NCLEX Cardiac

Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. How is angina treated?

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2. Which jugular veins give a more accurate estimate of the jugular vein pressure and pressure in the right atrium?
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.
NO NSAIDS or ASA.
The internal jugular veins (external are less reliable).


3. What should be done is a patient on anticoagulants suffers from epistaxis for more than 15 mins?
Use sterile gloves and aseptic technique - clean skin over port with alcohol or iodine - insert a 21 or 22 gauge HUBER needle (noncoring - won't break apart) attached to syringe or tubing into the middle of the port until rigid back of port is palpab
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
Keep clean and dry for 72 hours - DON'T LIFT The ELBOW OR ARM ON The INCISION SIDE FOR FOUR WEEKS (CAN'T BRUSH HAIR OR TEECH BC PULLS CAN ROLL MARBLES) - DON'T LIFT PUSH OR PULL MORE THAN 10 LBS FOR FOUR WEEKS - take pulse and wt each day - CAll CARD
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.


4. What are signs and symptoms of an MI?
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
Premature beats that are not preceded by a P- wave - QRS is wide and bizarre - and the T wave of the premature beat is generally large and in the opposite direction of the QRS.
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.


5. When should a patient call their doctor after having an implantable cardioverter defibrillator (ICD) placed?
No magnets (cell phone 6 inches away from) - DO Not DRINK CAFFEINATED BEVERAGES - DO Not ENGAGE In ROUGH ACTIVITIES (FOOTBAll OR WRESTLING) - and no tight clothing over site.
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
If feel more than 3 shocks in a row or develop signs of infection at the site.


6. What are the S&S of air embolism?
Fifth left intercostal space medial to the midclavicular line.
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
NO because it isn't sterile so keep out.


7. Should the tubing for a venous access port be included under the dressing site?

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8. What is Raynauds disease? Tx?
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.
Must be flushed 1x/month with heparin and between treatments.


9. What are the S&S of cardiac tamponade?
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.
A life threatening emergency that involves a tear in the aorta's intimal layer allowing blood to flow through a false lumen creating a hematoma or false aneurysm.
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
To inhibit thrombus and clot formation.


10. In What time period is the greatest risk of sudden death from an MI?
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
In the first 72 hours!!!!!


11. What does vasotec (Enalapril Maleate) do/SE?
Lowers BP and makes heart beat stronger. SE: flushed face.
It is a noninvasive test that takes 15 mins. Electrodes are applied to sites on your body. You must lie still - relax - and breathe normally and remain quiet. Talking or moving distorts the images
A complication from a venous access device or port. It is a blockage of the superior vena cava preventing superior blood flow from reaching the heart.
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.


12. Where is the tricuspid valve landmark on the chest?
File toe nails - if have new shoes only wear 2 hrs/day d/t neuropathy can't feel if problem. To decrease pain of claudication massage legs to increase circulation.
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
Lower left sternal border


13. What is pulsus paradoxus?
PT. Normal= 12 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PT= 18-30 sec.
Used to detect an abdominal aortic aneurysm. This noninvasive test takes 15 to 30 mins. They apply conductive gel to your abdomen and move a transducer over abdomen to scan blood vessels. Sound waves bouncing off anatomic structures are translated in
Chronic arteriosclerotic disease.
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.


14. What needs to be held during the placement of a femoral artery compression device?
0.5-2.0 ng/ml
Second Left intercostal space
NO NSAIDS or ASA.
Exercise and use graduated compression devices as directed - don't stand for long period of time - to avoid dislodging blood clots don't rub or massage your legs.


15. What should be checked in a patient on a beta blocker?
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
Pulse before and after giving.
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.


16. What is important to remember when taking care of patients with compression devices?
Have the patient use the val salva maneuver when the line is being removed (bear down/hold breath) to prevent air from entering where the line was and causing a PE.
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
Keep clean and dry for 72 hours - DON'T LIFT The ELBOW OR ARM ON The INCISION SIDE FOR FOUR WEEKS (CAN'T BRUSH HAIR OR TEECH BC PULLS CAN ROLL MARBLES) - DON'T LIFT PUSH OR PULL MORE THAN 10 LBS FOR FOUR WEEKS - take pulse and wt each day - CAll CARD


17. What should be done immediately for someone with PE?
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
Keep clean and dry for 72 hours - DON'T LIFT The ELBOW OR ARM ON The INCISION SIDE FOR FOUR WEEKS (CAN'T BRUSH HAIR OR TEECH BC PULLS CAN ROLL MARBLES) - DON'T LIFT PUSH OR PULL MORE THAN 10 LBS FOR FOUR WEEKS - take pulse and wt each day - CAll CARD
Stand behind the victim - wrap arms around waist (IF PREGNANT WRAP ABOVE The BABy) - make a fist with one had and place thumb against abdomen midline - grasp fist with other hand - press into victims abdomen with quick upward thrusts.


18. Where is the aortic valve landmark on the chest?
Lung disease
Second right intercostal space
NO NSAIDS or ASA.
A fluid accumulation in the pericardial space that compromises cardiac function. It is considered a medical emergency and is a hemodynamic consequence of blood or excess fluid accumulation in the pericardial sac. Common causes are surgical or traumat


19. When should bleeding precautions be implemented?
Hematuria (tea or coca cola colored) - nosebleeds - gingival bleeding (no medicated mouth wash - flossing - or lemon glycerin swabs) - and bruising (assess for abuse w/o caregiver).
(S1 - S2) Third left intercostal space
When: using anticoagulants - liver disease - decrease in platelets (less than 150 -000) - hemophilia - using thrombolytic meds - DIC - CA - HIV - chemo - bone marrow problems - and ASA/NSAIDS.
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).


20. How long is contrast media in the body?
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
Only for a few hours
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.


21. Where do the internal jugular veins lie?
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
Stand behind the victim - wrap arms around waist (IF PREGNANT WRAP ABOVE The BABy) - make a fist with one had and place thumb against abdomen midline - grasp fist with other hand - press into victims abdomen with quick upward thrusts.
Fat - Air - DVT - or Amniotic
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.


22. What would make someone more at risk for digoxin toxicity?
No radial artery punctures if negative
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
Elderly - hypothyroidism - renal dysfunction - dehydration - HYPOKALEMIA - hypomagnesemia - or hypercalcemia. Patients with abnormal potassium levels have a higher risk because hypokalemia makes the heart more sensitive to digoxin.
Gently insert the oropharyngeal airway by turning it upside down (into U shape) and slide it into the mouth. As continue to insert rotate it so the ends of the U turn downward into an arch shape after it transverses the oral cavity and approaches the


23. What should you do if you are going to ventilate someone with an ambu bag?
They may feel a slight stinging under there tongue when they are dissolving - and they should get a HA (if no HA may not be good bc the pills only last for 6 months). Keep with you at all times.
Old truck driver or someone on bed rest or with pelvic trauma.
Right atrium - TRICUSPID VALVE (tissue) - right ventricle - PULMONIC VALVE (paper) - lungs - left atrium - MITRAL VALVE (My) - left ventricle - AORTIC VALVE (Assets). Tissue PAPER MY ASSETS!
Lower HOB - place patient supine - assess LOC - open airway - assess breathing - get ambu bag - put on gloves - connect tubing from O2 source - adjust flow to 10 to 15 liters. First RESCUER: PLACE APEX of MASK OVER BRIDGE of NOSE And BASE BETWEEN LOW


24. What is a nursing diagnosis for arterial occlusion? Tx
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.


25. What is the maintenance for venous access port that isn't being regularly used?
Put on gloves - remove the previous application paper and use a tissue to remove all ointment from the site to prevent overdose - squeeze the prescribed ointment in a thin layer onto a clean ruled application paper - choose an unused site on the ches
Must be flushed 1x/month with heparin and between treatments.
Protamine Sulfate
Give furosemide (lasix) 40-60 mg IV - O2 administration - morphine sulfate 3-5 mg IV - have patient sit up with feet lowered (decreases venous return to the heart) - nitroglycerin given sublingual or IV - and rotating tourniquets (can reduce intratho


26. What is the nursing care associated with chemical stress tests (persantine stress test)?
Fat - Air - DVT - or Amniotic
Explain procedure - stress importance of reporting symptoms. INSTRUCT The PATIENT NO TO EAT DRINK OR SMOKE AT LEAST 1 HOUR BEFORE The TEST. EVALUATE PATIENTS HISTORY FOR ANY CARDIAC CONDITIONS OR MEDICATIONS THAT MAY INTERFERE WITH The TEST!!! (No va
ST segment elevation (STEMI)
Assess and mark the location of the dorsalis pedis and posterior tibial pulses in affected leg - wash hands and put on sterile gloves - gown - and mask - position device - check circulation and make sure good pedal pulse is present - IMMEDIATELY REPO


27. What is a transthoracic echocardiograph (TTE)?
Fifth left intercostal space medial to the midclavicular line.
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
Maintain BED REST


28. Where should you place your stethescope to find the tricuspid valve?
Keep clean and dry for 72 hours - DON'T LIFT The ELBOW OR ARM ON The INCISION SIDE FOR FOUR WEEKS (CAN'T BRUSH HAIR OR TEECH BC PULLS CAN ROLL MARBLES) - DON'T LIFT PUSH OR PULL MORE THAN 10 LBS FOR FOUR WEEKS - take pulse and wt each day - CAll CARD
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip
4th left intercostal space lower sternal border


29. What could happen without immediate intervention for a hematoma?
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
The patient may suffer significant blood loss or femoral nerve compression.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.


30. What type of surgery is done for an aortic dissection?
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
Second Left intercostal space
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.


31. What are the four types of pulmonary emboli?
Fat - Air - DVT - or Amniotic
Before
One at a time to assess the pulse amplitude and contour.
Right sided heart failure


32. How is the arterial brachial index (ABI) calculated? Who should perform this? What is normal?
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table
Using both gloved hands - apply firm pressure just above the skin puncture site and over the hematoma to compress the area. Wait at least 15 mins before removing pressure and reassessing the site. Then notify the health care provider.
It is calculated by checking the brachial BP and the ankle BP. The ankle systolic pressure is divided by the brachial systolic. The NA can perform. 0.97-1 is normal anything below indicates ischemia.
Ask patient to make a tight fist - using your index and middle fingers compress both the radial and ulnar arteries to obstruct blood flow to hand - ask pt to relax hand (hand and palm should appear blanched bc flow stopped) - release pressure on ulna


33. What nursing interventions are associated with a pt. experiencing ventricular fibrillation?
Pneumothorax and will end up with chest tube to help reinflate lung.
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Fat - Air - DVT - or Amniotic
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).


34. What should you teach a patient regarding discharge after a DVT?

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35. What is the treatment for a patient in complete heart block?
Having the patient supine is ideal but any position is acceptable so long as in same position for each monitoring session - locate clean and dry sensor sites on the neck (in line with earlobe) and thorax (midaxillary at xiphoid process) - connect lea
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
Assess and mark the location of the dorsalis pedis and posterior tibial pulses in affected leg - wash hands and put on sterile gloves - gown - and mask - position device - check circulation and make sure good pedal pulse is present - IMMEDIATELY REPO


36. What is the proper way to access and implanted venous access port (IVAP) (Mediport)?

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37. What is characteristic of complete heart block?
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
Explain procedure - stress importance of reporting symptoms. INSTRUCT The PATIENT NO TO EAT DRINK OR SMOKE AT LEAST 1 HOUR BEFORE The TEST. EVALUATE PATIENTS HISTORY FOR ANY CARDIAC CONDITIONS OR MEDICATIONS THAT MAY INTERFERE WITH The TEST!!! (No va
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.


38. What is cardioversion?

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39. What should you observe for in someone on bleeding precautions?
Second right intercostal space
Hematuria (tea or coca cola colored) - nosebleeds - gingival bleeding (no medicated mouth wash - flossing - or lemon glycerin swabs) - and bruising (assess for abuse w/o caregiver).
Lower left sternal border
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.


40. What are the signs and symptoms of left sided HF?
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
Check for response - activate ERS and AED - open airway with head tilt chin lift - checking breathing (5-10 sec) - give 2 breaths (1 sec each) - check carotid pulse (5-10 sec) - locate CPR hand position - deliver first cycle of compressions (30 compr
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.


41. What is defibrillation?
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
Decrease in weight - diuretics (watch K loss) - aldactone (k sparing but check renal fx) - inderal (do Not give to asthma patients or diabetic patients) - more exercise - no smoking - and decreased Na intake.
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.


42. What disease can cause right sided heart failure?
Lung disease
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!


43. Where should you place your stethescope to find the pulmonic valve?
NO because it isn't sterile so keep out.
Direct current cardioversion and digoxin/propranolol (inderal).
Second Left intercostal space
A monitor with four dual electrodes that are applied to the patients neck and thorax.


44. What is a chemical stress test (persantine stress test)?
It is a test that examines the hearts response to being stressed by a pharmacologic agent. Persantine and adenosine vasodilate the coronary arteries and cause blood to shunt away from partially occluded coronary vessels. Then dobutamine stresses the
When: using anticoagulants - liver disease - decrease in platelets (less than 150 -000) - hemophilia - using thrombolytic meds - DIC - CA - HIV - chemo - bone marrow problems - and ASA/NSAIDS.
A life threatening emergency that involves a tear in the aorta's intimal layer allowing blood to flow through a false lumen creating a hematoma or false aneurysm.
Second Right intercostal space.


45. What should be immediately done for a patient experiencing digoxin toxicity?
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).


46. What does plan of care include?
Protamine Sulfate
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
Put on gloves - remove the previous application paper and use a tissue to remove all ointment from the site to prevent overdose - squeeze the prescribed ointment in a thin layer onto a clean ruled application paper - choose an unused site on the ches
Chest pain or discomfort that occurs when your heart doesn't get enough blood and oxygen. Stable: the feeling comes and goes at expected times. Unstable: the pattern of your pain has changed (longer - hurts more - etc.)


47. What is more harmful a lot of little emboli or one large emboli?
One large emboli (smaller=better)
This noninvasive test takes 24 hours and causes no discomfort. Electrodes are applied to your body - you need to log your activities for a 24 hour period (walking - sleeping - urinating - physical symptoms - and medications). Don't tamper with the mo
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
It is a sterile procedure so both nurse and patient should wear a mask - arrange sterile field - remove dressing - assess the catheter insertion site for infection - put on sterile gloves - clean the site moving outwardly in a circular motion - apply


48. What will the Transthoracic echocardiograph (TTE) show that will indicate cardiac tamponade?
An enlarged space indicates fluid accumulation in the pericardial sac.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Identify the highest point of pulsation and measure from this point to the sternal angle. A measurement of greater than 3 cm= an elevated venous pressure.
Used to detect an abdominal aortic aneurysm. This noninvasive test takes 15 to 30 mins. They apply conductive gel to your abdomen and move a transducer over abdomen to scan blood vessels. Sound waves bouncing off anatomic structures are translated in


49. What is a good diagnosis for someone with right sided HF?
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
Having the patient supine is ideal but any position is acceptable so long as in same position for each monitoring session - locate clean and dry sensor sites on the neck (in line with earlobe) and thorax (midaxillary at xiphoid process) - connect lea
Activity intolerance
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.


50. Who would most likely have peripheral venous disease?
Use sterile gloves and aseptic technique - clean skin over port with alcohol or iodine - insert a 21 or 22 gauge HUBER needle (noncoring - won't break apart) attached to syringe or tubing into the middle of the port until rigid back of port is palpab
Idiopathic
Old truck driver or someone on bed rest or with pelvic trauma.
Vascular - artery disease causing fluid to back up into the lungs.