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EKG - how many big squares equals 1 sec
5 (25 little squares)
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2 ways to calculate HR from an ekg
- divide 300 by the number of big boxes btwn QRS complexes
- take the number of peaks in a 6 second strip (30 big boxes) and multiply by ten
-
which heart block is life threatening?
what med to give it?
-
what drops in BP qualify a pt as orthostatic
- systolic > 20
- diastolic > 10
-
pediatric BP norms
110/60
-
children 3-5 y/o normal BP
1115/70
-
HR norms for adults, kids, newborns
- 60-100
- 60-140
- 90-160 (norm is 127)
-
MAP
what is it, how to calculate, norm
- mean arterial pressure (pressure in large arteries over time) -- dependent on av blood flow and arterial compliance
- (SBP + 2xDBP)/3
- norm 70-110mmHg
-
RR norms for adults, kids, newborns
-
grade 1 HTN BP
grade 2
grade 3
- 140-159/90-99
- 160-179/100-109
- >180/>120
- (either number, DBP or SPB will get you into that category)
-
modified Borg dyspnea scale
- 0 - nothing
- 5 - severe
- 10 - max
-
orthopnea
inability to breath in reclining or supine pos
-
crackles/rales -- due to what?
secretions in lungs
-
angina scale
- 1+ light, barely noticeable
- 4+ most severe pain ever
-
grading scale for peripheral pulses
- 0 absent
- 2+ normal
- 4+ bounding
-
diaphoresis
excess sweating
-
clubbing of fingernails
describe
associated w what?
- excessive curvature of fingernails w soft tissue enlargement at base of nail
- chronic O2 deficiency, chronic pulm disease, heart failure
-
bilat edema is associated w __
congestive heart failure
-
which to check first - venous or arterial system?
venous -- if it's insufficient it can invalidate some arterial tests
-
percussion test - for what? how?
- venous valve insufficiency
- palpate one segment of vein while percussing approx 20 cm higher
- if it's felt by lower hand, the valves are shite
-
trendelenburg test / retrograde filling test
- supine w legs elev 60 degrees
- tourniquet put on prox thigh
- stand up
- see if veins refill in normal pattern within 30 sec
-
grade scale for intermittent claudication
- grade I: minimal discomfort or pain
- grade IV: excruciating, exquisite
-
echocardiogram assess what?
internal structures of heart -- size of chambers, wall thickness, ejection fraction, movement of valves, septum, abnormal wall mvmnt
-
cardiac catheterization gives info on what?
anatomy of heart, vessels, ventricular and valve function, abnormal wall mvnts, ejection fraction
tiny tube goes from brachial or femoral artery thru aorta into blood vessels
-
central line / swan-ganz catheter -- how? for what?
catheter inserted thru vessels into R side of heartmeasures central venous pressure, pulmnary artery pressure, pulmonary capillary wedge pressures
-
what lab values are raised after MI
- troponin
- and also creatine kinase or creatine phosphocinase
-
polycythemia / erythrocytosis
increase in RBCs / high hematocrit
-
erythrocyte sedimentation rate - norms, indicates what?
- male < 15 mm/hr
- female < 20 mm/hr
- if higher, indicates infection, inflammation, RA, SLE, Hodgkins...
-
Levine's sign
sign of angina - pt clenches fist over sternum
-
prinzmetal's angina
- happens at rest 2/2 vasospasm rather than atherosclerosis
- responds well to nitroglycerin or calcium channel blocker
-
congestive heart failure
aka
char by
2/2
- L sided heart failure
- pulmonary congestion, edema, low CO
- insult to L vent from myocardial disease, excessive work load (HTN, valvular disease, congenital defects)
-
R sided heart failure char by
edema, higher pulmonary vascular pressures, jugular vein distension
-
associated symptoms of heart failure
muscle wasting, myopathies, osteoporosis
-
compensated heart failure
heart returns to functional status but w reduced CO and exercise tolerance
control is achieved thru: SNS stim, LV hypertrophy, anaerobic metabolism, cardiac dilation, arterial vasoconstriction
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