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When does a pulse begin?
When the Left Ventricle Contracts
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When does a pulse end?
When the Left Ventricle Relaxes
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The peak of the wave, or the contraction of the heart is known as?
Systole (Contration of the Heart)
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The trough or resting phase of the heart is known as?
Diastole (Relaxation of the Heart)
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The Pusle Rate is regulated by what?
the Autonomic Nervous System (ANS)
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What is the Normal Adult Pulse Rate?
- 60-100 bpm
- Average is b/t 70-80 bpm
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Which Node is primarily responsible for the rate of the heart?
- The SA Node (Sino Atrial)
- The pacemaker of the heart
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Which Node works with the SA node to pace the heart rate?
The AV Node (Atrio Ventricular)
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What factors influence the Pulse?
- Age (Children are more rapid than Adults)
- Sex (Females have highre HR than males b/c of hormones)
- Exercise (Athletes have a slower HR)
- Food (a full stomach increases heart rate)
- Stress
- Fever (increases HR)
- Disease
- Blood Loss (increases HR)
- Position Changes
- Medications:
- Narcotics (decrease HR)
- Breathing Meds (increases HR)
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Which pulse location is most acurate?
- The Apical Pulse
- 5th ICS, MCL (on left)
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What makes the "Lub" heart sound (S1)?
Closure of the Tricuspid and Mitral (AV) Valves
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What makes the "Dub" heart sound (S2)?
Closure of the Aortic and Pulmonic (Semilunar) Valves
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What are the common Pulse points?
- Apical (apex of heart - 1 full minute)
- Carotid
- Brachial
- Radial
- Femoral
- Popliteal
- Pedal
- Posterior Tibial
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Inadequate Circulation could present ______ & ______
Pallor and Cynosis
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A Heart Rate Less than 60 bpm is _______
Bradycardia
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A Heart Rate Greater than 100 bpm is _______
Tachycardia
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How long should you take a pulse if it is irregular?
one minute
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How do you rate the quality of a pulse?
- 0 = none
- 1 + weak
- 2 + normal
- 3 + bounding
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What is the Stroke Volume?
The quantity of blood pumped out by each contraction of the left ventricle
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What is the Cardiac Output?
The Stroke Volume times the pulse (heart) rate
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What Factors can affect a Pulse Rate?
Exercise, Temperature, Emotions, Drugs, Hemorrhage, Postural Changes, Pulmonary Conditions
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What is Respiration?
The exchange of oxygen (O2) and carbon dioxide (CO2) in the body
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What are the 2 processes of Respiration?
Mechanical and Chemical
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Explain the Mechanical process of Repiration.
- Pulmonary Ventilation; breathing
- Active movement of air in and out of the respiratory system
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Explain the Chemical process in Respiration.
- Exchange of O2 and CO2
- Transport of O2 and CO2 throughout the body
- Exchange of gases between the capillaries and tissues
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What regulates repiration in the brain?
The Medulla Oblongata and the Pons
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What is the most potent stimulant in normal lungs?
CO2 (it causes you to breath in order to get rid of it)
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What happens if you give a COPD patient too much O2?
The O2 will supress their respiratory drive (drive to breath)
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What does Hypercapnia mean?
How do you treat it?
- High CO2Treat w/ Hypoxia (high oxygen)
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What are the 2 Mechanics of Respiration?
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Explain Inspiration.
What does it involve?
- Drawing air into the lungs
- Involves the ribs and diaphragm, creating negative pressure and allowing air to flow into the lungs
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Explain Expiration.
Relaxation of thoracic muscles and diaphragm, causing air to expel from the lungs
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The diaphragm moves ______ in Inspiration and ______ in Expiration.
down, up
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What is the normal Rate of Respirations?
12 - 16 breaths per minute
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How should the rhythm and effort be in a normal respiration?
regular and unlabored
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What should you make sure to look for in assessing repirations in a COPD patient?
- Accessory Muscles
- Flaring of Nostrils
- Pursed Lips
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Cessation of breathing is ______
Apnea
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Abnormally slow breathing is _______
- Bradypnea
- (less than 12 breaths per min.)
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Abnormally fast breathing is ______
- Tachypnea
- (more than 16-20 breaths per min.)
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High pitched, musical, and usually expiratory breath sounds are ______
Wheezes
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(Maybe) High pitched/popping, and usually inspiratory breath sounds are ______
Crackles
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A piercing, high-pitched sound heard primarily during inspiration and in respiratory distress is ______
Stridor
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Labored breathing that produces a snoring sound is _______
Stertor
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Hyperventilation is
- Rapid and deep breathing resulting in excess loss of CO2 (hypocapnea)
- Client may complain of feeling light-headed and tingly
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Hypoventilation is
The rate and depth of respirations are decreased and CO2 is retained
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What factors influence Respirations?
- Exercise (Increases)
- Pain (Increases)
- Stress (Increases)
- Smoking (Increases)
- Fever (Increases)
- Pulse Rate (Increases)
- Hemoglobin (if low - Increases)
- Disease (Both I/D)
- Medications (Both I/D)
- Position
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What do Arterial Blood Gases (ABGs) do?
Directly measures the partial pressures of oxygen, carbon dioxide, and blood pH
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What is Pulse Oximetry, and how do you measure it?
- Noninvasive method of monitoring respiratory status
- Uses an external device (on the finger) that measures oxygen saturation
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What is a late sign of Respiratory distress that is alot of trouble?
Cyanosis
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Blowing off too much CO2 is ______ and retaining too much CO2 is _______.
Hyperventilation, and Hypoventilation
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