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Obj 27 Heart Transplant
What does a denervated heart rely on to control rate?
Will a denervated heart perceive angina?
Higher or lower resting heart rate and rises more or less slowly with exercise?
Will they reach the normal THR max?
Physiologically have lower______, lower ______ uptake, and higher ________.
- Catecholamines
- No
- Higher, more slowly
- No
- CO, oxygen, work of breathing
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Obj 27 Heart Transplant
Precaution with what kind of exercise?
ECG shows ______ P waves for each complex
More or less likely to have arrhythmias?
What do they take to prevent organ rejection and for how long?
- Isometric, doesn't stimulate catecholamines well
- two
- Less, no enervation
- immunosuppressants for life
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Obj 28
About stats for racial/ethnic groups in U.S. for rate of heart disease.
No info given, but I know that African Americans have a higher risk.
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Obj 29
Goal of a pacemaker?
Theres also a lot of info that basically says pacemakers can be rate modulated (adapt to what you desire) or fixed and some have an Implanted Cardioverting Defibrillator.
goal is to improve synchrony and increase CO
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Obj 29
If a person with an automatic implantable cardioverter-defbrillator (AICD) has a heart attack (3 main things)
- administer CPR and external defib according to Watchie pg 64
- place external defib pads at least an inch to side of AICD
- if AICD delivers shock (visible contraction), wait 30-60 seconds before using external defib
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Obj 30
Valve Dysfunction
_________: inadequate closure of the valve so it becomes leaky
________: narrowed, small lumen because the valve doesn't open fully
Valvular disease may have 3 sounds (2 heart and adventitious)
- insufficient/regurgitant
- stenotic
- S3, S4, clicking/snapping
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Obj 30
Valve Dysfunction
____________: can lead to valve dysfunction. Insult often occurs in childhood, lifelong murmur may be present, but may not become symptomatic until adulthood or older.
Which valves most prone to dysfunction/failure (think about highest pressure)?
- rheumatic fever
- mitral/bicuspid and aortic valves
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Obj 30
Valve dysfunction (just think about anatomy)
_________: widening of stenosed valve
___________ cause retrograde pressure => L atrial dilation => pulmonary edema => pulmonary HTN => R heart failure/ Cor Pulmonale
___________: during systole, blood regurgitates backwards into L atrium.
________: causes increased afterload pressure, so L ventricle must work harder to maintain CO, leading to inc SBP and L ventricular hypertrophy
_________: during diastolic phase, aortic blood can leak back into L ventricle causing increased EDV (LVEDV), may lead to L heart failure
- valvulotomy
- mitral valve stenosis
- mitral valve insufficiency
- aortic valve stenosis
- aortic valve insufficiency
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Obj 31
in presence of fever (pyrexia) for every rise of _____d Farenheit expect pulse increase of ___ bpm (simplified version)
Hypothermia or Hyperthermia Signs and Symptoms?
-increased HR, increased metabolic rate, hypoxia with possible confusion, dehydration
-vasoconstriction/cyanosis, first tachycardic, then brady, first shivering with increased metabolic rate then shivering stops and perfusion drops systemically, oxyhemoglobin curve shifts to left
- 2degrees = 10 bpm
- Hyperthermia
- Hypothermia
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