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36 Cards in this Set
- Front
- Back
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wilkins chapter 10 page 207 to 215 |
Egans chapter 18, 381 to 388 Workbook Chapter 18 page 141 to 146 |
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summary of normal values for electrocardiogram interpretation and common alterations |
Rate 60 to 100 /min |
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SInus bradycardia |
Meets all the criters for NSR but is too slow :Rate: less than 60 bpm :Rhythm: regular :P waves normal and is followed by a QRS :PR interval 0.12 to 0.2 seconds |
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SInus Tachycardia |
Meets all criteria for NSR but is too fast :Rate 100 to 150 bpm Rhythm regular P waves normal but increased |
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SInus Tachycardia |
Meets all the criteria for NSR but is too fast :Pr interval: 0.12 to 0.2 second :QRS less than 0.12 seconds |
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SInus dysrhythmia |
Meets all the criteria for normal sinus rhythm but is irregular :Rate 60 to 100 beats per minu, may also be bradycardia :Rhythm: irregular :P waves: normal and followed by a QRS complex :PR interval 0.12 to 0.2 second in length :QRS: less than 0.12 second in width |
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Atrial FLutter |
Distinct rapid swtooth pattern between normal WRS :Rate: atrial rates 180 to 400; ventricular rate is slower :Rhythm: regular :P waves, sawtooth and uniform |
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Atrial FLutter |
Distinct rapid sawtooth pattern between normal WRS :PRI: not measurable :QRS less than 0.12 second |
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Atrial fib |
Characterized by chaotic baseline between WRSs :Rate: variable (count WRSs in 6 second strip) :Rhythm: irregularly irregular :P waves: fibrillatory waves that all vary |
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Atrial fibrillation |
Characterized by chaotic baseline between WRSs :PRI not measurable :QRS is less than 0.12 seconds
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Premature ventricular contractions |
Underlying rhythms is interrupted by wide QRS (greater than 0.12 seconds) not preceded by a P wave and has an inverted T :Rate: that of the underlying rhythm :Rhythm: regular rhythm is interrupted by PVC :P waves: not associated with the PVC
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Premature ventricular contractions |
Underlying rhythm is interrupted by wide QRS so greater than 0.12 sec, and is not preceded by a P wave, and has an inverted T :PR interval not measurable :QRS is greater than 0.12 sec, premature, abnormal configuration, |
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Ventricular Tachycardia |
Wide QRS occuring rapidly without P waves :Rate of 140 to 300 bpm :Rhythm is regular :P waves not associated with QRS complexes |
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VVentricular tachycardia |
Wide QRS occuring rapidly without P waves :PR interval: not measurable :QRS: abnormal and greater tthan 0.12 second in width |
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Ventricular fib |
Chaotic rhythm, characterized by wavy irregular pattern :Rate: none :Rhythm, irregular, chaotic waves :P waves: none :PRI, non :QRS: none or sporadic low amplitutde |
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Asystole |
Characterized by a straight or almost flat line Rate: none :Rhythm non :P waves non :PRI non ;QRS none |
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AV Heart block |
General term: problems conducting impulses from the atrial to the ventricules Blocks can occur at the AV node, bundle of His or the bundle branches Complete heart block may be associated with hypotension Milkder forms of heart block often cause no symptoms |
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First degree AV block |
Looks like NSR but a prolonged PR interval (greater than 0.2 seconds) :Rate: underlying rhythm rate :Rhythm: regular :P waves: normal, each preceding a QRS complex |
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Radiograph views |
Standard views :Anteroposterior (film behind your back, camera in front) :Posterior anterior view Special views :Lateral decubitus :Apical lordotic :Oblique (side of lungs) :expiratory |
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Anterior Posterior view |
Indications for AP portable films :Evaluate the lung status :evaluate lines and tubers :See results of invasive therapeutic maneuvers :Portable chest film Film cassette placed behind patients back X ray beam moves from front to back :anterior to posterior) 4 feet from beams origin :More magnification artifact that PA Chest X ray |
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Evaluation of the chest radiograph |
Recognition of anatomic landmarks Review clinical finding before viewing CXR Placing the chest film :Patient facing clinician :cardiac shadow more prominent |
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Xray |
Penetration inversely proportional to density of structure Normal lung density tissue has low density :Cavities, blebs darkers Consolidation increases density :Pneumonia, tumer, collapse (white patch) Greatest density in the chest: bones Systemic review of all structures :A through Z
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Determine quality of the film |
Visualize vertebral bodies through cardiac shadow :If easily seen, overexposed, recognize rotation of the patient SPnous processes to medial ends of clavicles Degree of patients inspiratory effort :10 posterior ribs on PA film
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Silhouette Sign and air bronchogram |
Silhouette sign :infiltrate that obliterates heart border or :diaphragm must be located in anterior segments of the lung Air bronchogram :visible bronchi when surrounded by consolidated alveoli :Confirms intrapulmonary disease |
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Clinical and radiographic findings in lung disease |
Atelectasis Hyperinflation Interstitial lung disease |
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Atelectasis |
Compressive atelectasis :pleural effusion, pneumothorax, hemomthorax :If severe, mediastinal shift Obstructive atelectasis :Tumor, aspirated foreign body, mucus plugging Posteroperative atelectasis :Microatelectasis CXR: lung volume loss, mediastinal shift |
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Emphysema |
Anatomic alterations of the lungs Permanent enlarbement of alveoli Results in dereased surface area for optimum gas exchange Causes ventilation in excess of perfusion which is deadspace Wasted ventilation Distal airways, weakended in the process, then collapse during expiration trapped gas is a result in the alveoli This leads to increased alveolar deadspace increase Vd alv Increase PaCO2 Alveolar ventilation and PaCO2 are inversely related |
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Emphysema |
Alpha 1 antitrypsin deficiency Alpha 1 is secreted by the liver When white blood cells are destroyed in the lungs the alpha 1 is released that destroys elastic tissue |
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CXR COPD |
Translucent (dark lung fields) Density of the lungs decreases because of the air trapping Decrease in the lung recoiling Flattened diaphragms Long narrow heart |
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Pneumothorax |
Tall, thin young males COPD with bullous dissease Trauma :Broken ribs :Puncture wound :latrogenic Air enters pleural space Pleura separate Affected lung collapses |
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Tension pneumothorax is a medical emergency |
Needs immidiate relief via tube thoracostomy
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Pleural diagnostic evaluation |
Size of pleural effusion :To see on chest film :200 cc
Radography Thoracentesis Thoracoscopy :Video assisted thoracic surgery Thoracotomy |
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Thoracentesis |
Insertion of needle into pleural space :Use of local anesthetic :sample for cell counts, cultures, chemistries, cytology and pH Catheter placed :If theres a lot of fluid to be drained :Lung re expansion needed Needle placed just superior to a rib 3 major risks :intercostal artery laceration, infection, pneumothorax |
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Thoracoscopy |
Video assisted thoracic surgery Local anesthesia and conscoius sedation Thoracoscope placed through intercostal incision :Visualization of lung surfaces :drainage of pleural fluid :Biopsy under direct visualization |
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Chylothorax |
Chyle in pleural space :Milky appearance :leakage of thoracic duct Ruptures into pleural space |
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Hemothorax |
Blood in pleural space(usually occures cause of trauma) Life threatening |
