DAANCE module 2 Exam 2023

DAANCE module 2 Exam 2023 4 key medical history questions - ANSWER Current medical conditions/under physician care Prior hospitalizations/ surgeries Current meds Allergies & reactions 8 review systems - ANSWER General, Skin, Cardiovascular, Pulmonary, Gastrointestinal, Genitourinary, Neurologic, skeletal Mallampati Classification - ANSWER 1 Visualize soft palate, fauces, uvula, anterior and posterior pillars 2 Visualize soft palate, fauces, uvula 3 Visualize soft palate and base of uvula 4 no soft palate visualized Fasting - ANSWER 8 hrs- no fatty, fried food and meat 6 hrs- light meal and liquid- toast 2 hrs- clear liquids Classify sedation per pt - ANSWER 1 Healthy for all 2 mild systemic disturbance ( smoker) 3 severe systemic disease/disturbance managed by medications. Consult with physician 4 Pt has life threatening systemic disease 5 pt moribund - surgery in despiration Angina PEctoris - ANSWER pain in chest bec of inadequatecoronary circulation, and flow of o2 in heart. Relieved by vasodilator drugs- nitroglycerine atherosclerosis - ANSWER hardening of arteries Thromosis - ANSWER larger clot totally occludes artery treatment for severe ischemic heart disease - ANSWER coronary bypass and angioplasties angiplasties - ANSWER changing shape of occluded blood vessel and squashing plaque. stent places to keep shape. pt on antiplatelet drugs (1-2 yrs) Ischemic heart disease & acute coronary syndrome - ANSWER diease with blood flow in coronary arteries & decreasing blood flow into ischemia Myocardial infaction - ANSWER result from severe deficient coronary arterial blood supply to myocardium - resulting in necrosis. Treat with Thrombolitics 1-2 hrs post attack. no surgery 6-8 wks post rheumatic heart diease - ANSWER bacteria from strep throat infects and damages valvesmitral valve. back flow of blood= murmer mitral valve prolapse - ANSWER mvp= upward, redundant motion of valve leafeletsinto left atrium. Hypothryoidism/ heridetory antibiotic prophylaxis - ANSWER prevents subacute bacteriam endocarditis. damage to heart valves/ systemic infection prosthetic valves post op - ANSWER anticoagulants, prophylactic antibiotics hypertension - ANSWER above 120/80 controlling rate and force - ANSWER antihypertensive- Beta Blockers (adgernic blocking) ending in "olol" dilate vasculature - ANSWER antihypertensive- Lisinopril, valsartin control volume of blood - ANSWER antihypertensives- Diuretics - exert effects of kidneys and decrease vasculature volume. Lasix, HATS congestive heart failure - ANSWER CHF= hearts inability to pump blood peripherally. meds increase forces of contractions. LEeft sided heart failure - ANSWER fails to pump out to circulation. Blood backs up into lungs. High BP. Fluid leaks into lungs = sob right sided heart failure - ANSWER fails to pump blood to lungs= blood backs up into peripheral. Edema, ascites congenital heart disease - ANSWER present at birth- holes contraction of atria - ANSWER p wave contraction of ventricles - ANSWER qrs complex repoloaization of ventricles - ANSWER t wave automacity of myocardium contraction nodes - ANSWER SA node (right atrium)- AV node (inferior portion of right atrium)- bundle of His ( r and l ventricles) naming rhythems and dysrhythmias - ANSWER pace maker site, type of dys premature atrial contraction - ANSWER PAC firing of ectopic focus in atrir prior to SA node. Premature P wave within T Wave Caffine supraventricular tachycardia - ANSWER SVT. regular narrow complex beats 150-250. sudden = proximal. p&t merged. pt c/o palpatations. stress, COPD Atrial Fibrillation - ANSWER AFib. multiple ectopic foci. wavey baseline, small erratic spikes. emotional stress, caffine, acute MI, hypertension atrial flutter - ANSWER chaotic baseline. slower ventricular rate. heart valve disease, copd, junctional rhythems - ANSWER extopic pacemaker btwn atria and ventricles. p wave inverted premature ventricular contractions - ANSWER PVC- extopic foci in ventricles fire before artias SA node. No p wave. qrs wide and blunt multifocal ventriular contractions - ANSWER MVC hypoxia, failing heart. 2= couplets. 3= run 3+= onset of v tach ventricular tachycardia - ANSWER wide, blunt, rapid with no p, t wave. watch pulse. cardiac arrest= treach as v fib venticular fibrillation - ANSWER no depolorization of ventricles. no pumping of blood. presceeds asystole. only treat with electrical defib. course vfib - ANSWER prominent erractic baseline deflections fine vfib - ANSWER less vacillations. no discernable p, qrs, t asystole - ANSWER cessation of all contractions, follows v tach, v fib. flat line. only manage with cpr and epi pulseless electrical activity - ANSWER looks similar to bradycardia. but no pulse on pt. cessation of all contractions id abnormallities R - ANSWER rhythm (normal, wide, narrow waves) rate (of ventricle) regularity narrow rhythm - ANSWER atria pacemaker wide rhythm - ANSWER ventricular pacemaker rate equlation - ANSWER # of qrs / 300. Concers. 50, 150. o2 for low number when to avoid electrosurge - ANSWER implanted pacemakers, defibrillators asthma - ANSWER chronic inflammation of cells in mucous airway lining swollen. thick brochioles. branchioconstriction poss adgrenic drugs- adrenaline wheezing, good expiration, bad expiration asthma meds - ANSWER corticosteroids- counteract inflammation short acting/ long acting beta blocker inhalation chronic bronchitis - ANSWER Blue bloaters. pt loses ability to get adequate o2 into blood. membranes swollen in trachea bronchiol tree. Fibrosis/ thickening airway. Hyperactive sectrtions= bronchiospasm/laryngospasm. Emphysema - ANSWER pink puffers- enlarged alveoli sacs in lungs. less surface area for gas exchange. pt. symptoms of dyspnea upper respiratiry infections - ANSWER cold, cough, with secretions. no surgery 2-3 weeks post cough acute bronchitis and pneumonia - ANSWER inflammation and heavy secretions in lower respiratory ( trachea and lungs) with viral bacterial infection. Fever, cough, dyspnea, ausculation of lunchs= crackeling and bubbling diabetes mellitus - ANSWER impaired metabolism of glucose= elevated blood glucose levelshyperglycemic. glucose metabolism controlled by insulin and glucagon produced by Islets of Langerhans in Pancreas. type 1- insulin dependent type 2 non inulin dependent mamagement of diabetic pts - ANSWER healing slowed higher risk for infection blood sugar btwn 150 250 fbs amount - ANSWER fasting blood sugar 125 mg/dL hemoglobin a1c - ANSWER lab value of rbs life span. serum glucose high= diabetes. tests 2-3 month blood sugar levels, bec rbs life span 120 days hypoglycemia - ANSWER abnormally low blood sugar. High insulin dose. poss death. Symptoms sweating, nervous, tremor adrenal dysfunction - ANSWER (gland on top of kidneys) secreting hormones (epinephrine and norepinephrine) responding to stimulation by symptomatic nervous syatem corticosteroids secreted excessive secretions - ANSWER of corticosteroids = cishings disease. by tuor or excessive prednisone. Humpback, hypotension inadequate secretions, - ANSWER cortisol. Addesons disease. gi problems. most important corticosteroid- cortisol - ANSWER converts proteins and fat to glucose, high bs, suppresses immune system. permits norephinerphine, and epinephrine to exert vasoconstriction responding to stress, and bp plummets adrenocortical insufficiency - ANSWER artifically induced in pts taking corticosteroidsprednisone (antoinflamatory) pts bp can fall, body wont respond to stress bec it senses the corticosteriod thyroid - ANSWER anterior to neck. hormones released to regulate rate glucose is utilized, body heat, body's organs hypothyroidism - ANSWER decreased function. lethargy, weight gain, slow pulse, high narcotic sensitivty hyperthyroidism- graves disease - ANSWER tremors, insomnia, weight loss, heat intolerance. Goiter- swollen gland. sensitive to epinephrine thyroid crisis - ANSWER problems with cardiovascular, pulmonary systems. high bp, and HR. body tissue needs more nutrient substance. high metabolic demand. Liver (hepatic) disease - ANSWER hapetitis, alcholol. impaired blood flow bec swelling and scarring- peripheral edema, heart working harder, adscides, hepatitis - ANSWER a (food), b (sex)- highly contagious, c (drugs), d, g, e, physical appearence of liver disease - ANSWER jaundice, low blood clotting abilities, ascites, elevaed liver enzymes- LFTs decreased ability to metabolize drugs = prolonged effects -- hepatic coma= no toxins removed and loss of brain function. cirrohis - ANSWER end stage liver disease. too much fibrosis/ scar tissue. Due to injury, toxins, viral infection, medabolic disorders kidney - ANSWER renal system- filters blood and maintains blood volume. acute renal failure - ANSWER acute kidney injury due to heavy blood loss, dehydration, nsaid drug reaction, kidney stones, enlarged prostate chronic renal failure - ANSWER due to diabetes, hypertension, glomerulonephritis (inflammation of kidney) not reversable- needs dialysis dialysis - ANSWER filters blood when kidneys cannot hemodialysis peripheral dialysis seizure disorders - ANSWER transiet disturbance of cerebral function bec of abnormal discharge of signals. tonic clonic/ grand mal seizure - ANSWER has precipitating events- fatigue, alcohol, stim, menstration 1. prodromal phase- pt anxious, depressed, aura- muscle jerks and epileptic cry 2. ictal tonic clonic phase- stiffening of body, dyspnea, cyanosis, 10-20 sec muscle jerking 3. post ictal phase- respiration normal, consciousness, loss of bladder and bowel funct = 5+ mins petit mal - ANSWER 2-5 mins brief syncose with minor spasm cerebrovascular accidents - ANSWER stroke- neurologic impairment x disrupted blood supply to brain. predisposing factors- hypertension, congestive heart failure, diabeties, a-fib (iregular blood flow) pt on anticoagulants- warfirin, coumadin poss complications is pt has lost swalling reflexes transiet ischemic attack - ANSWER mini stroke ischemic cva - ANSWER 85% occur bec of occluded blood vessel hemorrhagic cva - ANSWER 15% reptured artery/ aneurysm pregnancy and surgery - ANSWER best time electively is 2nd trimester (13-28 weeks) careful for supine position bec lg uterise occludes inferior vena cave and poss. sncope. never at 1st trimester obese pts - ANSWER 20% above their ideal body weight. complications with venipuncture, maintaining airway, respiratory, cv function, pt semi-fowler, lg bp cuff, hiv/aids - ANSWER human immunodificiency virus/ acquired imminodificiency syndrome meds may prolong benzodiapine effects anticoagulant therapy - ANSWER warfirin, coumadin, prodaxa, plavix, aspirin. pt can be on bec of cva, surgery, stents, a-fib, embolism stages of coagulation - ANSWER formation of platelet plug vasculature spasm platelets at plug constrict est. definitave clot. 13 factors with chemicals create mesh. drugs counteracting blood clotting - ANSWER orally- antagonise action of clotting factors (coumadin) 3-5 accenerates body's own factors- (heparin) instantanous inhibits platelet adhesion and sticky development (nsaids, plavix, aspirin) 7-10