Exam 3 Part 1 RESP 132.txt

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  1. Is an indirect measurement of the electrical activity within the heart.
    ECG (AKG)
  2. ECG are obtained by placing electrodes containing a conductive media to each extremity and to nuerous locations on the chest wall to create a ________
    12-lead ECG.
  3. The tracing of the electrode to specific position is called.
  4. the purpose of 12- leads is to obtain _____
    12 differnt views.
  5. Continuous patients are placed on 3-5 lead systems when pt's have:
    cardiac events or dysrhythmias
  6. ECG placed only on the chest, less cumbersome, more mobility, allows for a gross recognition of abnormalities.
    3-5 lead
  7. Provides valuable information about the cariac satatus of a patient presenting signs and sympoms suggestive of heart disease.
  8. Does not reflect the pumping ability of the heart or the likelihood of the patient having a myocardial infraction in the near future.
    The Resting ECG
  9. The heart is made up of four chambers: Two upper and two lower. what are these called?
    Atria and Ventricles
  10. Two upper chambers of the heart are called?
  11. Two lower chamber sof the heart are called?
  12. Two side of the heart:
    Right and Left
  13. recieves deoxygenated blood from the venae cavae and directs the blood into the right ventricle.
    Right Atrium
  14. Contraction of this ejects blood into the pulmonary artery, which carries blood to the mungs for oxygenation.
    Rigth ventricular
  15. Oxygenated blood returns to_________ via the pulmonary veins where it is the directed to the left ventricles.
    Left Atrium
  16. Contractuin of this ejects blood into the aorta which braches off into the systemic circulation.
    Left ventricular
  17. Which side is bigger due to pumping blood throughout the body?
  18. Chest pain, Dyspnea on exertion in a patient >40yrs., Orthopnea, Paroxysmal nocturnal dyspnea, pedal edema, fainting spells, palpations, and Unexplained and persistent nausea and indigestion in a high- risk patient what kind of indications for ECG
    Chief Complaints
  19. What two things from past medical history would indicated the need of an ECG?
    Past history of heart disease and cardiac surgery
  20. Unexpl. Tachycardia @ rest., Decr.capillary refill, abnormal heart sounds or murmmurs, pedal edema, cool cyanotic extremities, abonorm. heaves or lifts on the precordium, diaphoresis, jugular cenous distention, abnormal sensorium, Hepatojugular reflex, and bilateral inspir. cracjles in the dependent lung zones are what kind of indications?
    Physical exam.
  21. Cell that have a high degree of automaticity and provide the electrical power for the heart.
    Pacemaker cells.
  22. Cells that conduct the electrical impulse throughout the heart
    Conducting cells
  23. cells that contract in responce to electrical stimuli and pump the blood.
    myocardial cells
  24. Cardiac muscle is refered to as the:
  25. Myocardium is coordinated by electrical stimulation. An electrical conduting system is resoncible of this, which iis made up of:
    Special pacemaker and conducting cells.
  26. The elctrical activity of the heart is intiated in the ____ or ___ located in the right atrium.
    sinus or sinoartrial (SA) node
  27. Cells that have the ability to generate electrical activity spontaneously are said to have ?
  28. This controls the way the heart beats dur to haveing the most automaticity cells.
    SA node
  29. SA node is the primary pacemaker of the heart. It discharges ________ at rest
    60-100 beats/min.
  30. The SA node is strongly influenced by the ___________.
    Autonomic Nervous System
  31. Increased activity of the sympathetic system increases the _______
    heart rate
  32. Contraction of the atria just before ventricular contraction aids in filling the ventricles with blood and accounts for about 10-30% of subsequent stroke volume. This is refered to as?
    Atrial Kick
  33. Damage to the AV junction usually leads to excessive delays of the electrical impulse passing into the ventricles. The is condition is know as?
    Heart Block
  34. Normally guides only the electrical impulse from the atria into the ventricles.
    AV junction
  35. Under certain circumstances thos can sever as a backup pacemaker
    AV junction
  36. When there is a 40-60 beats/min and an distinct pattern what is serving as the pacemaker?
    AV junction
  37. The heartbeat can be paced outside of heart tissue. Any impulse that that originates outside the SA node is called?
    Ectopic impulse.
  38. The site from which the ectopic impulse originates is called the?
  39. when the ectropic impulse results from depression of the normal impulse origin.
    Escape Beat
  40. Blockage of one of the coronary arteries leads to ______ and infraction of a portion of the ______.
    ischemia myocardium
  41. This leads to dysrhythmias and reduced cardiac output in most cases.
    Blockage of one or more coronary arteries
  42. Three sources of the newborn's history.
    The parents, mother's labor/delivery chart, and the infants chart.
  43. Infants that are born to mothers with diabetes mellitus often are maturationally delayed and may be susceptible to diseases of prematurity such as_______.
    respiratory distress syndrome (RDS)
  44. Infants that are born to mothers who have chronic hypertension may be maturationally ___________.
  45. is a pregnant woman.
  46. is a woman who delivers a live infant
  47. is the delivering of a dead infant
  48. G2, P1, and Ab0 means what?
    2nd pregnacy, 1 live birth, and 0 abortions.
  49. Abortions can be further subdived into therapeutic and spontaneous; these are abrviated as
    TAb SAb
  50. G is a smybol for
  51. P is a symbol for
  52. Ab is the symbol for
  53. If the mother has had multiple pregnacies that have ended with SAb rather than living infants, there is a possiblity of?
    Chromosomial or metabolic disease.
  54. If the mother has had multiple pregnacies that have eneded with multiple TAb, the historian should think?
    Posssiblr maternal drug abuse.
  55. This is a score that is useful in identifying infoants who need resuscitation.
    Apgar Score
  56. Healthy well adjusting infants will have a 1-min apgar score of ______.
  57. Infants with a score of 7-10 require routine new born care such as:
    Drying, temp. maintenance, and clearing of airway. Maybe, O2
  58. Moderately depressed infants have a score of?
  59. Moderateless depressed infants need more than routine care and often need an increased FiO2 w/?
    bag and mask ventilation ( most repond well and improve soon after)
  60. Infants who are severly depressed and need extensive medical care such as intubation and mechanical ventilation have a score of?
  61. Which apgar score is better, 1-min or 5-min?
  62. Infants who have a 5-min score less than 5 have greater risk of what?
    neurologic impairment at the age of 1
  63. Newborns are evaluated at _______ intervals after birth with the apgar score.
    1-and 5-minute
  64. After delivery the historian should document what?
    Magnitude of resuscitation, presence of disease, treatment of disease, length of stay, condition of discharge, and problems that have developed.
  65. All infants require some sort of resuscitation. The simpilest is:
    clearing of airway and drying.
  66. Examination of a newborn is based on three of the four classic principles of physical examination:
    Inspection, palpation, and auscultation (percussion is not used due to their small cavity and organ sizes)
  67. Gestational age can be assigned by three ways:
    Maternal dates, fetal ultrasound, and gestational assessment examination.
  68. Most nurses use a _________, which is amodification of the dubowitz examination.
    Ballard Examination
  69. The Ballard examination is divided into two sections:
    Neuromuscular maturity and physical maturity
  70. The examiner should look at the infant's skin to see whether the infant is ______.
  71. Infants w/ hypothermia or infants w/ polycythemia may have blueish extremities, yet they are not really ______.
  72. Infants who are preterm and immature with thick skin can look quite link when they are really _______.
  73. When should you be looking for physical representation of good oxygenation on an infant?
    Mucous membranes in the mouth and tounge and nail beds in the extremities.
  74. This is skin sinking inward of the skin around the chest wall during inspiration. Occurs when the lung's compliance is less than the compliance of the chest wall or when there is a significant ariway obstruction.
  75. The three common points of collapse are:
    the intercostal area, subcostal area, and substernal area.
  76. In tthe infant indicates a serious increase in the work of breathing, and further assessment and monitoring are mandatory.
  77. is the dilation of the nasi during inspiration. Is an attempt by the infant to achieve airway dilation to decrease airway resistance, increase gas flowm and achieve larger Vt.
    Nasal Flaring
  78. is a sound heard at the end of expoiration just before rapid inspiration. Is the infants attempt to increase the gas volume in the lung.
  79. Infants accomplish grunting by, occluding the ariway with ______ and actively exhaling against the closed _____ after the end of inspiration. (exhale, inhale, Hold)
    Glottic closure, glottis
  80. Increased motion of the pericardium should be observed in infants. This increase of motion is called:_________.
    Hyperdynamic precordium
  81. is an indication of increased volume load on the heart, usually secondary to a left-to-right shunt of blood through a ductus arteriosus.
    Hyperdynamic precordium
  82. If a preterm infant has a ________ the anatomic connection between the aorta and pulmonary artery remains open and blood from the aorta flows into the pulmonary artery, which can cause congestive heart failure and pulmonary edema.
    Patent Ductus Arteriosus
  83. The easiest organ to palpate on a newborn is?
    the skin
  84. The three aspects of the skin that are usful in evaluating cardiac output are:
    Skin perfusion, skin temp., and peripheral pulses
  85. To check for the skin perfusion/capillary refill, should blanch the infant's ______ and not how long it take for the color to return.
  86. Capillary refill should be?
    < 3 sec.
  87. An approximation of the infant's skin temp. can be determined by?
    feeling the newborns skin
  88. The _____ should be used to feel for temp. its more sensative than the fingers.
    Dorsum (backside)
  89. The infant may have an aortic obstruction such as coarctation of the aorta or interrupted aortic arch syndrome if the pulses are?
    Lower in the extremities are weaker than those in the upper.
  90. Anything that impedes the motion of the abdomen or its organs will hinder the infants?
  91. In older persons older than 65 yrs. what is the most common medical diagnosis?
  92. May result from valvular disease, hypertension, cardio,yopathy, or ischemic heart disease.
  93. The incidence of CHF _____ for each decade of life between 45 and 75 yrs.
  94. Age related pulmonary chage: These become more rigid with age.
    Trachea and bronchi
  95. Age related pulmonary change: Smooth muscle fibers in the lungs are progressively replaced with?
    Fibrous connective tissue.
  96. Age related pulmoanry change: What happens to the Alveolar septa?
    It deteriorates
  97. Age related pulmonary change: The amount of alveoli does not change, but what does?
    The walls increase, thus ruducing surface area
  98. Age related pulmonary change: This causes a reduction in diffusion of pulmonary gases withing the alveoli.
    Alveolar-capillary membrane thickening
  99. Age related pulmonary change: Aging lungs have less?
  100. Exertional dyspnea, orthopnea, possible nocturnal dyspnea, cheyne-stokes breathing, pale/cool skin, dysrhythmias, fatigue, restlessness, irritability, and shortened attention span are all symptoms of?
    Left-sided CHF
  101. Edema, distended neck veins, cyanosis, dyspnea, dysrhythmias, hepatomegaly, and occasional ascites are symptoms of what?
    Right-sided CHF
  102. At what gae does the resspiratory muscle strength begin to weaken?
  103. The diaphragm may be reduced to about ______of the normal for healthy young adults with age.
  104. The combination of age-related and disease-related pulmonary changes puts the patient at risk for increased _______ and ______.
    Morbidity and mortality
  105. Aging not only alters physiologic functioning of the lung, but also affects the?
    protectuve function of the lungs.
  106. The sudden loss of the negative charge within the cell is called?
  107. The return of the negative electrical charge to the cell is called?
  108. A patient should be placed on an ECG when there is?
    a risk of cardiac events or dysrhythmias
  109. Disturbances in cardiac conduction are called?
  110. Hypoxia, Ischemia, Sympathetic stimulation, drugs, electolyte imbalances, rate, and strech can cause?
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Exam 3 Part 1 RESP 132.txt
Exam 3 Part 1
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