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Monitoring Cardiovascular Pulmonary S&S
Terms in this set (30)
Adverse Cardiopulmonary S&S
-SBP or HR fails to rise or decrease significantly (10-20)
CHF, Pump Failure, tachypnea, dyspnea, orthopnea, fatigue, increased L.E. Edema, wt gain > 2-3/ day, Jagular Venous Distension (JVD) rales, crackles, ausculated S3 heart sounds
Signs of acute heart pump failure
Which is a worse sign? SBP rising excessively or falls?
Interpreting CV response is based on:
Risk factors/ history
Number & type of dosage level of cardiac meds
How do you respond to cardiac distress when abnormally high vitals during exercise come down when RPE is reduced. No patient compliant.
Titrate RPE and %THR to a lower level and continue exercising assess vital signs and tolerance at the reduced level; document
Vital signs drop with exercise but stabilize w/ rest. No patient S&S. Your response would be?
Stop exercise; monitor vitals every 5 mins, document, fax to PCP
Angina (non stable) diaphoresis, pallor, nausea, confusion, ataxia, dizziness, that is relieved with rest. Your response would be to?
Stop exercise, monitor vitals every 5 mins, document, Call PCP to report findings and solicit guidance
Angina (non stable) that is not relieved with sublingual nitroglycerin
No angina, but diaphoresis, pallor, nausea, confusion, ataxia, dizziness, NOT relieved with rest.
Stop exercise, call 911. Retrieve AED, monitor vitals, document
When to monitor vitals signs?
Before, during, and after each aerobically demanding activity
Obstructive vs. Restrictive
Obstructive- lung diseases include conditions that make it hard to exhale all the air in the lungs.
Restrictive-restrictive lung disease cannot fully fill their lungs with air. Their lungs are restricted from fully expanding.
For persons with heart disease, do not begin exercise if...
Resting SBP > 180 mmHg
Resting DBP > 110mmHg
Resting tachycardia > 120 bpm
HR returns to preexercise level within ___ mins of stopping and restinf
SBP returns to pre exercise level within ____of stopping and resting
For persons with congestive heart failure, OK to start if
-Speaks w/o dyspnea and RR < 30
- crackles < 1/2 lungs
-HR < 120 bpm
For persons w/ heart disease, stop exercise if
DBP is more or equal to 110mmHg
SBP decreases > 10 mmHg
Signs of intolerance (angina, diaphoresis, pallor, nausea, confusion, ataxia, dizziness, arthythmia)
For persons with congestive heart failure, stop exercise if
Dyspnea > 3/10 "moderately SOB"
RR > 40
S3 heart appears
New/ increased crackles
Pulse pressure < 10 ( SBP- DBP)
HR or BP decreases > 10 ( but also rule out pre exercise jitters nervousness)
Incr supraventricular and ventricular ectopy
Angina, diaphoresis, pallor, nausea, confusion, ataxia, dizziness
Beginning intensity for cardiac patients post MI ( w/o ETT)
RPE < 13/20 ( or if deconditioned can start at 10-11 RPE)
HR < 120 bpm
Rise of 20 bpm over resting HR
Beginning intensity Post surgery (CABG)
RPE <13/20 ( or if deconditioned can start at 10-11 RPE)
HR< 130 bpm
Rise of 30 bpm over resting HR
NORMAL BP at rest
120-129 SBP and < 80
HTN, Stage 1 Range
130-139 SBP and 80-89 DBP
HTN stage 2
> 140 SBP and > 90 DBP
SBP will rise in a linear fashion with exertion, _______ for every MET level above basal MET level of 1-2 METs
SBP increases ____ mm or more with minimal to moderate exercise
SBP increases ____mm with intense exercise
For healthy adult when exercising, DBP will ______ with exercise.
remain flat, or slightly decrease
During exercise, DBP May rise or fall ____ or it may remain flat.
DBP of ____mmHg is criteria for termination of exercise
HR rises linearly ___ bpm for each MET level
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