Cardiopulmonary Exam 2 Study guide PDF

Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 1. right coronary artery artery that arises from right anterolateral surface of aorta, descends into coronary...

Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 1. right coronary artery artery that arises from right anterolateral surface of aorta, descends into coronary sulcus. Gives off posterior descending artery 2. left coronary artery artery that arises from left anterolateral aspect of aorta gives off the left anterior descending (in- terventricular) and the left circumflex 3. coronary sulcus separates atria from ventricles 4. right atrium the right coronary artery supplies these 4 right ventricle structures SA node AV node 5. left atrium the left coronary artery supplies these 3 left ventricle structures IV septum 6. sympathetic which system vasodilates the coronary arteries: the sympathetic or the parasympathetic? 7. diastole (makes sense w/ coro- Coronary circulation & perfusion occurs nary sinus anatomy) during which phase of heart contraction: systole or diastole? 8. diastolic pressure coronary pressure is primarily determined by _______________ ______________. 9. mitral valve valve between the left atrium and the left ventricle 1 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 10. aortic valve The semilunar valve separating the aorta from the left ventricle that prevents blood from flowing back into the left ventricle. 11. CN X parasympathetic innervation of the heart comes from this cranial nerve 12. beta 1 receptors adrenergic receptor found on the heart; stimulation causes HR increase 13. atrial septal defect heart defect where the foramen ovale (connects the 2 atria) does not properly close. 14. increases HR medication with a positive chronotropic effect does this to the heart 15. reduces contractility medication with a negative ionotropic ef- fect does this to the heart 16. ejection fraction ratio of blood pumped from the ventricle to the amount remaining at the end of diastole normal is 60-70% 17. 60-70% normal ejection fraction range 18. Mean Arterial Pressure (MAP) pressure within the aorta, averaged over 1 cardiac cycle diastolic pressure + 1/3 pulse pressure 19. abnormal response to exercise One of the cardinal signs of someone (drop in BP, HR, dizziness, pain) with a cardiac condition. it is especially important for us as PTs to recognize this 20. angina scale for reference angina scale for reference 2 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 21. 4+ "most severe pain ever experienced" rat- ing on the angina scale is what score? 22. 2+ "moderate, bothersome" rating on the angina scale is what score? 23. dyspnea level scale. dyspnea level scale. all the levels 0-3 are one numer- all the levels 0-3 are one numerical ical breath greater. breath greater. A score of 0 can perform the task A score of 0 can perform the task in 1 in 1 breath. breath. 24. functional dyspnea scale functional dyspnea scale 25. skeletal High levels of creatinine phosphokinase MM (CK-MM) enzymes in the blood are most likely from damage to which type of muscle? 26. cardiac 3 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 High levels of creatinine phosphokinase MB (CK-MB) enzymes in the blood are most likely from damage to which type of muscle? 27. patients who have heart failure For which type of Pts would you NOT elevate the legs to assist venous return when putting them back to bed? 28. 1 Functional dyspnea scale score when SOB only with hurrying on level ground, or going up an incline 29. 0 functional dyspnea scale where SOB only w/ stressful exercise 30. 3 functional dyspnea scale where some- one stops from SOB after 100 level me- ters 31. 2 functional dyspnea scale where some- one has to periodically stop on a level surface due to SOB, and walks slower 32. 4 Worst score for functional dyspnea scale, pt is breathless performing ADLs in the house 33. pulmonic valve stenosis Name the 4 heart defects within the right ventricle hypertrophy tetralogy of Fallot ventricular septal defect dextroposition (overriding, in- correctly positioned) aorta 34. S1 (lub) the first heart sound, heard when the atri- oventricular (mitral and tricuspid) valves close 35. 55-100 mL normal heart stroke volume 4 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 36. less than 120 and less than 80 What is normal blood pressure? 37. 120-129 AND 40" in Name the 5 diagnostic criteria for meta- men, > 35" in women) bolic syndrome elevated triglycerides ( > 150) reduced HDL ( < 40 men, < 50 women) HTN ( > 130/85) high fasting plasma glucose ( > 100) 66. 3 how many diagnostic criteria must be met for someone to have metabolic syn- drome? 67. pulmonary HTN 3 conditions that can result from mitral or right HF tricuspid stenosis arrythmia 68. tricuspid regurgitation For which type of valve defect is no repair required? 69. right heart failure tricuspid regurgitation is associated with this heart condition 70. aortic valve stenosis a child not eating enough, or not gaining enough weight, is associated with this valvular defect 71. right ventricle dysfunction pulmonary valve regurgitation is associ- right heart failure ated with these 2 heart conditions 72. 60 bradycardia is fewer than _________ bpm. 73. 100 8 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 tachycardia is greater than __________ bpm. 74. 40-60 beats per minute intrinsic depolarization rate for AV node 75. SA node Name the 5 steps of the heart's conduc- AV node tion pathway, beginning with the SA node bundle of his left & right bundle branches Purkinje fibers 76. P wave name the 6 components of the basic PR interval ECG cycle QRS complex QT interval ST segment T wave 77. atrial depolarization What does the P wave represent? 78. atrial hypertrophy A tall P-wave on an ECG can signify this 79. hyperkalemia This condition can produce a flattened P-wave on an ECG 80. 2-3 The P-wave should occupy how many small boxes on the ECG paper? 81. P-wave the PR interval starts at the beginning QRS complex of the __________ and travels until the beginning of the _______________. 82. shorten The R-R interval, the QT interval, the ST segment & the PR interval all _____________ with exercise. 9 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 83. RR interval name the 4 portions of the ECG that QT interval shorten with exercise ST segment PR interval 84. 3-5 The PR interval should occupy how many small boxes on the ECG paper? 85. ventricular depolarization what mechanical event occurs during the QRS complex? 86. AV node During the QRS complex, the impulse purkinje fibers travels from the ____________ all the way to the _________________, where it will trigger contraction of the myocardial cells 87. 5-25 the amplitude (vertical height) of the QRS complex should be _________ small boxes on the ECG paper 88. 2 the horizontal distance of the QRS com- plex should be how many boxes on the ECG paper? 89. impulse was initiated above A narrow (normal) QRS complex with no the ventricles, but NOT in the P-wave indicates what? SA node (supraventricular initi- ation) 90. ST segment This element on the ECG represents the interval between ventricular depolariza- tion and ventricular repolarization 91. myocardial infarct 2 conditions that produce ST segment hypothermia elevation, where there is no return to the isoelectric line after the QRS complex 10 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 92. ischemia ST segment depression is typically seen in _____________, because this seg- ment represents the heart's ability to re- cover after contraction 93. T-wave what portion of the ECG is this? 94. ventricular repolarization (relax- What does the T wave represent? ation) 95. ischemia An inverted T-wave could indicate either pulmonary embolism of these two conditions 96. heart rate The R-R interval is used to calculate this 97. QT interval represents the time from ventricular de- polarization to repolarization 98. 10-11 boxes Normal length of the QT interval for men 99. 11-11.5 boxes Normal length of the QT interval for women 100. 1500/number of small boxes be- Describe the accurate method of deter- tween R waves mining HR from an ECG using the RR wave 101. 100 bpm A patient has an RR wave that is 15 box- es in length. What is this pt's heart rate? 102. 300, 150, 100, 75, 60, 50 What is the numerical count down for thick boxes you use to determine heart rate on an EKG strip? 11 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 103. athletes Describe 5 kinds of Pts that may display taking beta blockers bradycardia (< 60 bpm) on an ECG increased vagal stimulation (vomiting, suctioning) TBI 2nd & 3rd degree blockage 104. atropine 2 treatments for bradycardia (only treated temporary pacemaker if symptomatic) 105. atrial flutter irregular beating of the atria; a rapid atrial ectopic focus. "saw-tooth" appearance w/ multiple P-waves per QRS complex (2:1, 3:1, or 4:1 ratio) 106. dizziness (which indicates com- With an atrial flutter (multiple P-waves), promised cardiac output) we are only concerned clinically if this symptom is also present 107. atrial fibrillation rapid, random, ineffective contractions of the atrium. P-waves are not identifiable 108. Dizziness (problem has not describe the 3 situations where atrial fib- spread to ventricles, lack of car- rillation is concerning for the Pt diac output) 12 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 Heart rate > 100 at rest (life-threatening) embolus (lack of CO means blood is more stationary throughout the body) 109. Atrial ectopic focus (paroxysmal which type of ectopic foci: atrial contraction) does not impact CO is followed by a normal QRS is often asymptomatic? 110. ventricular ectopic foci (parox- which type of ectopic foci: ysmal ventricular contractions, PVC) might impact CO have no P-wave are generally more serious in nature? 111. paroxysmal atrial contractions another name for atrial ectopic foci, when (PACs) the impulse is still arising from the atria but NOT from the SA node like it should 112. paroxysmal ventricular contrac- another name for ventricular ectopic foci, tions (PVCs) when the impulse is still arising from the ventricles 113. premature atrial contraction irregular heart rhythm characterized by (PAC) atrial contractions occurring before the expected time 114. Bigeminy type of atrial abnormality where every other beat is a PAC 115. trigeminy type of atrial abnormality where every third beat is a PAC 13 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 116. premature ventricular contrac- a ventricular contraction that precedes tion (PVC) the normal impulse initiated by the SA node. Features a bizarre looking QRS and the absence of a P-wave 117. more than 6 per minute Premature ventricular contractions coming from multiple ectopic ar- (PVCs) are clinically more serious than eas (the bizarre QRS complexes premature atrial contractions. will look different) Describe 2 characteristics that increase the seriousness of a PVC 118. sinus rhythm with one PVC (uni- Describe this ECG focal) 119. unifocal Bigeminy PVC (PVC Describe this ECG every other beat) 120. unifocal Trigeminy PVC (PVC Describe this ECG every third beat, unifocal) 121. couplets and triplets (myocardi- Which is more clinically serious: um is depolarizing during its rel- ative refractory period) Trigeminy/bigeminy, or couplets and triplets? 122. multifocal PVC couplet (2 Describe this ECG back-to-back PVCs from differ- ent foci) 14 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 123. Ventricular tachycardia Name 2 different ways to describe this triplet ECG 124. ventricular fibrillation Type of arrhythmia where there really isn't any semblance of a QRS complex, erratic quivering 125. tachycardia with ventricular fibrillation _____________________, there is diminished cardiac output. With ventricular ________________, there is no cardiac output. 126. asystole absence of heart electrical activity; indi- cates patient is dying 127. ST segment depression This ECG is abnormal because it fea- ischemia tures ________________, which is most often caused by _____________. 128. 15 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 ischemia ST depression that features a flat or depressed T wave indicates coronary vasospasm __________________, and can be pro- atherosclerosis duced by any of these 3 conditions thrombus 129. depression myocardial infarct can present as ST seg- elevation ment __________________ or ST seg- ment ________________ on an ECG 130. non-ST-segment elevation my- ECG reading of a myocardial infarct that ocardial infarction (NSTEMI) is a subendothelial infarct (non Q-wave); the infarct is not transmural and did not include the entire thickness of the heart wall 131. persistent ST segment depres- Unique feature of NSTEMI on an ECG sion concerning the ST segment 132. ST segment Elevation MI (STE- ECG reading of a myocardial infarct that MI) is a transmural infarct (Q-wave); includes the entire thickness of the heart wall 133. ST segment elevation Describe 3 characteristics of a STEMI T-wave inversion ECG reading in the acute "injury" phase Q-wave > 1/3 height of QRS 134. ST segment Days after a STEMI, the T wave _______________ will normalize. Q wave Weeks after a STEMI, the __________ will normalize but the abnormally deep __________ will persist. 135. patient symptoms The trifecta of myocardial infarct evalu- ECG ation; all three components need to be enzymes monitored and considered in relation to one another if someone is suspected of having an MI 16 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 136. Sinus Tachycardia what condition does this ECG reveal, and Check patient, if new onset or what should be your next action regard- patient is symptomatic, notify ing the Pt? MD 137. atrial fibrillation what condition does this ECG reveal, and Check patient, if new onset or what should be your next action regard- patient is symptomatic, notify ing the Pt? MD 138. sinus rhythm with pause what condition does this ECG reveal, and Check patient, obtain VS and no- what should be your next action regard- tify MD ing the Pt? 139. sinus rhythm with premature what condition does this ECG reveal, and atrial complexes (PACs) what should be your next action regard- Check patient, if new onset or ing the Pt? patient is symptomatic, notify MD 140. Sinus rhythm with PVC Couplets what condition does this ECG reveal, and Check patient, obtain VS and no- what should be your next action regard- tify MD if couplets persist ing the Pt? 141. Sinus rhythm with 6 beats of what condition does this ECG reveal, and Ventricular Tachycardia (VT) what should be your next action regard- Check patient, obtain VS and no- ing the Pt? tify emergency support 142. sinus bradycardia what condition does this ECG reveal, and Continue to monitor patient what should be your next action regard- ing the Pt? 143. 17 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 Ventricular Fibrillation (VF) what condition does this ECG reveal, and Call Code Blue, obtain AED and what should be your next action regard- prepare to shock the patient ing the Pt? 144. Asystole what condition does this ECG reveal, and Call Code Blue, begin CPR what should be your next action regard- ing the Pt? 145. atrial flutter what condition does this ECG reveal, and Check patient, if new onset or what should be your next action regard- patient is symptomatic, notify ing the Pt? MD 146. the MI has to have occurred in who is appropriate for a MI cardiac rehab the past 12 months program? 147. acute what are the 4 phases of cardiac rehab? subacute training and maintenance disease prevention 148. Monitoring phase 1 cardiac rehab, which is the acute ICU or ________________ phase, begins in the ___________ 149. conditioning/transition In phase 2 cardiac rehab, which is the subacute or ________________ phase, home, inpatient, SNF the patient could be located in any one of these 3 places 150. intensive rehabilitation Primary characteristic of phase 3 (train- ing and maintenance) of cardiac rehab 151. phase 4, disease prevention Which phase of cardiac rehab features phase the greatest amount of patient indepen- dence? 18 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 152. home If the phase 1 rehab stay in the ICU is longer than a week, typically the Pt will NOT be discharged to this location 153. early mobilization Describe the two primary goals for phase assess cardiovascular response 1 of cardiac rehab to ADLs (to inform appropriate discharge location) 154. incentive spirometry describe 4 types of adjunct therapy that ventilation training are appropriate for a Pt in phase 1 of coughing techniques cardiac rehab pillow for splinting 155. pillow splinting type of respiratory splinting that occurs when a patient holds a pillow, also known as a splint pillow, firmly over an incision on the chest 156. 2-3 Concerning exercise intensity during 4-5 phase 1 of cardiac rehab: we want to begin with a low intensity of __________ METS, and then when ap- propriate progress to __________ METS 157. 3-5 days typical length of stay in the ICU for phase 1 of cardiac rehab 158. gait Describe 5 types of exercises that would transfers be appropriate for a phase 1 cardiac Pt out of bed activities 19 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 AROM with the LEs stair training (if indicated) 159. 4 times daily concerning exercise for Pts in phase 1 of twice daily cardiac rehab: for days 1-3, we want to exercise them ________________. From days 4-7, we would want to exercise them _____________. 160. sternal precautions Name 3 areas of Pt education for some- move in the tube one in phase 1 of cardiac rehab therapy progression timeline 161. "Move in the Tube" precautions a name for a set of sternal precautions that restricts a Pt's UE movement away from their trunk 162. greater than 95% O2 saturation goal for phase 1 of cardiac rehab 163. greater than 92% O2 saturation goal for phase 2 of cardiac rehab 164. phase 2 In which phase of cardiac rehab is Kar- vonen's formula first introduced to de- termine an appropriate exercise intensity and range of HR? 165. tanaka formula 20 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 This target HR formula can be used as a substitute for the Karvonen formula in healthier Pts 166. 208 - 0.7 × Age = max HR What is the tanaka formula to calculate target HR? 167. Target Heart Rate = ((max HR What is the Karvonen formula to calcu- resting HR) × %Intensity) + rest- late target HR? ing HR 168. continuity of exercise at home Name the two primary goals of phase 2 Assess CV responses to exer- of cardiac rehab cise 169. transitional rehab Name 2 possible locations for phase 2 of home health cardiac rehab to occur 170. continuous phase 1 of cardiac rehab features supervised _____________________ ECG moni- toring. Phase 2 of cardiac rehab features _____________________ ECG moni- toring 171. 40-60% of max what is the target HR during phase 2 of cardiac rehab with someone who has impaired ventricular performance or suf- fered an MI? 172. 60-70% of max what is the target HR during phase 2 of cardiac rehab with someone who has NO impaired ventricular performance and DID NOT suffer an MI? 173. independent monitoring of vi- the adjunct therapy for phase 2 of cardiac tals rehab is the same as phase 1, with this one addition for the patient 21 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 174. 9 What is the target level of METS for a Pt in phase 2 of cardiac rehab? 175. light resistance training, 20-60 Describe the type of exercise and dosing minutes per session, 5-7 ses- that is appropriate for a Pt who is in phase sions a week 2 of cardiac rehab 176. 12 weeks What is the average length of phase 2 of cardiac rehab? 177. benefits of exercise Describe 4 areas of Pt education that are smoking cessation appropriate for phase 2 of cardiac rehab self-monitoring risk factors 178. conditioning describe the primary goal for phase 3 of cardiac rehab 179. community based setting In what type of setting would phases 3 (YMCA) and 4 of cardiac rehab occur? 180. 92-98 what is the O2 sat range for both phase 3 and phase 4 of cardiac rehab? 181. intermittent (or possibly none) What type of ECG monitoring is standard for phase 3 of cardiac rehab? 182. RPE 11-14 on the borg scale Weight training is first introduced in 70-85% of max HR phase 3 of cardiac rehab. Describe 2 dosing parameters of weight training in this phase 183. HIIT In addition to weight training, phase 3 of cardiac rehab is also the first phase where this type of exercise is introduced 184. brisk walking For phase 3 of cardiac rehab, we want to swimming ideally pair HIIT and resistance training 22 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 jogging with these 4 types of aerobic endurance stair climbing activities 185. phases 3 and 4 in which phases of cardiac rehab is the patient education goal focusing on a life- long commitment to BOTH risk factor modification and healthy exercise? 186. no ECG monitoring in phase 4 Phases 3 and 4 of cardiac rehab are very METS range 11-16 in phase 4 similar...describe the 3 primary phase target HR range 70-85% of max 4 characteristics that distinguish it from for all Pts in phase 4 phase 3 187. COPD pulmonary rehab was initially designed for people with this condition 188. dyspnea the most classic symptom for COPD 189. cardiorespiratory fitness Ultimate goal of HIIT training, according to Dr. King 190. 80-100% of maximum target HR range for High intensity interval training (HIIT) 191. presence and status of coronary 6 absolute contraindications for HIIT artery disease training hemodynamic instability history of arrhythmia reactive airway glycemic control exertional symptoms 192. low-volume HIIT patients with COPD have been shown to benefit from this type of HIIT 193. 4 x 4-minute bouts of 85-95% describe a typical high-volume HIIT bout max HR of exercise in terms of: between each of those bouts, a 3-minute lower intensity bout of number of bouts 60-70% max HR HR for each phase 23 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 194. 30-seconds high (70-80% of max describe a typical low-volume HIIT bout HR), followed by 30-seconds low of exercise in terms of: (55-65% max HR), 5 bouts total number of bouts HR for each phase 195. Heart rate reserve (HRR, Karvo- which method of heart rate calculation nen) method (for both the upper and lower end of train- ing) is used for Pts engaging in HIIT train- ing? 196. heart rate 3 ways to monitor exercise intensity dur- RPE ing HIIT talk test 197. mitochondria HIIT training increases the capacity of this cellular organelle 198. ejection fraction Echcardiogram is useful for calculating this 199. Positive emission tomography what diagnostic test is the gold standard (PET) for assessing bloodflow? 200. metal objects in the body This is a contraindication for the use of MRI on a patient 201. magnetic resonance angiogra- type of MRI that provides highly detailed phy (MRA) images of blood vessels using an intra- venous contrast 202. angiogram 24 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 The radiographic visualization of blood vessels after the injection of radiopaque substance. results in an "x-ray" of the blood vessels 203. cardiac catheterization a diagnostic procedure in which a catheter is passed into a vein or artery and then guided into the heart. provides information on bloodflow, ejec- tion fraction, chamber pressures 204. femoral artery or femoral vein cardiac catheterization sheaths are (brachial vein/artery is sec- placed into the ondary) __________________________________, depending on which side of the heart you want to examine 205. revascularization What is the purpose of percutaneous coronary intervention (aka percutaneous transluminal angioplasty)? 206. percutaneous coronary inter- balloon-tipped catheter is inserted into a vention (PCI) coronary artery to open the artery; stents are put in place this is a type of cardiac catheterization 207. electrophysiological studies an invasive measure of electrical activi- ty, induce specific dysrhythmias to deter- mine the pathways through the heart uses a cardiac catheterization 208. sudden death episode w/ revival Name 4 indications for electrophysiologi- ventricular tachycardia cal studies of the heart wolff-parkinson-white syn- drome heart blocks 25 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 209. coronary artery bypass graft surgical technique to bring a new blood supply to heart muscle by detouring around blocked arteries 210. saphenous vein Which 2 vessels are harvested for a coro- internal mammary artery nary artery bypass graft? 211. traditional CABG two types of coronary bypass procedures mid CAB 212. median sternotomy an incision through the midline of the sternum allowing surgical access to the organs in the thoracic cavity. Used during a traditional CABG 213. traditional CABG Type of bypass that: requires a median sternotomy use of a heart-lung machine harvesting of saphenous veins for anas- tomosis 214. mid-CAB Which type of bypass is minimally inva- sive: traditional CABG or mid CAB? 215. heart lung machine device that serves as artificial heart and lungs during some cardiac procedures 216. mid CAB Type of coronary bypass with no median sternotomy and no heart-lung machine 217. cannot use on high risk Pts Name 2 disadvantages of the mid CAB only single artery involvement heart operation 218. sternotomy This type of incision is required when installing a ventricular assist device 26 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 219. ventricular assist device a mechanical pump that provides support to a failing ventricle. considered a "band-aid" solution until a suitable donor is located for heart trans- plant 220. false (can be both; LVAD or T or F: a ventricular assist device can only RVAD) be used for the left ventricle 221. bridge to transplant (temporary) two types of ventricular assist device destination therapy (more per- uses. manent) One is considered a temporary solution, the other a more permanent one 222. blood pressure If someone has had a heart transplant, RPE the heart has been denervated and should not be used to gauge response to exercise. Instead, we should use either of these 2 methods. 223. intra-aortic balloon pump (IABP) device that acts as a temporary, sec- ondary pump to supplement ineffectual contraction of the heart's left ventricle 224. reduces resistance to left ventri- Name 3 functions of an intra-aortic bal- cle ejection loon pump 27 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 increases coronary bloodflow reduces afterload during systole 225. bend the hip Pts with an intra-aortic balloon pump may not be able to do this 226. descending thoracic aorta In which part of the aorta is an intra-aortic balloon pump inserted? 227. diastole during which phase of the cardiac cycle is an intra-aortic balloon pump inflated: systole or diastole? 228. less than.2 ug/mL normal troponin levels 229. 5 ug/ml minor cardiac dysfunction is occurring when troponin levels are near this num- ber 230. more than 10 ug/ml troponin levels for a significant MI 231. femoral A central arterial line could be located in brachial these 3 arteries radial (most common) 232. medication delivery Only venous lines (never arterial lines) are used for this purpose 233. measure arterial pressure 3 common uses of an arterial line draw blood invasive BP measurement 234. central venous line a type of intravenous line (IV) that is in- serted into a large vein in the body Often placed into the R atrium 235. femoral vein 28 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 When inserting a central venous line, which location should be avoided due to risk of infection and DVT? 236. Swan-Ganz catheter soft, flexible catheter that is inserted through a vein into pulmonary artery. used to provide continuous measure- ments of pulm artery pressure. can exercise with device but patient should avoid activities that increase pres- sure on injection site 237. Pulmonary Capillary Wedge Pressure measured by a swan-ganz Pressure (PCWP) catheter in a branch of the pulmonary artery. It is an indirect measure of pressure in the left atrium 238. pulmonary artery catheteriza- another name for a swan-ganz catheter tion 239. manually measure blood pres- What should be done after moving a pa- sure (may need to calibrate the tient with an arterial line or a swan-ganz machine) line? 240. peripheral intravenous central intravenous line inserted into a vein in catheter (PICC) the arm and threaded through to a larger vein. typically used for long-term therapy, such as chemotherapy or antibiotics 241. attempt therapeutic exercise on If our Pt is on 3 L/min of O2 or less, and room air their O2 sat is > 95%, what should we do concerning therapeutic exercise? 242. attempt ambulation on room air If our Pt is on 3 L/min of O2 or less, and they tolerate room air by maintaining > 29 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 92% O2 sat, what should we do concern- ing therapeutic exercise? 243. perform ambulation with supple- If our Pt is on 3 L/min of O2 or less, mental O2 and they do not tolerate room air (< 92% O2 sat), what should we do concerning therapeutic exercise? 244. coronary artery disease 3 common conditions that are diagnosed HTN w/ diagnostic exercise pulmonary conditions 245. arrythmia 3 common conditions that are assessed dyspnea w/ diagnostic exercise evaluation of surgical interven- tion 246. 3-5 days s/p MI or surgery 2 instances where low-level exercise test- just before discharge ing is indicated 247. it provides information for med- What is the purpose of low-level exercise ical management after an MI or testing? surgery 248. in sub-maximal, there is a What are the differences between Sub- pre-determined HR or BP maxi- maximal and Maximal testing? mum (once we reach it, the test is over) In maximal, there is no pre-de- termined maximum; the Pt de- cides when to end the test (fa- tigue, SOB, etc) 249. maximal _____________ exercise testing is a non-invasive way to detect coronary dis- ease 250. balke Which treadmill protocol is most com- monly used w/ athletes? 30 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 251. bruce Which treadmill protocol is most com- monly used clinically? 252. bruce low level Which treadmill protocol is most com- monly used w/ heart patients? 253. Bruce treadmill test. Bruce treadmill test. duration remains consistent, but duration remains consistent, but grade grade and speed increase. and speed increase. Stage 1 is 4-5 mets, stage 3 is Stage 1 is 4-5 mets, stage 3 is 8-10 mets 8-10 mets 254. bruce low level. bruce low level. speed is 1.7 for first 3 stages, speed is 1.7 for first 3 stages, grade is grade is also different than nor- also different than normal bruce mal bruce 255. drop of > 10 SBP 5 absolute criteria for termination of diag- moderately severe angina nostic exercise poor perfusion sustain V-tach Pt request 256. ST or QRS changes 5 relative criteria for termination of diag- arrythmia nostic exercise Fatigue, SOB, claudication increasing chest pain HTN response (SBP > 250, DBP > 115) 31 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 257. Recent MI 5 contraindications for diagnostic exer- Acute pericarditis or myocardi- cise testing tis Resting or unstable angina Aortic Stenosis Serious ventricular or rapid atri- al arrhythmias 258. radial vein What is the best line to administer med- ications? 259. PICC most appropriate type of line for long term intravenous therapy 260. Internal jugular vein preferred spot for the placement of a cen- tral venous line? 261. 100-400 BNP/ANP levels for someone with heart failure 262. state of calcification in the coro- An electron beam CT provides this infor- nary arteries mation 263. linear increase with exertion describe how systolic BP should change in response to exercise 264. remain relatively stable, plus-mi- describe how diastolic BP should change nus 10 mm hg from original val- in response to exercise ue 265. multigated acquisition (MUGA) uses a radioactive tracer and a special scan camera, the camera takes pictures of the heart as it pumps dfd provides information on ejection fraction 266. angioplasty the technique of mechanically widening a narrowed or obstructed blood vessel with a balloon 32 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 267. 92 cardiopulmonary pts should not allow O2 sat to fall below this 268. Troponin I and Troponin T Preferred and most specific enzyme markers for MI 269. b. low level Which type of exercise testing is best for high-risk Pts, as in people who have already had MIs or are sedentary? a. maximal b. low level c. sub-maximal d. balke 270. the angina threshold will be Why are UE diagnostic exercise tests reached much faster with UE ex- usually not as useful as LE tests? ercise 271. levels of heart failure levels of heart failure 272. between 70 and 100 mmHg Normal MAP 273. 11-20 mm Hg at rest Normal mean pulmonary artery pressure 274. systolic failure Which type of left sided heart failure has a reduced ejection fraction? 33 / 34  Cardio-pulm Exam 2 Study online at https://quizlet.com/_fs8sp1 275. diastolic failure Which type of left sided heart failure has a preserved ejection fraction? 276. 300 meters If a patient cannot walk greater than this distance on the 6MWT, it predicts mortal- ity 277. 750 feet If a patient exceeds this distance on the 6MWT, it often means a shorter hospital stay 278. coronary artery disease 3 causes of left-sided heart failure MI long-term HTN 279. left-sided heart failure right sided heart failure is almost always caused by this 34 / 34