
SLANTING OR DIAGONAL VIEW
AID IN LOCALIZING LESIONS
OBLIQUE POSITION
PT LYING ON THE AFFECTED SIDE
VALUABLE FOR DETECTING SMALL PLEURAL EFFUSIONS
LATERAL DECUBITUS
PROJECTION OF THE LUNG APICES
APICAL LORDOTIC
1. BOTH HEMIDIAPHRAGMS ARE ROUNDED(DOME-SHAPED)
2. THE RIGHT HEMIDIAPHRAGM IS SLIGHTLY HIGHER THAN THE LEFT
3. THE RIGHT HEMIDIAPHRAGM IS AT THE LEVEL OF THE SIXTH ANTERIOR RIB
4. TRACHEA IS MIDLINE, BILATERAL RADIOLUCENCY, WITH SHARP COSTROPHENIC ANGLES
NORMAL CXR
CHEST TUBES SHOULD BE LOCATED IN
THE PLEURAL SPACE SURROUNDING THE LUNG
NASOGASTRIC TUBES AND FEEDING TUBES SHOULD BE POSITIONED IN
THE STOMACH AND SMALL BOWEL BELOW THE DIAPHRAGM
PULMONARY ARTERY CATHETERS SHOULD APPEAR IN THE
RIGHT LOWER LUNG FIELD
PACEMAKER SHOULD BE NORMALLY POSITIONED IN THE
RIGHT VENTRICLE
CENTRAL VENOUS CATHETERS ARE PLACED IN THE
RIGHT OR LEFT SUBCLAVIAN OR JUGULAR VEIN AND SHOULD REST IN THE VENA CAVA OR RIGHT ATRIUM OF THE HEART
DARK PATTERN(AIR) ON CXR
NORMAL FOR LUNGS
RADIOLUCENT
WHITE PATTERN (SOLID OR FLUID)ON CXR
NORMAL FOR BONES AND ORGANS
RADIODENSE
ANY ILL DEFINED RADIODENSITY
INFILTRATE
INFILTRATES ON CXR INDICATES
ATELECTASIS
SOLID WHITE AREA ON CXR
CONSOLIDATION
CONSOLIDATION ON CXR INDICATES
PNEUMONIA
PLERAL EFFUSION
EXTRA PULMONARY AIR ON CXR
HYPERLUCENCY
HYPERLUCENCY ON CXR INDICATES
COPD
ASTHMA ATTACK
PNEUMOTHORAX
LYMPHATICS, VESSELS, LUNG TISSUES ON CXR
VASCULAR MARKINGS
VASCULAR MARKINGS ARE INCREASED IN
CHF
VASCULAR MARKINGS ARE ABSENT IN
PNEUMOTHORAX
SPREAD THROUGOUT ON CXR
DIFFUSE
DIFFUSE ON CXR INDICATES
ATELECTASIS
PNEUMONIA
FLUID OR SOLID ON CXR
OPAQUE
OPAQUE ON CXR INDICATES
CONSOLIDATION
ON BOTH SIDES
BILATERAL
ON ONE SIDE
UNILATERAL
FLUFFY INFILTRATES (DIFFUSE WHITENESS) ON CXR INDICATES
PULMONARY EDEMA
BUTTERFLY/BATWING PATTERN (INFILTRATE IN SHAPE OF BUTTERFLY) ON CXR INDICATES
PULMONARY EDEMA
PATCHY INFILTRATES (SCATTERED DENSITIES) ON CXR INDICATES
ATELECTASIS
PLATELIKE INFILTRATES (THIN LAYERED DENSITIES) ON CXR INDICATES
ATELECTASIS
GROUND GLASS APPEARANCE (RETICULOGRANULAR) ON CXR INDICATES
ARDS/IRDS
HONEYCOMB PATTERN (RETICULOGRANULAR) ON CXR INDICATES
ARDS/IRDS
AIR BRONCHOGRAM ON CXR INDICATES
PNEUMONIA
EDEMA
PERIPHERAL WEDGE-SHAPED INFILTRATE
PULMONARY EMBOLUS
INFARCTION
CONCAVE SUPERIOR INTERFACE/BORDER
PLEURAL EFFUSION
BASILAR INFILTRATES WITH MENISCUS
PLEURAL EFFUSION
INJECTION OF RADIO-OPAQUE CONTRAST MEDIUM INTO THE TRACHEOBRONCHIAL TREE
BRONCHOGRAPHY (BRONCHOGRAMS)
MULTIFOCAL PVC
MULTIFOCAL
MAIN INDICATION OF BRONCHOGRAPHY(BRONCHOGRAMS)
BY OUTLINING THE AIRWAYS IT WILL ALLOW SYUDY OF BRONCHIECTASIS(MAIN)/OBSTRUCTING LESIONS(2ND)
IDENTIFIES THE LOCATION OF INVOLVED AREAS THAT WILL ALLOW BETTER ADMINISTRATION OF POSTURAL DRAINAGE IN BRONCHIECTASIS
BRONCHOGRAM
HAZARDS OF BRONCHOGRAMS
ALLERGIC REACTION AND IMPAIRMENT OF RESPIRATORY STATE
A. RADIOISOTOPES XENON GAS IS INHALED AND THE LOCATION OF THE GAS IS RECORDED PRODUCING A PHOTGRAPHIC PATTERN OF DISTRIBUTION T/O LUNGS
B. ANY OBSTRUCTION TO AIRFLOW WILL ALLOW LITTLE GAS TO ENTER THAT AREA
VENTILATION SCANS
ALBUMIN, TAGGED WITH RADIOACTIVE IODINE IS INJECTED INTO A PERIPHERAL VEIN AND WHEN IT PASSES INTO THE PULMONARY CIRCULATION, THEY IMPACT ON THE CAPILLARIES
B. A SCANNING DEVICE IS PASSED OVER THE CHEST AND PRODUCES A PATTERN OF RADIATION THAT INDICATES THE DISTRIBUTION AND VOLUME OF PERFUSION
PERFUSION SCANS
NORMAL VENTILATION SCAN BUT ABNORMAL PERFUSION SCAN INDICATES
PULMONARY EMBOLI
MRI
MAGNETIC RESONANCE IMAGING
MRI IS USEFUL FOR DETERMINING WHAT?
THORACIC ANEURYSMS
CONGENITAL ANOMALIES OF THE AORTA
MAJOR THORACIC VESSELS ESPECIALLY IN THE HILAR AREA
MRI HAS THE ABILITY TO?
1. DETERMINE THE PRECISE POSITION OF TUMORS AND
2. THE INVOLVEMENT OF SURROUNDING STRUCTURES
WHAT TYPES OF VENTILATOR SHOULD WE USE ON A VENT PT REQUIRING AN MRI DONE?
1. FLUIDIC (NON-ELECTRIC, GAS POWERED) VENTILATORS IS USED BECAUSE THE MAGNETIC FIELDS WOULD DISRUPT ELECTRONIC DEVICES.
2. MANUAL VENTILATORS-SHOULD HAVE DETACHABLE NON-REBREATHING VALVES MADE OF NON-FERROUS(NON-METALLIC) MATERIALS.
PROVIDES A CROSS SECTIONAL VIEW (SLICES) OF BODY STRUCTURES AT MULTIPLE LEVELS
COMPUTERIZED TOMOGRAPHY
CT
COMPUTERIZED TOMOGRAPHY
CT SCAN IS USEFUL IN DETECTING THE PRESENCE OF WHAT?
MEDIASTINAL MASS
PLEURAL MASS
PARENCHYMAL MASS
PULMONARY NODULES
LESIONS THAT CANNOT BE VISUALIZED ON A CXR
RADIOGRAPHIC EXAMINATION OF THE ESOPHAGUS BY INJECTING CONTRAST OF BARIUM SULFATE
BARIUM SWALLOW
BARIUM SWALLOW IS INDICATED FOR DIAGNOSING WHAT?
ESOPHAGEAL VARICES
CBC
COMPLETE BLOOD COUNT
MEASUREMENT OF ALL MAJOR INGREDIENTS OF THE BLOOD
CBC
RBC
RED BLOOD CELLS
CARRIES THE HG/O2
RBC
RBC NORMAL VALUE
4-6 MILL/CU MM
RBC ARE INCREASED(POLYCYTHEMIA) IN PT'S WITH
CHRONIC TISSUE HYPOXEMIA (COPD)
HIGH RBC IS CALLED
POLYCYTHEMIA
LOW RBC (ANEMIA)OCCURS IN PT'S WITH
BLOOD LOSS
HEMORRHAGE
LOW RBC IS CALLED
ANEMIA
CARRIES O2 (1.34 ML/GRAM Hb)
HEMOGLOBIN
Hb
HEMOGLOBIN
NORMAL VALUE OF Hb
12-16 gm/100 mL blood (gm/dl)
LOW Hb RESULTS IN?
ANEMIA
HIGH Hb RESULTS IN?
POLYCYTHEMIA
Hct
HEMATOCRIT
HOW TO MEASURE Hct
SPIN THE WHOLE BLOOD AND MEASURE THE % OF RBC TO THE ORIGINAL BLOOD VOLUME
NORMAL VALUE OF Hct
40-50%
LOW Hct RESULTS IN
ANEMIA
HIGH Hct RESULTS IN
POLYCYTHEMIA
WBC
WHITE BLOOD CELLS
ARE USED BY THE BODY TO FIGHT BACTERIAL INFECTIONS
WBC
NORMAL VALUE OF WBC
5,000-10,000 PER CU MM
INCREASED WBC IS CALLED
LEUKOCYTOSIS
DECREASED WBC IS CALLED
LEUKOPENIA
INCREASED WBC IS DUE TO
BACTERIAL INFECTION
DECREASED WBC IS DUE TO
VIRAL INFECTION
TYPES OF WBC'S
1. NEUTROPHILS
2. EOSINOPHILS
3. MONOCYTES
4. LYMPHOCYTES
5. BASOPHILS
MAJOR WBC'S
NEUTROPHILS
IMMATURE CELLS NORMALLY 4% OF WBC'S
BANDS
MATURE CELLS NORMALLY 60% OF WBC'S
SEGS
WHEN BANDS(PART OF WBC) NORMALLY 4% OF WBC'S INCREASED THIS IS DUE TO
BACTERIAL INFECTIONS
WHEN SEGS (PART OF WBC) NORMALLY 60% OF WBC'S DECREASED THIS IS DUE TO
BACTERIAL INFECTIONS
ASSOCIATED WITH ASTHMA 2% OF WBC'S INCREASED WITH ALLERGIC REACTIONS(PRODUCE A "YELLOW" SPUTUM)
EOSINOPHILS
ASSOCIATED WITH TB 3% OF WBC'S
MONOCYTES
30% OF WBC'S
LYMPHOCYTES
1% OF WBC'S
BASOPHILS
ELECTROLYTES
K+
Na+
Cl-
HCO3-(CO2 content)
ELEMENTS REQUIRED BY THE BODY FOR NORMAL METABOLISM
ELECTROLYTES
ABNORMAL ELECTROLYTE LEVELS INDICATE
ABNORMAL BODY FUNCTION
ELECTROLYTES ARE CLOSELY ASSOCIATED WITH
FLUID LEVELS
KIDNEY FUNCTION
ELECTROLYTE IMBALANCE ARE ASSOCIATED WITH
1. MUSCLE WEAKNESS
2. SORENESS
3. NAUSEA
4. MENTAL CHANGES
(I.E. LETHARGY, DIZZINESS, AND DROWSINESS)
K+
POTASSIUM
MAJOR INTRACELLULAR CATION
K+
K+ IS IMPORTANT FOR
ACID-BASE BALANCE
NORMAL K+ VALUE
4.0 mEq/L (305-5.0 range)
low k+ will result in
hypokalemia
metabolic alkalosis
excessive excretion
renal loss
vomitting
flattened T waves on EKG
high k+ will result in
hyperkalemia
kidney failure
spiked T wave
metabolic acidosis
low k+ IS CALLED
hypokalemia
high k+ IS CALLED
hyperkalemia
Na+
SODIUM
MAJOR EXTRACELLULAR CATION CONTROLLED BY KIDNEYS
Na+
NORMAL Na+ VALUE
140 mEq/L (135-145 range)
LOW Na+ IS CALLED
HYPONATREMIA
HIGH Na+ IS CALLED
HYPERNATREMIA
LOW Na+ FLUID LOSS FROM
DIURETICS
VOMITTING
DIARRHEA
LOW Na+ FLUID GAIN FROM
CHF
IV THERAPY
HIGH Na+ RESULTS IN
DEHYDRATION
Na+ IS RETAINED IN EXCHANG FOR
K+
Cl-
CHLORIDE
MAJOR EXTRACELLULAR ANION
Cl-
Cl- LEVELS ARE CLOSELY ASSOCIATED WITH
Na+
NORMAL Cl- VALUE
90 mEq/L (85-100 range)
LOW Cl- IS CALLED
HYPOCHLOREMIA
HIGH Cl- IS CALLED
HYPERCHLOREMIA
LOW Cl- RESULTS TO
METABOLIC ALKALOSIS
HIGH Cl- RESULTS TO
METABOLIC ACIDOSIS
HCO3
BICARBONATE (TOTAL CO2 CONTENT)
MOST OF THE CO2 IN THE BLOOD IS CARRIED AS
HCO3
TOTAL CO2 CONTENT REFLECT CHANGES IN
BLOOD BASE
*INC CO2 CONTENT=INC HCO3=METABOLIC ALKOLOSIS
*DEC CO2 CONTENT=DEC HCO3=METABOLIC ACIDOSIS

THIS IS OPPOSITE OF PCO2 CHANGES
INC PCO2=RESP ACIDOSIS
DEC PCO2=RESP ALKALOSIS
EXCRETED BY KIDNEYS
CREATININE
CREATININE EVALUATES
KIDNEY FUNCTION
NORMAL VALUE FOR CREATININE
0.7-1.3 MG/DL
CREATININE IS MORE SPECIFIC FOR_______THAN THE____.
KIDNEY FAILURE
BUN
BUN
BLOOD UREA NITROGEN
BUN EVALUATES
KIDNEY FUNCTION
BUN NORMAL VALUE
8-25 MG/DL
INCREASED BUN INDICATES
KIDNEY FAILURE
NORMAL SPUTUM COLOR
CLEAR
MUCOID(WHITE/GRAY) SPUTUM INDICATES
CHRONIC BRONCHITIS
YELLOW SPUTUM INDICATES
PRESENCE OF WBC'S
BACTERIAL INFECTION
GREEN SPUTUM INDICATES
STAGNANT SPUTUM
GRAM NEGATIVE BACTERIA(BRONCHIECTASIS)
BROWN/DARK SPUTUM INDICATES
OLD BLOOD
BRIGHT RED SPUTUM INDICATES
HEMOPTYSIS(BLEEDING TUMOR, TB)
PINK FROTHY SPUTUM INDICATES
PULMONARY EDEMA
TEST DONE TO IDENTIFY THE BACTERIA PRESENT
SPUTUM CULTURE
TEST DONE TO IDENTIFY WHAT DRUGS WILL KILL BACTERIA
SENSITIVITY TEST
TEST DONE TO IDENTIFY WHETHER IT IS GRAM POSITIVE OR GRAM NEGATIVE
GRAM STAIN
ACID FAST STAIN IS DONE TO IDENTIFY
MYCOBACTERIUM TB
APTT
ACTIVATED PARTIAL THROMBOPLASTIN TIME
MEASURES THE LENGTH OF TIME REQUIRED FOR PLASMA TO FORM A FIBRIN CLOT
APTT
APTT NORMAL VALUE
24-32 SECONDS
APTT IS USED FOR MONITORING
HEPARIN THERAPY
PT
PROTHROMBIN TIME
SIMILAR TO APTT/MEASURES THE LENGTH OF TIME REQUIRED FOR PLASMA TO FORM A FIBRIN CLOT
PT
PROTHROMBIN TIME IS USED TO MONITOR
WARFARIN (COUMADIN) THERAPY
PROTHROMBIN TIME NORMAL VALUE
12-15 SECONDS
REFLECTS METABOLIC STATUS OF PT.
URINALYSIS
URINALYSIS IS A SCREENING TEST FOR
KIDNEY DISEASE
URINALYSIS CAN INDICATE_____BEFORE BLOOD CULTURE RESULTS.
URINARY TRACT INFECTIONS
URINALYSIS ALSO MEASURES
APPEARANCE
SPECIFIC GRAVITY
pH
GLUCOSE
KETONES
BLOOD BILIRUBIN
SEDIMENTATION
HEMODYNAMICS IS SIMPLY THE MONITORING OF
BLOOD PRESSURES
BLOOD MOVEMENT(CIRCULATION/PERFUSION) OCCURS BECAUSE OF
BLOOD PRESSURES
HEMO MEANS
BLOOD
DYNAMIC MEANS
MOVEMENT
REFERS TO THE TWO LIFE FUNCTIONS CIRCULATION AND PERFUSION
HEMODYNAMICS
WITHOUT SUFFICIENT BP THE TISSUE WILL
NOT RECEIVE THE O2 AND NUTRIENTS IT NEEDS TO SURVIVE
WHAT WOULD HIGH BP DO TO THE HEART?
STRAIN THE HEART AND EVENTUALLY CAUSE HEART FAILURE
IS THE PUMP THAT CREATES THE BP
HEART
CHANGES IN THE HEART WILL EFFECT THE
BP DIRECTLY
INCREASE IN THE HR/STRENGTH
WILL INCREASE THE
BP
DECREASE IN THE HR/STRENGTH
WILL DECREASE THE
BP
THE AMOUNT OF FLUID(BLOOD) IN THE CIRCULATORY SYSTEM WILL EFFECT THE
BP
EXCESSIVE FLUIDS(BLOOD) WILL RESULT IN
INCREASE PRESSURES
LOSS OF FLUIDS(BLOOD)WILL RESULT IN
DECREASE PRESSURES
THE CONDITION OF THE BLOOD VESSELS WILL CAUSE
THE BP TO CHANGE
VESSEL CONSTRICTION WILL RESULT IN
INCREASE PRESSURES
VESSEL DILATION WILL RESULT IN
DECREASE PRESSURES
SYSTEMIC ARTERIAL SYSTEM
MEAN AIRWAY PRESSURE(MAP)
NORMAL VALUE
90 mmHg (80-100)
SYSTEMIC VENOUS SYSTEM
CENTRAL VENOUS PRESSURE(CVP)
NORMAL VALUE
1-6 mmHg
PULMONARY ARTERIAL SYSTEM
PULMONARY ARTERY PRESSURE(PAP)
NORMAL VALUE
SYSTOLIC 18-30 mmHg
DIASTOLIC 6-15 mmHg
MEAN PULMONARY ARTERY PRESSURE
NORMAL VALUE
10-20 mmHg
FORMULA FOR MEAN PULMONARY ARTERY PRESSURE
PAP SYSTOLIC + (2 X PAP DIASTOLIC)/3
PULMONARY VENOUS SYSTEM
PULMONARY(CAPILLARY) WEDGE PRESSURE(PWP)
NORMAL VALUE
4-12 mmHg
ESTIMATES LEFT VENTRICLE FILLING AND PRELOAD
EQUAL TO LEFT ATRIAL PRESSURES
PCWP
IF PCWP IS ELEVATED THIS INDICATES
LEFT HEART FAILURE
MEAN RIGHT ATRIAL PRESSURE
ESTIMATES RIGHT VENTRICLE PRELOAD
CVP
THE OUTPUT OF THE LEFT VENTRICLE IS MEASURED AND IS CALLED?
L/MIN
CARDIAC OUTPUT(QT)
QT NORMAL VALUE
4-8 L/MIN
QT/BSA OF THE PT IS CALLED?
CARDIAC INDEX(CI)
NORMAL CI IS
2-4 L/min/m2
TYPE OF DISORDERS
CVP=uu
PAP=N/d
PCWP=N/d
QT=N
RIGHT HEART FAILURE
COR PULMONALE
TYPE OF DISORDERS
CVP=u
PAP=uu
PCWP=N/d
QT=N
LUNG DISORDERS
PULMONARY EMBOLISM
PULMONARY HYPERTENSION
AIR EMBOLISM
TYPES OF DISORDERS
CVP=N
PAP=u
PCWP=uu
QT=d
LEFT HEART FAILURE
MITRAL VALVE STENOSIS
CHF/PULMONARY EDEMA
HIGH PEEP EFFECTS
TYPE OF DISORDERS
CVP=uu
PAP=u
PCWP=u
QT=u
HYPERVOLEMIA
TYPES OF DISORDERS
CVP=dd
PAP=d
PCWP=d
QT=d
HYPOVOLEMIA
PACEMAKER OF THE HEART
SA NODE
ELECTRICAL IMPULSES IS GENERATED BY THE
SA NODE
1. THE ELECTRICAL IMPULSE IS GENERATED BY THE SA NODE
2. THE WAVE OF DEPOLARIZATION MOVES TROUGH THE ATRIA CAUSING CONTRACTION(P WAVE)
3. THE IMPULSE IS RECEIVED BY THE AV NODE WHERE IT IS DELAYED FOR A SHORT TIME. (P-R INTERVAL)
4. THE STIMULUS IS SENT THROUGH THE BUNDLE OF HIS AND THE LEFT AND RIGHT BUNDLE BRANCHES TO THE PURKINJE FIBERS. THIS PRODUCES VENTRICULAR DEPOLARIZATION AND CONTRACTION. (QRS COMPLEX)
5. AFTER A SHORT DELAY(S-T SEGMENT)THE HEART REPOLARIZES.(T WAVE)
Electrophysiology of the Heart
LIMB LEADS(ELECTRODES) ARE PLACED ON THE
ARMS AND LEGS
PRECORDIAL LEADS ARE PLACED...
ON THE CHEST AROUND THE HEART
THE ECG ADJUSTS WHAT?
WHICH ELECTRODE WILL BE POSITIVE AND WHICH ONE WILL BE NEGATIVE
AN UPWARD DEFLECTION IS MADE ON THE ECG PAPER WHEN...
THE IMPULSE OF THE HEART MOVES TOWARD THE POSITIVE ELECTRODE
A DOWNWARD DEFLECTION IS MADE ON THE ECG PAPER WHEN
THE MOVEMENT OF THE IMPULSE IS AWAY FROM THE POSITIVE ELECTRODE
HOW MANY LEADS ARE USED FOR EKG?
12 LEADS
6(LIMB LEADS)
6(PRECORDIAL CHEST LEADS)
LT. ARM POSITIVE/RIGHT ARM NEGATIVE
LEAD 1
LT LEG POSITIVE/RT. ARM NEGATIVE
LEAD 2
LT. LEG POSITIVE/LT. ARM NEGATIVE
LEAD 3
RT. ARM POSITIVE/EVERYTHING ELSE NEGATIVE
AVR
LT. ARM POSITIVE/EVERYTHING ELSE NEGATIVE
AVL
LT.LEG(FOOT)POSITIVE/EVERYTHING ELSE NEGATIVE
AVF
IS THE ONLY LIMB LEAD THAT PRODUCES AN UPSIDE DOWN (NEG.)PATTERN
AVR
NORMAL ELECTRICAL IMPULSE MOVES
DOWNWARD AND TOWARD THE LEFT THROUGH THE HEART
AN INVERTED PATTERN WILL SHOW ON THE EKG IF
ANY POSITIVE ELECTRODE IS PLACED ABOVE AND TO THE RIGHT OF THE HEART(AVR)
ALL OF THESE LEADS ARE POSITIVE AND IS PLACED DIRECTLY OVER THE HEART IN SIX POSITIONS AROUND THE HEART
CHEST LEADS
PLACEMENT OF V1 CHEST LEAD
4TH INTERCOSTAL SPACE ON RIGHT SIDE OF STERNUM
PLACEMENT OF V2 CHEST LEAD
4TH INTERCOSTAL SPACE ON LEFT SIDE OF STERNUM
PLACEMENT OF V3 CHEST LEAD
BETWEEN V2 AND V4 ON LEFT SIDE
PLACEMENT OF V4 CHEST LEAD
5TH INTERCOSTAL SPACE, LEFT MID-CLAVICULAR LINE
PLACEMENT OF V5 CHEST LEAD
BETWEEN V4 AND V6 ON THE LEFT SIDE
PLACEMENT OF V6 CHEST LEAD
5TH INTERCOSTAL SPACE, LEFT MID-AXILLARY LINE
V1 AND V2 CHEST LEADS MONITORS
THE RIGHT HEART
V3 AND V4 CHEST LEADS MONITORS
THE VENTRICULAR SEPTUM
V5 AND V6 CHEST LEADS MONITORS
THE LEFT HEART
NORMAL HR
60-100 BPM
HR <60
BRADYCARDIA
HR >100
TACHYCARDIA
HR >200
FLUTTER
HR TOO FAST TO COUNT
FIBRILLATION
IF THE TWO R WAVES ARE BETWEEN 3 AND 5 LARGE BLOCKS
THE HR IS NORMAL
IF THE TWO R WAVES ARE CLOSER THAN 3 LARGE BLOCKS(15 SMALL SQUARES)
THE HR IS >100(TACHYCARDIA)
IF THE TWO R WAVES ARE WIDER THAN 5 LARGE BLOCKS(25 SMALL SQUARES)
THE HR <60(BRADYCARDIA)
FORMULA TO GET HR ON EKG
HR=300/# OF LARGE BLOCKS BETWEEN R WAVES OR
=1500/# OF SMALL BLOCKS BETWEEN R WAVES

EX. 300/4=75
1500/20=75
NORMAL SINUS RHYTHM(NSR)
NORMAL RATE
NO SKIPS
NO EXTRA BEATS
IDENTIFY STRIP
SINUS TACHYCARDIA
SINUS RHTHM WITH RATE>100
GIVE O2
TREAT SYMPTOMS
IDENTIFY STRIP AND TYPE OF TX THAT SHOULD BE GIVEN
SINUS BRADYCARDIA
SINUS RHYTHM WITH RATE <60
GIVE 100% O2
ATROPINE
IDENTIFY STRIP AND TYPE OF TX THAT SHOULD BE GIVEN
PVC'S-PREMATURE VENTRICULAR CONTRACTIONS
GIVE 100% O2
LIDOCAINE
IDENTIFY STRIP AND TX THAT SHOULD BE GIVEN
V-TACH-VENTRICULAR TACHYCARDIA
VENTRICULAR RHYTHM WITH RATE >100
DEFIBRILLATE 200 JOULES(IF NO PULSE)
IDENTIFY STRIP AND TX THAT SHOULD BE GIVEN
V-FIB-VENTRICULAR FIBRILLATION
COMPLETELY IRREGULAR VENTRICULAR RHYTHM
DEFIB@ 200 JOULES
IDENTIFY AND TYPE OF TX THAT SHOULD BE GIVEN
IF DEFIB DOES NOT CHANGE ARRHYTHMIA AFTER 3 COUNTER SHOCKS WHAT SHOULD YOU DO?
ADMINISTER 1 MG OF EPINEPHRINE
1ST DEGREE AV BLOCK
PR INTERVAL >.20 SEC, >200 MILLISECONDS OR 5mm(MEASURED FROM THE BEGINNING OF THE P WAVE TO THE BEGINNING OF THE QRS
MAY BE CAUSED BY ISCHEMIA OR DIGITALIS (NOT AN EMERGENCY)
TX GIVE/ATROPINE/ISUPREL
IDENTIFY STRIP AND TYPE OF TX NEEDED
1ST DEGREE AV BLOCK MAY BE CAUSED BY
ISCHEMIA OR DIGITALIS (NOT AN EMERGENCY)
IRREGULAR RHYTHM
NORMAL P WAVES
BUT QRS COMPLEX IS MISSING
2ND DEGREE AV BLOCK
TX FOR 2ND DEGREE AV BLOCK(POTENTIAL EMERGENCY)
ATROPINE
ISUPREL
ELECTRICAL PACEMAKER
ATRIAL RATE >60
VENTRICULAR RATE <40/MIN
PR INTERVAL CANNOT BE DETERMINED
QRS COMPLEX WILL BE WIDENED
(AN EMERGENCY, CIRCULATORY FAILURE)
3RD DEGREE AV BLOCK
TX FOR 3RD DEGREE AV BLOCK
ELECTRICAL PACEMAKER
MEASURES THE NET DIRECTION OF ALL THE ELECTRICITY THROUGH THE HEART DURING CONTRACTION
THE AXIS OF AN ECG
THE NORMAL AXIS IS IN A DIRECTION OF
DOWN AND TO THE LEFT
2 FACTORS THAT AFFECT THE DIRECTION OF THE AXIS
HYPERTROPHY
INFARCTION
AXIS WILL SHIFT TOWARD IF PT HAS
HYPERTROPHY
AXIS WILL SHIFT AWAY IF PT HAS
INFARCTION
THIS DISORDER WILL INCREASE ELECTRICAL ACTIVITY TO THE RIGHT SIDE OF THE HEART
RIGHT VENTRICULAR HYPERTROPHY FROM PULMONARY HYPERTENSION(COPD)
THIS WOULD DECREASE THE ELECTRICAL ACTIVITY ON THE LEFT SIDE AND SHIFT THE AXIS TO THE RIGHT
MYOCARDIAL INFARCTION(DEAD TISSUE)
MOST OFTEN OCCURS IN THE LEFT VENTRICLE
REDUCED BLOOD FLOW TO TISSUE
ISCHEMIA
ACUTE DAMAGE TO TISSUE(OFTEN FROM ISCHEMIA)
INJURY
NECROSIS OR DEATH OF TISSUE(END RESULT OF ISCHEMIA AND INJURY)MAY BE RECENT, ACUTE OR OLD
INFARCTION
DEPRESSED OR INVERTED T WAVE INDICATES
ISCHEMIA
ELEVATED S-T SEGMENT INDICATES
INJURY
DIAGNOSED BY SIGNIFICANT Q WAVES
INARCTION
Q WAVES ARE SIGNIFICANT IF IT IS
1/2 THE HEIGHT OF THE R WAVE OR
1 SMALL SQUARE WIDE(0.04 MM)
ELEVATED OR SPIKED T WAVES ARE CAUSED BY
HYPERKALEMIA
NONINVASIVE METHOD FOR MONITORING CARDIAC PERFORMANCE. USES A DOPPLER FLOW MAPPING WITH TWO DIMENSIONAL AND M MODE ECHOCARDIOGRAPHY TO ASSESS OVERALL VENTRICULAR FUNCTION INCLUDING LEFT VENTRICULAR VOLUME AND EJECTION FRACTION
ECHOCARDIOGRAPHY
ELECTROCARDIOGRAPHY CAN ALSO BE USED TO
EVALUATE CARDIAC ANOMALIES IN THE INFANT
TETRALOGY OF FALLOT
COARCTATION OF THE AORTA
TRANSPOSITION OF THE GREAT VESSELS
ASD
VSD
PDA
AND OTHERS
MOTHERS WITH_______ARE PRONE TO HAVE PROBLEMS WITH PREMATURE INFANTS
DIABETES
TIME SINCE THE ESTIMATED DATE OF CONCEPTION
GESTATIONAL AGE
FROM 38 TO 42 WEEKS GESTATIONAL AGE
TERM INFANT
ETT SIZE FOR A TERM INFANT
3mm
LESS THAN 38 WEEKS GESTATIONAL AGE
PRETERM INFANT(PREMATUR)
MORE THAN 42 WEEKS GESTATIONAL AGE
POST TERM INFANT
PROVIDES A CLNICAL METHOD FOR EVALUATING THE INFANT IMMEDIATELY AFTER BIRTH.
ALLOWS FOR A RAPID APPRAISAL OF AN INFANT IN DETERMINING THE NEED FOR RESUSCITATION
APGAR SCORE
APGAR SCORE IS ROUTINELY DONE AT
1 AND 5 MINUTES
APGAR SCORE DONE IN 1 MINUTE PREDICTS
THE NEONATAL SURVIVAL
APGAR SCORE DONE IN 5 MINUTES PREDICTS
FUTURE NEUROLOGIC DAMAGE
5 FACTORS ARE EVALUATED IN APGAR
A-PPEARANCE/COLOR
P-ULSE/HR
G-RIMACE/REFLEX IRRITABILITY
A-CTIVITY/MUSCLE TONE
R-ESPIRTORY EFFORT
APGAR SCORE OF 0-3 INDICATES
RESUSCITATION
APGAR SCORE OF 4-6 INDICATES
SUPPORT-STIMULATE, WARM ADMINISTER 02
APGAR SCORE OF 7-10 INDICATES
MONITOR- ROUTINE CARE
A BRIGHT FIBEROPTIC LIGHT IS PLACED AGAINST THE INFANTS CHEST IN A DARKENED ROOM.
NORMALLY A LIGHTED HALO IS SEEN AROUND THE POINT OF CONTACT
TRANSILLUMINATION
TRANSILLUMINATION WILL CAUSE THE ENTIRE HEMOTHORAX TO LIGHT UP DUE TO
A PNEUMOTHORAX OR
PNEUMOMEDIASTINUM
TRANSILLUMINATION IS RECOMMENDED WHEN
A PNEUMOTHORAX IS SUSPECTED
INFANTS LOSE BODY HEAT VERY QUICKLY AND MAY NEED TO BE PLACED IN A WARM ENVIRONMENT TO MAINTAIN ADEQUATE BODY TEMPERATURE
TEMP OF INFANT
NORMAL TEMPERATURE FOR AN INFANT
36.5 C
Normal transillumination
a lighted "halo" is seen around the point of contact
What is the new ballard score used for?
Estimates gestational age in very low birth weight infants
What is the normal score?
Normal score of 40 corresponds to 40 weeks
A blood gas drawn from the right radial artery(pre-ductal) indicates a PaO2 of 90 mmhg, and a blood gas drawn from the umbilical artery(post-ductal)indicates a PaO2 of 60 mmHg. What does the difference in the PaO2 indicate?
R-L shunting occurs across the ductus arteriosus.

*PaO2 differences greater than 15 mmHg indicates R-L shunting accross the ductus arteriosus.
What does L/S stand for?
Lecithin/Sphingomyelin
What is L/S ratio used as?
Lung maturity information
What does a 2:1 ratio or higher indicate?
Good Lung maturity
What does a ratio of less than 1:1 indicate?
anything less than 2:1 is a high risk
What is the most reliable indicator of pulmonary maturity even with diabetes?
PG-Phosphatidylglycerol