Brad\'s Final Part 3.txt

Is an indirect measurement of the electrical activity within the heart.

ECG are obtained by placing electrodes containing a conductive media to each extremity and to nuerous locations on the chest wall to create a ________

The tracing of the electrode to specific position is called.

the purpose of 12- leads is to obtain _____

Continuous patients are placed on 3-5 lead systems when pt's have:

ECG placed only on the chest, less cumbersome, more mobility, allows for a gross recognition of abnormalities.

Provides valuable information about the cariac satatus of a patient presenting signs and sympoms suggestive of heart disease.

Does not reflect the pumping ability of the heart or the likelihood of the patient having a myocardial infraction in the near future.

The heart is made up of four chambers: Two upper and two lower. what are these called?

Two upper chambers of the heart are called?

Two lower chamber sof the heart are called?

Two side of the heart:

recieves deoxygenated blood from the venae cavae and directs the blood into the right ventricle.

Contraction of this ejects blood into the pulmonary artery, which carries blood to the mungs for oxygenation.

Oxygenated blood returns to_________ via the pulmonary veins where it is the directed to the left ventricles.

Contractuin of this ejects blood into the aorta which braches off into the systemic circulation.

Which side is bigger due to pumping blood throughout the body?

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

What two things from past medical history would indicated the need of an ECG?

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?

Cell that have a high degree of automaticity and provide the electrical power for the heart.

Cells that conduct the electrical impulse throughout the heart

cells that contract in responce to electrical stimuli and pump the blood.

Cardiac muscle is refered to as the:

Myocardium is coordinated by electrical stimulation. An electrical conduting system is resoncible of this, which iis made up of:

The elctrical activity of the heart is intiated in the ____ or ___ located in the right atrium.

Cells that have the ability to generate electrical activity spontaneously are said to have ?

This controls the way the heart beats dur to haveing the most automaticity cells.

SA node is the primary pacemaker of the heart. It discharges ________ at rest

The SA node is strongly influenced by the ___________.

Increased activity of the sympathetic system increases the _______

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?

Damage to the AV junction usually leads to excessive delays of the electrical impulse passing into the ventricles. The is condition is know as?

Normally guides only the electrical impulse from the atria into the ventricles.

Under certain circumstances thos can sever as a backup pacemaker

When there is a 40-60 beats/min and an distinct pattern what is serving as the pacemaker?

The heartbeat can be paced outside of heart tissue. Any impulse that that originates outside the SA node is called?

The site from which the ectopic impulse originates is called the?

when the ectropic impulse results from depression of the normal impulse origin.

Blockage of one of the coronary arteries leads to ______ and infraction of a portion of the ______.

This leads to dysrhythmias and reduced cardiac output in most cases.

In older persons older than 65 yrs. what is the most common medical diagnosis?

May result from valvular disease, hypertension, cardio,yopathy, or ischemic heart disease.

The incidence of CHF _____ for each decade of life between 45 and 75 yrs.

Age related pulmonary chage: These become more rigid with age.

Age related pulmonary change: Smooth muscle fibers in the lungs are progressively replaced with?

Age related pulmoanry change: What happens to the Alveolar septa?

Age related pulmonary change: The amount of alveoli does not change, but what does?

Age related pulmonary change: This causes a reduction in diffusion of pulmonary gases withing the alveoli.

Age related pulmonary change: Aging lungs have less?

Exertional dyspnea, orthopnea, possible nocturnal dyspnea, cheyne-stokes breathing, pale/cool skin, dysrhythmias, fatigue, restlessness, irritability, and shortened attention span are all symptoms of?

Edema, distended neck veins, cyanosis, dyspnea, dysrhythmias, hepatomegaly, and occasional ascites are symptoms of what?

At what gae does the resspiratory muscle strength begin to weaken?

The diaphragm may be reduced to about ______of the normal for healthy young adults with age.

The combination of age-related and disease-related pulmonary changes puts the patient at risk for increased _______ and ______.

Aging not only alters physiologic functioning of the lung, but also affects the?

The sudden loss of the negative charge within the cell is called?

The return of the negative electrical charge to the cell is called?

A patient should be placed on an ECG when there is?

Disturbances in cardiac conduction are called?

Hypoxia, Ischemia, Sympathetic stimulation, drugs, electolyte imbalances, rate, and strech can cause?

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.

refers to the process of continuously evaluating the cardiopulmonary status of patients for the purpose of improving clinical outcomes.

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?

The ventilatory measurements that can be monitored at the bedside in the ICU include:

Norm. VT

critical value for VT

Norm frequncey of breath

crtical frequency of breath

Rapid shollow breathing index

dead space/VT ratio normal value

crtical value of deapspace/Vt ratio

Minute Vol. norm.

crtical value for VE

Norm VC

Crtical value of VC

Max. Inspiratory Pressure norm (Pimax)

Critical value of Max Inspir. press. (Pimax)

is the p[rocess of moving gases between the atmosphere and the lung

The four reasons why lung volumes are improtant to the clinician are:

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?

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?

is defined as the volume of air inspired or passively exhaled in a normal respiratory cycle.

VT has two components:

portion of VT that effectively exchanges with alveolar-capillary blood

the portion of VT that does not exchange with capillary blood

VD is normal what percentage of VT

The conductive airways and alveolar units that are ventilated but not perfused create the true or?

If VD increases to 60% the patient may need?

how many sighs in an hour?

a VT less than 5ml/kg is?

Rapid and shollow breathing in a critically ill patient at rest may indicate?

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?

may be seen with metabolic acidosis, sepsis, or severe neurologic injury.

Patients receiving continuous mechanical ventilation (CMV) are routinely ventilated with VT of?

The use of high-VT ventilation may predispose patients to _________, a lung injury that occurs from overdistention of the terminal respiratory units.

often develops in nondependent lung regions and is a main reason why lung damage persists after recovery from severe protracted ARDS

patients at risk for developing ARDS should be ventilated with mechanical VT of

A low measured VT can also be caused by �stacking� or _________, which is a problem seen with severe airway obstruction.

The application of PEEP in combination with smaller VT maintains FRC and prevents the fall in?

Montioring the VT of mechanically PT's is?

This creates higher peaks in airway pressure and barotrauma may result. TX w/ bronchodilators and decreasing VT may help resolve the problem

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?

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?

When a PT is ready to be weaned from mech. vent, what should be attempted?

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.

incorporates this spontaneous breathing rate change and measures the ratio of respiratory frequency (f) to VT. _______ = f (breaths/min)/VT (liters)

RSBI values greater than 105 have been reported to be string prognostic indicators of?

Normal VE

If a VE greater than 10lpm is needed for a mech. vent. PT to maintain normal PaCO2, weaning is?

Normal VC for healthy people

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.

VC can be measured two ways?