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201B Exam2 > 201 B Exam 2 Cardiac and Respiratory > Flashcards

201 B Exam 2 Cardiac and Respiratory Flashcards

cardiac and respiratory assessment

1
Q

CMS stands for what?

A

Circulatory, sensory and motor

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2
Q

In the cardiovascular system there are two parts, what are they?

A

the heart and the peripheral vascular system

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3
Q

the heart is also known as the?

A

myocardium muscle

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4
Q

the peripheral vascular system consists of what?

A

arteries, arterioles, capillaries, venules and veins

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5
Q

what is perfusion?

A

the passage of fluids through the circulatory system (or lymphatic system)

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6
Q

what is turbulence?

A

disruption in smooth laminar (layered) blood flow

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7
Q

in a cardiac assessment, what are you looking for in the inspection phase?

A

look for any obvious abnormality of the chest (like broken ribs), asymmetry of shape, the sternum and clavicle

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8
Q

landmarks of the heart (4)

A

Apex, Base, AV valves, and SL valves

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9
Q

Base of heart

A

at top where great vessels attach

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10
Q

Apex of heart

A

at bottom, point furthest away from base

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11
Q

AV valves of heart

A

tricuspid (R), mitral (L) make the S1 sound when closing (systole)

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12
Q

SL valves of heart

A

aortic and pulmonic, make the S2 sound when closing (diastole)

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13
Q

what is a precordial exam?

A

a physical exam that checks for signs of heart disease

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14
Q

what are the landmarks for the precordial exam?

A

APT.M Aortic, Pulmonic, Tricuspid, and Mitral. these are the points at which you can hear each of the particular valves open and close

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15
Q

where to listen to the aortic valve?

A

2nd-3rd right interspace (right side on outside of upper sternum)

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16
Q

where to listen to the pulmonic valve?

A

2nd-3rd left interspace (left side on outside of upper sternum)

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17
Q

where to listen to the tricuspid valve?

A

at the left sternal border (left bottom of sternum)

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18
Q

where to listen to the mitral valve?

A

at the apex of the heart (mid lower pec area)

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19
Q

where to best hear the “lub” sound?

A

aka S1 or systole is the tricuspid and the mitral valves closing, best heard at the apex (bottom) of the heart. T and M locations

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20
Q

where to best hear the “dub” sound?

A

aka S2 or diastole is the pulmonic and aortic valves closing, best heard at the base (top) of the heart. A and P locations

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21
Q

where is the point of maximum impulse?

A

normally heard at the Apex of the heart (mitral area)
Heard best in diff. places dep. on pt. due to disease process like HF.

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22
Q

what is an innocent murmur?

A

doesn’t bother patient

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23
Q

what are murmurs caused by and what do they sound like?

A

caused by incomplete closure of valves, blood is being shared at little too much. sounds like a”whooshing” .

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24
Q

what is a friction rub?

A

sounds like a grating, rasping noise. sign of inflammation of the pericardium that surrounds the heart (pericarditis)

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25
what pulse point do we avoid checking in the elderly?
the carotid bc plaques can break off in carotid if it is palpated
26
when is a diastolic murmur heard?
heard between S2 and S1 sounds or after S2
27
when is a systolic murmur heard?
between S1 and S2 sounds
28
what are the peripheral pulses?
radial brachial femoral popliteal dorsalis pedis posterior tibial carotid temporal
29
what pulses are we required to check in assesment?
radial brachial dorsalis pedis posterior tibial ** if pedal and radial are found brachial and tibial are not necessary
30
how are pulse qualities rated?
0=absent 1+ weak 2+ normal 3+ increased, full, bounding
31
what are ultrasound devices used for in relation to cardiovascular system?
called "doppler pulses" if only found using a doppler device. used to assess arterial blood flow if unable to palpate the blood flow to extremity
32
what are 10 factors that affect cardiovascular function?
cigarette smoking highBP nutrition lack of exercise diabetes obesity medical or family history medications and drug use stress "inflammation" (becoming important)
33
for cardiac assessment what are our goals for auscultation (in 1st semester)?
auscultate all four sites, identify S1 and S2, apical rate and rhythm and listen for murmurs
34
what are cardiac distress signs and symptoms to report immediately?
chest pain and pressure, dyspnea
35
what is edema? and where is it commonly?
fluid in interstitial spaces, between organs and cells. common in extremities, lungs, abdomen
36
how what is an edema rating based on? and how do you check?
based on how much pitting you see, best to check over bony areas (ex: shins)
37
what are the edema ratings?
1+ (2mm) 2+ (4 mm) 3+ (6mm) 4+ (8mm)
38
what to assess in "Circulation" of CMS check?
pulses color capillary refill
38
what are some abnormal findings in a CMS check?
color- pale or cyanotic cap refill- sluggish or absent pulse- weak or absent numbness/tingling present inability to move
38
what to assess in "motion" of CMS check?
fingers toes able to move
38
what are the signs of deep vein thrombosis?
pain, swelling, warmth, redness, usually in calf area
38
how to diagnose DVT?
D-Dimer blood test ultrasound of legs
38
how to prevent DVT?
sequestial compression devices (SCDs), ambulation, hydration, anticoagulants as ordered, active ROM while on bed rest
38
what to assess in "sensation" of CMS check?
either normal or abnormal sensation (numbness, tingling, inability to feel)
38
what is a CMS check?
neuro-vascular, motor check that compares extremities
38
what is the treatment for DVT?
bed rest for a time, anticoagulants, prevention
39
why is DVT dangerous?
can lead to a PE
40
when are sequential compression devices (SCDs) used?
venous insufficiency or edema prolonged bed rest intra-opertively post-operatively trauma
41
what are some contraindications for the use of SCDs?
arterial insufficiency presence of DVT
42
what are the requirements for the fit of TED hose?
properly fitted no wrinkles or bunching removed for 30 min per 8 hrs of wear CMS of pt. toes intact
43
Cardiac assessment criteria (7)
subjective statements, pain? heart sounds (S1 and S2) any extra sounds? skin color, temp, turgor pulse presence and strength presence of edema (amt?) circulation problem? DVT?
44
the physical assessment of the mouth consists of what areas?
oral cavity tongue teeth/gums lips (assess for symmetry, color, pain and tenderness, yeast infection)
45
a respiratory assessment documentation consists of what body parts and data?
the mouth thorax lungs O2 sat (mode of air) cough (characteristics, sputum?) resp. (rhythm, depth and effort) breath sounds use of accessory muscles? subjective statements position of patient
46
what are adventitious lung sounds?
sounds heard in addition to normal breath sounds and can indicate lung problems
46
what are diminished lung sounds?
sounds less on one side or throughout due to poor air movement, less lung space
47
what are 6 examples of adventitious lung sounds?
diminished lung sounds crackles Rhonchi wheezes stridor pleural friction rub
48
what are crackles? and when do u hear them?
-can be coarse or fine -air is moving through mucous or fluid -may be heard on inspiration or expiration
49
when do you hear a pleural friction rub?
may be heard on inspiration or expiration
50
what is stridor and when do you hear it?
heard on inspiration and it is a loud, high pitched "crowing sound"
51
what is a velcro rale?
a kind of crackle ex: pulmonary fibrosis
52
what is Rhonchi? where is it heard?
airflow obstruction caused by secretions (mucus, infection). sometimes cleared by coughing. heard in upper airways. "snoring sound"
53
what are wheezes?
sound made by air squeezed through narrowed passageways/ high pitched sound "musical"
54
what is a rale?
crackle
55
most important spots to listen to lung sounds?
areas 5 and 8 (both right and left)
56
where is the base of the lung?
at the bottom
57
what to inspect for with the thorax?
any obvious abnormality, asymmetry of movement, sternum, intercostal muscle use, dyspnea
58
what to assess for with cough?
frequency, productive or not? (if yes describe color and amount of mucous, smell)
59
what to asses with O2 saturation
document O2 saturation and what is the "mode" of air? ex: RA- room air ex: O22LNC- supplemental O2 (1 liter or 2 liter cannula)
60
what are the primary areas to check the lungs in assessment?
2 area, 3 area (mid pec area), 5 area and 8 area (outer chest under arm pits)

201B Exam2 (2 decks)

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