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141 Cards in this Set
- Front
- Back
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What is the percent of O2 in room air?
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21
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Oxygenation is much more than just breathing
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Oxygenation is much more than just breathing
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What is the function of the circulatory system?
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exchanges respiratory gases, nutrients, and wastes
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What is the rubber band law?
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Frank-Starling
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What are the first signs of respiratory problems with older adults?
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forgetfulness and irritability
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What does a thickening of the ventricular wall in older adults lead to?
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decreased cardiac output
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What does heart valves becoming stiffer in older adults lead to?
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murmurs
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What does a decreased chest wall compliance with a loss of elastic recoil in older adults lead to?
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prolonged exhalation phase and decreased vital capacity
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What does an increased ventilation/perfusion mismatch in older adults lead to?
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decreased pO2
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what does decreased alveolar surface area in older adults lead to?
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decreased cardiac output
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What does decreased carbon dioxide diffusion capacity in older adults lead to?
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slightly increased pCO2
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What does decreased responsiveness of central chemoreceptors to hypoxiema and hypercapnemia and peripheral in older adults lead to?
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increased respiratory rate and decreased tidal volume
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What does decreased number of cilia in older adults lead to?
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decreased airway clearance
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What does a decreased IgA production and humoral and cellular immunity in older adults lead to?
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diminished cough reflex
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What does decreased respiratory drive in older adults lead to?
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increased risk of aspiration and respiratory infection
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What does decreased tone of upper airway muscles in older adults lead to?
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decreased pO2 and snoring, obstructive sleep apnea
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In what age group is corneal arcus (whitish opaque ring around junciton of cornea and sclera) normal for?
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older adults with arcus senilis
(in middle adults and younger it indicates hyperlipidemia) |
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What does a petechiae on the conjuntivae mean?
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fat embolus or bacterial endocarditis
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If neck veins are distended what can you infer?
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right-sided heart failure
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If the chest has retractions what could be the cause?
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increased work of breathing, dyspnea
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What could be the cause with a patient with periorbital edema?
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kidney disease
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What could be the cause with a patient with splinter hemorrhages?
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bacterial endocarditis
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What does a positive result for a TST look like?
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palpable, elevated, hardened area around the injection site
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Would you measure a flat area on a TST? Why?
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no because it is not a positive result
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What does a CBC determine?
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the number and type of red and white blood cells per cubic millimeter of blood
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Why do people do cardiac enzyme tests?
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to diagnose acute myocardial infarctions
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How much myoglobin should you have?
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< 90 mcg/L
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After a heart attack when would you start seeing an increase in circulating myoglobin?
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within 3 hours
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How much circulating cardiac kinase should a male have? a woman?
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55-170 units/l
30-135 units/l |
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When does cardiac kinase peak?
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12 hours after chest pain
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How long does plasma cardiac troponin I stay elevated for after a cardiac infarction?
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7-10 days
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How long does plasma cardiac troponin T stay elevated for after a cardiac infarction?
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10-14 days
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What should a person's fasting cholesterol be?
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200 mg/dl
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How much LDLs should a person have?
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60-180 mg/dl
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Which cholesterol is the good kind? the bad?
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HDL = good
LDL = bad |
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How much HDLs should a person have?
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male: > 45 mg/dl
female: > 55 mg/dl |
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How many triglycerides should a person have?
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male: 40-160 mg/dl
female: 35-135 mg/dl |
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What is a scintigraphy test for?
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used to evaluate cardiac structure, myocardial perfusion and contractility
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What is the purpose of a bronchoscopy?
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can see and remove stuff from tracheobronchial tree
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What is a lung scan for?
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identify abnormal masses
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What is a thoracentesis used for?
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obtain a specimen of plural fluid
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What is a sputum culture and sensitivity done for?
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identify a specific microorganism in sputum
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What is a sputum for acid fast bacillus for?
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detection of TB on consecutive mornings
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What is a sputum for cytology for?
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identify abnormal lung cancer
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Which culture has the larges chest size?
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white Americans then african americans, asian americans, and native americans
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Which culture has the highest rating of TB?
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asian americans then native hawaiians
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Which of the american minority groups has the largest reported cases of TB?
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african americans followed by hispanics
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Which ethnic/gender groups has the highest mortality rates related to asthma?
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african american women
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Who has the highest rates of COPD and cystic fibrosis?
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whites
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Who should not get flu vaccine?
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those allergic to eggs and those with acute febrile illness
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When is the heart supplied with blood?
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at rest
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What happens if a patient's heart rate is > 160?
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blood can't enter heart because it's beating too quickly
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How much is cardiac output?
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4-6 L/min
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What type of drugs deal with heart rate?
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chornotropic
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Chronotropic drugs deal with what function of the hear?
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heart rate
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What type of drugs deal with contractility?
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inotropic
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Inotropic drugs deal with what function of the heart?
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contractility
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Pre-load
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end of diastolic volume
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What is the intrinsic rate of the SA node?
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60-100
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What is the intrinsic rate of the AV node?
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40-60
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What is the intrinsic rate of the Bundle of His and Perkinje fibers?
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20-40
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What part of the conduction system is the pacemaker of the heart?
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SA node
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afterload
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resistance to left ventricular ejection
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ventilation
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process of moving gases into and out of lungs
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cardiac output
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amount of blood ejected from the left ventricle each minute
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perfusion
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the ability of the cardiovascular system to pump oxygenated blood to tissues and return deoxygenated blood back to lungs
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diffusion
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responsible for moving gases from one area to another
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What is the equation for cardiac output?
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CO=SV x HR
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What is the equation for cardiac index?
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CI = CO/BSA
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Cardiac index
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cardiac output that takes into consideration tissue perfusion and the client's body surface area
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What decreases O2 carrying capacity?
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anemia and inhalation of toxic substances
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What ca decrease inspired O2 concentration?
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airway obstruction, decreased environmental O2, incorrect ventilator settings
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What are two causes of hypovolemia?
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shock and dehydration
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What are four factors that increase metabolic rate?
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pregnancy, wound healing, exercise, fever
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What are some signs and symptoms of hypoxia?
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increased rate and depth of breathing, use of accessory muscles, purse-lip breathing, decreased activity tolerance, cyanosis, confusion
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What is the earliest sign of hypoxia?
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confusion
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What is the last sign of hypoxia?
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cyanosis
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When you inhale, do you increase or decrease pressure?
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decrease pressure
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When you exhale, do yo increase or decrease pressure?
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increase pressure
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If you have left sided heart failure what happens?
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pulmonary edema
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If you have right sided heart failure what happens?
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edema everywhere except lungs
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What happens with impaired valvular function?
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valves don't close all the way and there is some back flow
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Myocardial ischemia/angina
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decreased blood flow
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What does hyperventilation cause?
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hypocarbia
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What does hypoventilation cause?
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hypercarbia
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What can cause hypoventilation?
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atelectasis and COPD
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What can cause hypoxia?
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decrease Hgb, diminished inspired [O2], inability of tissued to extract O2, decreased perfusion of O2, poor tissue perfusion, impaired ventilation
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What problems prevent good oxygenation in older adults?
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calcification of heart valves, SA node changes, costal cartilage changes,m atherosclerosis, osteoporosis, cilia decrease, treacheal and bronchial calcification
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What foods and minerals provide cardioprotection?
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antioxidants (rich colored foods)
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How much exercise should you get a day?
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30-60 min
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Does smoking causes VC or VD?
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VC
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Where can you find the PMI?
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5th intercostal space, mid clavicular line
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What is the PMI?
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point of maximum intensity on the heart
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Should you be able to feel the PMI?
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no and if so barely
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What are crepitations?
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air under the skin
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What is thoracic excursion?
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palpation - feel how wide hands come apart on inspiration
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What is diaphramatic excursion?
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percussion - line where lungs stop on inspiration and expiration
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When should you check a patient's carotid artery?
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1st assessment and if hey are going down hill
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How much time does an EKG show you?
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12 seconds
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Holter moinitor
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portable EKG that a patient wears for 24 hours
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King's monitor
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can push button - 3 min before and after wear for 2 weeks
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Electrophysiology studies
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put leads in heart to feel where electrical impulses are going bad
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Echocardiogram
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shows figures of the heart
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What should you be concerned with on an echo?
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EF% and if valves are working
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What should an EF% be?
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55-70 %
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angiography
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inserting dye to see blockages
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Bradypnea
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rate of breathing is regular but abnormally slow
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Tachypnea
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rate of breathing is regular but abnormally rapid
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Hyperpnea
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respirations are labored, increased in depth,a nd increased in rate
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Apnea
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respirations cease for several seconds
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Hyperventilation
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rate and depth of respirations increase
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Hypoventilation
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respiratory rate is abnormally low and depth of ventilation is depressed
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Cheyne-stokes respiration
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respiratory rate and depth are irregular, characterized by alternating periods of apnea and hyperventilaiton
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Kussmauls's respiration
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respirations are abnormally, deep regular and increased in rate
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Biot's respiraton
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respirations are abnormally shallow for two to three breaths followed by irregular period of apnea
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If someone is on an ACE inhibiter what labs should you watch?
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ones that monitor K+ and Cr
Chem lab |
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Why does pursed lip breathing help?
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creates back pressure
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what enhances coumadin?
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ginko, garlic, ginsing
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How can you get abnormal cells in the resp tract?
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throat cultures, sputum specimens, and thoracentesis
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How often do you need a flu shot?
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every year
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How often do you need a pneumoccocal vaccine?
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10 or 5 yearts
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Why would someone need two does of the flu vaccine?
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HIV
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How much liquid should you get a day?
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2,000ml-2,500 ml
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How do you treat shortness for breath?
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treat the underlying cause, O2, PT, relaxation techniques, percussion techniques
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What kind of medications do you use to treat dyspnea?
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bronchodialators, steroids, mycolytics, antianxiety
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When a patient is taking O2, when do you need t humidify it?
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4 l/min
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What is the goal of o2 therapy?
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prevent or relieve hypoxia O2 stat about 92
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What are the methods of O2 delivery?
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nasal cannula, nasal catheter, transtracheal, O2 mask
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How much O2 does a simple O2 mask supply?
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30-60%
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How much O2 does a ventrui O2 mask supply?
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24-55%
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How much O2 does a nonbreather with a reservoir mask supply?
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80-90%
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How low does you O2 stat have to be to have O2 at home?
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below 88%
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How long can you go without O2 before brain death?
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4 min
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How often does a COPDer need to cough?
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Q2H
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What is a cascade cough?
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the client takes a slow, deep breath and holds it for 2 seconds while contracting expiatory muscles and then coughs throughout exhalation
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What is a huff cough?
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while exhaling the client opens the glottis by saying the word huff
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What is the quad cough?
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while the client breathes out with a maximal expiatory effort the client pushes inward and upward on the abdominal muscles
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Who is the quad cough for?
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clients without abdominal muscle control
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When assessing someone with left side heart failure what would you find?
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fatigue, breathlessness, dizziness, and confusion from hypoxia
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What is the major pathophysiology of right sided heart failure?
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elevated pulmonary vascular resistance
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What is the leading contributing factor for stroke in the older adult?
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atrial fibrillation
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