Cardiac Conditions and Orthostatic Hypotension
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Questions and Answers

What physiological changes are primarily associated with hypertension?

  • Decreased peripheral resistance and cardiac output
  • Improved blood vessel elasticity
  • Enhanced blood flow due to vasodilation
  • Increased peripheral resistance or cardiac output (correct)

    • Which of the following is NOT a recognized risk factor for hypertension?

  • Low sodium diet (correct)
  • Older age
  • Obesity
  • Diabetes

    • What is the recommended Rate of Perceived Exertion (RPE) range for moderate intensity in patients with just hypertension?

  • 12-15 (correct)
  • 6-10
  • 16-20
  • 11-14

    • What S&S indicates Stage 2 hypertension?

    <p>SBP &gt;140 or DBP &gt;90</p> Signup and view all the answers

    Which of these symptoms is NOT typically associated with orthostatic hypotension?

    <p>Shortness of breath</p> Signup and view all the answers

    Which treatment is effective for managing orthostatic hypotension?

    <p>Midodrine</p> Signup and view all the answers

    What behavioral strategy is recommended to manage orthostatic hypotension?

    <p>Gradually changing positions</p> Signup and view all the answers

    Which physiological indicator suggests a patient should avoid exercise due to hypertension?

    <p>Resting SBP &gt;180 or DBP &gt;100</p> Signup and view all the answers

    Which of the following treatments is NOT recommended for venous insufficiency?

    <p>Diaphragmatic breathing</p> Signup and view all the answers

    What is a common symptom of venous insufficiency?

    <p>Dull ache</p> Signup and view all the answers

    Which condition is associated with trouble getting air out of the lungs?

    <p>COPD</p> Signup and view all the answers

    The FEV1/FVC ratio is normal in which type of lung disease?

    <p>Restrictive lung disease</p> Signup and view all the answers

    What should be monitored post CABG and valve surgery to prevent complications?

    <p>Supine hypertension</p> Signup and view all the answers

    Which treatment modality is aimed at increasing chest expansion?

    <p>Incentive spirometer</p> Signup and view all the answers

    What preventative measure is crucial for patients with venous insufficiency?

    <p>Early ambulation</p> Signup and view all the answers

    Which statement best describes the symptomatology of obstructive lung disease?

    <p>Difficulty exhaling air</p> Signup and view all the answers

    Which breathing technique is specifically aimed at improving lung function in restrictive lung diseases?

    <p>Segmental breathing</p> Signup and view all the answers

    What is Virchow's Triad associated with?

    <p>Pulmonary embolism risks</p> Signup and view all the answers

    What is a common symptom experienced by individuals with chronic obstructive pulmonary disease (COPD)?

    <p>Shortness of breath (SOB)</p> Signup and view all the answers

    Which treatment technique focuses on improving gas exchange through positive pressure?

    <p>Positive expiratory pressure devices</p> Signup and view all the answers

    Which condition is characterized by increased mucus production and a chronic cough for at least three months each year for two consecutive years?

    <p>Chronic Bronchitis</p> Signup and view all the answers

    What is an effective airway clearance technique that involves controlled coughing?

    <p>Huffing</p> Signup and view all the answers

    Which of the following statements best describes the pathophysiology of emphysema?

    <p>Destruction of alveolar walls leading to air trapping</p> Signup and view all the answers

    What are typical examination findings in a patient with emphysema?

    <p>Decreased fremitus due to damaged alveoli</p> Signup and view all the answers

    What is the recommended exercise frequency for aerobic training in COPD patients?

    <p>3-5 days a week</p> Signup and view all the answers

    Which of the following is a risk factor for chronic bronchitis?

    <p>Smoking</p> Signup and view all the answers

    How does pursed lip breathing benefit COPD patients?

    <p>Decreases respiratory rate and airway collapse</p> Signup and view all the answers

    What is a common physical characteristic of patients with emphysema?

    <p>Thin and malnourished</p> Signup and view all the answers

    What is the primary purpose of interval training for COPD patients during inpatient rehabilitation?

    <p>Providing short bouts of activity throughout the day</p> Signup and view all the answers

    What is a potential complication of chronic obstructive pulmonary disease (COPD)?

    <p>Cor pulmonale</p> Signup and view all the answers

    What role does digital clubbing play in respiratory conditions?

    <p>Suggests chronic hypoxemia</p> Signup and view all the answers

    What is the significance of monitoring vital signs and oxygen saturation in COPD patients during exercise?

    <p>To assess the risk of desaturation</p> Signup and view all the answers

    What is a common sign of atelectasis?

    <p>Shifted trachea toward the collapsed side</p> Signup and view all the answers

    Which of the following is a treatment technique for atelectasis?

    <p>Diaphragmatic breathing</p> Signup and view all the answers

    Which risk factor is associated with Type 1 diabetes?

    <p>Genetics</p> Signup and view all the answers

    What is the recommended frequency for aerobic exercise in a diabetic patient?

    <p>5 days a week</p> Signup and view all the answers

    Which condition can result in peripheral neuropathy?

    <p>Diabetes</p> Signup and view all the answers

    What is one major complication of diabetes?

    <p>Retinopathy</p> Signup and view all the answers

    In what position should you place a patient to aid in bed mobility?

    <p>Trendelenburg position</p> Signup and view all the answers

    What is a common sign of hypoglycemia in diabetic patients?

    <p>Increased fatigue</p> Signup and view all the answers

    What type of breathing can improve lung expansion post-transplant?

    <p>Summed/stacked breathing</p> Signup and view all the answers

    What BMI value categorizes an individual as obese?

    <p>30</p> Signup and view all the answers

    What is a common symptom associated with hypersecretion of mucus?

    <p>Shortness of breath upon exertion</p> Signup and view all the answers

    Which treatment is recommended for patients with airway clearance issues?

    <p>Interval training</p> Signup and view all the answers

    What would likely NOT be a symptom of pneumonia?

    <p>Excessive cravings for salt</p> Signup and view all the answers

    Which risk factor is primarily associated with pneumonia?

    <p>Impaired swallowing</p> Signup and view all the answers

    What should a patient post-lobectomy avoid doing?

    <p>Prolonged side-lying with the operative side down</p> Signup and view all the answers

    Which of the following is a sign of rejection after a lung transplant?

    <p>Tachycardia</p> Signup and view all the answers

    Which treatment method is recommended for improving lung function after thoracic surgery?

    <p>Diaphragmatic breathing techniques</p> Signup and view all the answers

    What indicates a predominantly viral pneumonia?

    <p>Normal WBC with a nonproductive cough</p> Signup and view all the answers

    What is a critical restriction for patients after esophagectomy?

    <p>Abdominal lifting precautions</p> Signup and view all the answers

    Which therapeutic approach focuses on producing effective cough in pneumonia patients?

    <p>Breathing exercises and coughing techniques</p> Signup and view all the answers

    What is the typical treatment for asthma exacerbations?

    <p>Low intensity aerobic exercises</p> Signup and view all the answers

    What happens to lung function after lung volume reduction surgery?

    <p>Patients typically experience increased exercise tolerance</p> Signup and view all the answers

    What type of breathing technique is beneficial for patients with a barrel chest post-lung transplant?

    <p>Purse lip breathing</p> Signup and view all the answers

    Which physiological process primarily causes airway obstruction in asthma?

    <p>Bronchospasm and inflammation</p> Signup and view all the answers

    Study Notes

    Cardiac Conditions

    • Hypertension Pathophysiology: Increased blood pressure (PR) or cardiac output (CO), vasoconstriction (narrowing of blood vessels), and issues with the renin-angiotensin-aldosterone system.
    • Hypertension Risk Factors: Coronary artery disease (CAD), older age, male sex, diabetes, obesity, smoking, high sodium diet, and pre-eclampsia.
    • Hypertension Symptoms (S&S): Elevated blood pressure (systolic >130 mmHg, or diastolic >80 mmHg). Stages: Stage 1 (130-139 systolic or 80-89 diastolic), Stage 2 (>140 systolic or >90 diastolic).

    Orthostatic Hypotension

    • Orthostatic Hypotension Pathophysiology: Rapid drop in blood pressure (BP) due to positional changes. Decreased systolic BP by 20+ mmHg and/or a >10 mmHg decrease in diastolic BP.
    • Orthostatic Hypotension Risk Factors: Elderly, dehydration, blood loss, Parkinson's disease, spinal cord injury (SCI), diabetes, and medications (e.g., vasodilators, anti-hypertensive agents).
    • Orthostatic Hypotension Symptoms (S&S): Dizziness, lightheadedness, visual blurring, fatigue, and headache.

    Myocardial Infarction (MI)

    • Description: Chest pain, related enzymes (e.g., cardiac markers), and EKG changes. Can include non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI).
    • Treatment: Inpatient cardiac rehab.

    Angina

    • Description: Unstable/crescendo angina is characterized by worsening chest pain, frequently not relieved by rest and medication; stable angina means chest pain during exercise that improves with rest and medication. Prinzmetal/vasospastic angina involves vasospasm of coronary arteries, not caused by occlusion.
    • Treatment: Medications (e.g., morphine, oxygen, nitroglycerin [NTG], aspirin); lifestyle changes such as avoiding excess exertion or increasing relaxation techniques
    • Additional Considerations: Needs for determining RPP (heart rate x systolic blood pressure) and exercise thresholds for stable angina patients.

    Heart Transplant

    • Description: Needed at end-stage heart failure (HF), with cardiac denervation, blunted exercise response, resting heart rate of 95-115, and increased norepinephrine (nor-epi).
    • Treatment: FITT aerobic program: frequency 3-5 days per week, intensity using RPE (11-14), time 20-60 minutes per day, and type: treadmill, walking, cycling; FITT strength program: frequency 1-2 days, intensity RPE 11-14, duration 40%-70% 1 RM, type: 1-2 sets major muscle groups (10-15 reps).

    CHF

    • Description: Syndrome resulting from any structural or functional cardiac disorder that compromises the ventricle's ability to fill or pump blood.
    • Right-sided CHF symptoms: Jugular venous distention (JVD) and peripheral edema.
    • Left-sided CHF symptoms: Pulmonary symptoms (cough, shortness of breath).

    PAD

    • Description: Typically associated with atherosclerosis, causing inadequate oxygen and nutrients to tissues.

    • Symptoms(S&S): Pain (claudication), paresis, paresthesias, pallor, decreased pulse, and trophic changes

    • Tests: Capillary refill time (>15 seconds), ankle-brachial index (<0.9), and bruits.

    DVT

    • Description: Deep vein thrombosis (DVT) is a blood clot within a deep vein, typically in a leg.
    • Risk Factors: The Virchow's triad of venous stasis, hypercoagulation, and vascular damage.
    • Symptoms(S&S): Calf pain, redness, edema, palpable cord, and warmth along the affected area.

    Venous Insufficiency

    • Description: Damaged valves causing pooling and backflow of blood in the veins, typically in the legs.
    • Symptoms(S&S): Itching and tingling, dull aching, heaviness, swelling, cramping (especially with standing), increased pain with standing, and decreased pain with elevation.
    • Treatment: Compression, wound management, elevation, and ankle pumps.

    COPD

    • Obstructive Lung Diseases vs Restrictive Lung Diseases: Obstructive lung diseases primarily affect airflow (reduced FEV1/FVC ratio), and restrictive lung diseases primarily reduce lung expansion (reduced lung volumes). COPD is characterized by reduced air flow, while restrictive lung diseases are characterized by reduced chest wall expansion. The differences between the conditions should be highlighted during the class discussion.

    Emphysema

    • Pathophysiology: Alveolar walls destruction and dilatation, resulting in narrowed airways.
    • Risk factors: Smoking is a major risk factor.
    • Symptoms(S&S): Thin appearance, decreased fremitus, use of accessory muscles, pursed lip breathing, forward leaning posture, and SOB.
    • Treatment: Various breathing exercises and therapies are used to manage the obstruction of airflow.

    Chronic Bronchitis

    • Pathophysiology: Chronic productive cough for 3 months in each of 2 successive years. Often associated with hypersecretion of mucus and airway obstruction.
    • Risk factors: Smoking.
    • Symptoms: Hypersecretion of mucus, SOB on exertion, cough (often in the morning), and gunk (mucus).
    • Treatment: Mucolytics, postural drainage, and breathing treatments/devices.

    Asthma

    • Pathophysiology: Airway obstruction due to inflammation and bronchospasm, typically reversible.
    • Symptoms(S&S): Recurrent episodes of wheezing, coughing, shortness of breath (dyspnea), and chest tightness.
    • Treatment: Short-acting bronchodilators (rescue inhalers), long-acting bronchodilators, and inhaled corticosteroids.

    Cystic Fibrosis

    • Pathophysiology: Genetic disease causing excessive thick mucus, interfering with normal function of organs such as the lungs, pancreas, liver, and intestines.
    • Risk factors: Genetically predisposed.
    • Symptoms(S&S): Wet cough, chest infections, malnourishment, and rhonchi.
    • Treatment: Airway clearance techniques, mucolytics, postural drainage, exercise training, and nutritional support.

    Atelectasis

    • Pathophysiology: Partial or complete lung collapse, frequently caused by airway obstruction or reduced lung expansion.
    • Risk Factors: Post-operative procedures, decreased lung expansion, and or pneumonia.
    • Symptoms(S&S): Reduced chest wall movement, decreased breath sounds, and shifted trachea.
    • Treatment: Incentive spirometry, coughing or deep breathing exercises, and mobilization.

    Diabetes

    • Pathophysiology: Metabolic disorder characterized by improper glucose regulation/ production, and/or utilization.
    • Risk factors: Genetics, diet, and lifestyle.
    • Complications: Stroke, heart attack.

    Other Conditions (e.g., Metabolic syndrome, Obesity and Asthma)

    • Pathophysiology, Risk Factors, Symptoms, and Treatments for specific conditions are detailed, focusing on the salient characteristics of each. Note that specific data points for some conditions are not available.

    Respiratory Procedures and Interventions

    • Thoracic Surgeries such as lobectomy, and pneumonectomy, usually accompanied by post-surgical mobilization routines to maximize lung expansion, and airway clearance to reduce the risk of respiratory complications (frequently related to thoracic cavity and/or lung surgery)

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    Description

    This quiz covers essential aspects of cardiac conditions, specifically focusing on hypertension and orthostatic hypotension. It includes the pathophysiology, risk factors, and symptoms associated with these conditions. Perfect for students looking to deepen their understanding of cardiovascular health.

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