Brad\'s Final Part 3.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. In older persons older than 65 yrs. what is the most common medical diagnosis?
  43. May result from valvular disease, hypertension, cardio,yopathy, or ischemic heart disease.
  44. The incidence of CHF _____ for each decade of life between 45 and 75 yrs.
  45. Age related pulmonary chage: These become more rigid with age.
    Trachea and bronchi
  46. Age related pulmonary change: Smooth muscle fibers in the lungs are progressively replaced with?
    Fibrous connective tissue.
  47. Age related pulmoanry change: What happens to the Alveolar septa?
    It deteriorates
  48. Age related pulmonary change: The amount of alveoli does not change, but what does?
    The walls increase, thus ruducing surface area
  49. Age related pulmonary change: This causes a reduction in diffusion of pulmonary gases withing the alveoli.
    Alveolar-capillary membrane thickening
  50. Age related pulmonary change: Aging lungs have less?
  51. 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
  52. Edema, distended neck veins, cyanosis, dyspnea, dysrhythmias, hepatomegaly, and occasional ascites are symptoms of what?
    Right-sided CHF
  53. At what gae does the resspiratory muscle strength begin to weaken?
  54. The diaphragm may be reduced to about ______of the normal for healthy young adults with age.
  55. The combination of age-related and disease-related pulmonary changes puts the patient at risk for increased _______ and ______.
    Morbidity and mortality
  56. Aging not only alters physiologic functioning of the lung, but also affects the?
    protectuve function of the lungs.
  57. The sudden loss of the negative charge within the cell is called?
  58. The return of the negative electrical charge to the cell is called?
  59. A patient should be placed on an ECG when there is?
    a risk of cardiac events or dysrhythmias
  60. Disturbances in cardiac conduction are called?
  61. Hypoxia, Ischemia, Sympathetic stimulation, drugs, electolyte imbalances, rate, and strech can cause?
  62. is repeated or continuous observations or measurements of the patient, his or her physiologic function, and the function of life support equipment, for the pupose of guiding management decisions, and interventions.
  63. refers to the process of continuously evaluating the cardiopulmonary status of patients for the purpose of improving clinical outcomes.
    respiratory monitoring
  64. Changed in metabolism, lung mechanics, ventl efficiency, and equipment function will occur before changes are seen in the blood gases. So it is important to do what?
    monitor ventilatory parameters
  65. The ventilatory measurements that can be monitored at the bedside in the ICU include:
    Lung volumes/flows, airway pressures, fractional gas concentrations
  66. Norm. VT
    5-8 IBW
  67. critical value for VT
    <4-5ml/kg or <300 ml
  68. Norm frequncey of breath
  69. crtical frequency of breath
  70. Rapid shollow breathing index
    >105 w/o PS or CPAP
  71. dead space/VT ratio normal value
  72. crtical value of deapspace/Vt ratio
  73. Minute Vol. norm.
  74. crtical value for VE
  75. Norm VC
  76. Crtical value of VC
  77. Max. Inspiratory Pressure norm (Pimax)
    -80--100 cm H2O
  78. Critical value of Max Inspir. press. (Pimax)
    0-20 cm H2O
  79. is the p[rocess of moving gases between the atmosphere and the lung
  80. The four reasons why lung volumes are improtant to the clinician are:
    affect of gas exchange, rflect clinical status, indicate responce to therapy, and signal problem between patient and vent. interface.
  81. Intubated patients, patients being considered for or being weaned from mechanical vents, and patients with an abnormal breathing patter, and intubated patients should be monitored for what?
    Lung volumes
  82. Nonintubated patients: preoperative eval., adults w/ RR > 30bpm, w/ neuromuscular diseases, CNS depression, deteriorating blood gases, and patients recieveing noninvasive positive pressure vent. should be monitored for?
    lung volumes
  83. is defined as the volume of air inspired or passively exhaled in a normal respiratory cycle.
    Tidal Volume
  84. VT has two components:
    Alveolar volume VA and dead space volume VD
  85. portion of VT that effectively exchanges with alveolar-capillary blood
  86. the portion of VT that does not exchange with capillary blood
  87. VD is normal what percentage of VT
  88. The conductive airways and alveolar units that are ventilated but not perfused create the true or?
    physiological dead space.
  89. If VD increases to 60% the patient may need?
    Vent. Support
  90. how many sighs in an hour?
  91. a VT less than 5ml/kg is?
    indication of resp. prob.
  92. Rapid and shollow breathing in a critically ill patient at rest may indicate?
    impending respiratory failure
  93. pneumonia, atelectasis, the postoperative period after chest and abdominal surgery, chest trauma, acute exacerbation of chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), pulmonary edema, acute restrictive diseases such as acute respiratory distress syndrome (ARDS), neuromuscular diseases, and CNS depression (especially of the respiratory centers) can cause?
    VT to be reduced
  94. may be seen with metabolic acidosis, sepsis, or severe neurologic injury.
    Larger than normal VT
  95. Patients receiving continuous mechanical ventilation (CMV) are routinely ventilated with VT of?
  96. The use of high-VT ventilation may predispose patients to _________, a lung injury that occurs from overdistention of the terminal respiratory units.
  97. often develops in nondependent lung regions and is a main reason why lung damage persists after recovery from severe protracted ARDS
  98. patients at risk for developing ARDS should be ventilated with mechanical VT of
    6-8 ml/kg
  99. A low measured VT can also be caused by �stacking� or _________, which is a problem seen with severe airway obstruction.
    dynamic hyperinflation
  100. The application of PEEP in combination with smaller VT maintains FRC and prevents the fall in?
  101. Montioring the VT of mechanically PT's is?
  102. This creates higher peaks in airway pressure and barotrauma may result. TX w/ bronchodilators and decreasing VT may help resolve the problem
  103. Setting the circuit to high pressure limit of 120cm H2O, Setting PEEP to 0 cm H2O, setting a VT of 100ml and dividing the resulting peak inspriatory pressure by 100 will determine what?
    the circuits compliance
  104. VT for mechanically ventilated PT's should be adjusted for clinical conditions. Some PT's, including those at risk for aor trapping and dynamic hyperinflation or ARDS, should be ventilated with a lower VT of?
    6-8 ml/kg
  105. When a PT is ready to be weaned from mech. vent, what should be attempted?
    Spontaneous breathing trial (SBT)
  106. The following criteria for SBT means what: 20% increase or decrease in BP or HR, SPO2 35bpm, change in mental status, accessory muscle use, or the onset of diaphoresis.
  107. incorporates this spontaneous breathing rate change and measures the ratio of respiratory frequency (f) to VT. _______ = f (breaths/min)/VT (liters)
    Rapid-shallow breathing index (RSBI)
  108. RSBI values greater than 105 have been reported to be string prognostic indicators of?
    weaning failure
  109. Normal VE
  110. If a VE greater than 10lpm is needed for a mech. vent. PT to maintain normal PaCO2, weaning is?
    not possible. (less then it is okay)
  111. Normal VC for healthy people
  112. excellent measurment of vent. reserve in the cooperative PT. reflects the repiratory mescle strenth and volume capacity of the tung while the PT is performing a sustained maximal inpiratory or expiratory maneuver.
  113. VC can be measured two ways?
    FVC or SVC
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Brad\'s Final Part 3.txt
2011-12-04 01:49:47
Final RESP 132

Final RESP132
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