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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
Q

what pulse point do we avoid checking in the elderly?

A

the carotid bc plaques can break off in carotid if it is palpated

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26
Q

when is a diastolic murmur heard?

A

heard between S2 and S1 sounds or after S2

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27
Q

when is a systolic murmur heard?

A

between S1 and S2 sounds

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28
Q

what are the peripheral pulses?

A

radial
brachial
femoral
popliteal
dorsalis pedis
posterior tibial
carotid
temporal

29
Q

what pulses are we required to check in assesment?

A

radial
brachial
dorsalis pedis
posterior tibial
** if pedal and radial are found brachial and tibial are not necessary

30
Q

how are pulse qualities rated?

A

0=absent
1+ weak
2+ normal
3+ increased, full, bounding

31
Q

what are ultrasound devices used for in relation to cardiovascular system?

A

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
Q

what are 10 factors that affect cardiovascular function?

A

cigarette smoking
highBP
nutrition
lack of exercise
diabetes
obesity
medical or family history
medications and drug use
stress
“inflammation” (becoming important)

33
Q

for cardiac assessment what are our goals for auscultation (in 1st semester)?

A

auscultate all four sites, identify S1 and S2, apical rate and rhythm and listen for murmurs

34
Q

what are cardiac distress signs and symptoms to report immediately?

A

chest pain and pressure, dyspnea

35
Q

what is edema? and where is it commonly?

A

fluid in interstitial spaces, between organs and cells. common in extremities, lungs, abdomen

36
Q

how what is an edema rating based on? and how do you check?

A

based on how much pitting you see, best to check over bony areas (ex: shins)

37
Q

what are the edema ratings?

A

1+ (2mm)
2+ (4 mm)
3+ (6mm)
4+ (8mm)

38
Q

what to assess in “Circulation” of CMS check?

A

pulses
color
capillary refill

38
Q

what are some abnormal findings in a CMS check?

A

color- pale or cyanotic
cap refill- sluggish or
absent
pulse- weak or absent
numbness/tingling present
inability to move

38
Q

what to assess in “motion” of CMS check?

A

fingers toes able to move

38
Q

what are the signs of deep vein thrombosis?

A

pain, swelling, warmth, redness, usually in calf area

38
Q

how to diagnose DVT?

A

D-Dimer blood test
ultrasound of legs

38
Q

how to prevent DVT?

A

sequestial compression devices (SCDs), ambulation, hydration, anticoagulants as ordered, active ROM while on bed rest

38
Q

what to assess in “sensation” of CMS check?

A

either normal or abnormal sensation (numbness, tingling, inability to feel)

38
Q

what is a CMS check?

A

neuro-vascular, motor check that compares extremities

38
Q

what is the treatment for DVT?

A

bed rest for a time, anticoagulants, prevention

39
Q

why is DVT dangerous?

A

can lead to a PE

40
Q

when are sequential compression devices (SCDs) used?

A

venous insufficiency or
edema
prolonged bed rest
intra-opertively
post-operatively
trauma

41
Q

what are some contraindications for the use of SCDs?

A

arterial insufficiency
presence of DVT

42
Q

what are the requirements for the fit of TED hose?

A

properly fitted
no wrinkles or bunching
removed for 30 min per 8
hrs of wear
CMS of pt. toes intact

43
Q

Cardiac assessment criteria (7)

A

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
Q

the physical assessment of the mouth consists of what areas?

A

oral cavity
tongue
teeth/gums
lips
(assess for symmetry, color, pain and tenderness, yeast infection)

45
Q

a respiratory assessment documentation consists of what body parts and data?

A

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
Q

what are adventitious lung sounds?

A

sounds heard in addition to normal breath sounds and can indicate lung problems

46
Q

what are diminished lung sounds?

A

sounds less on one side or throughout due to poor air movement, less lung space

47
Q

what are 6 examples of adventitious lung sounds?

A

diminished lung sounds
crackles
Rhonchi
wheezes
stridor
pleural friction rub

48
Q

what are crackles? and when do u hear them?

A

-can be coarse or fine
-air is moving through
mucous or fluid
-may be heard on
inspiration or
expiration

49
Q

when do you hear a pleural friction rub?

A

may be heard on inspiration or expiration

50
Q

what is stridor and when do you hear it?

A

heard on inspiration and it is a loud, high pitched “crowing sound”

51
Q

what is a velcro rale?

A

a kind of crackle
ex: pulmonary fibrosis

52
Q

what is Rhonchi? where is it heard?

A

airflow obstruction caused by secretions (mucus, infection). sometimes cleared by coughing. heard in upper airways. “snoring sound”

53
Q

what are wheezes?

A

sound made by air squeezed through narrowed passageways/ high pitched sound “musical”

54
Q

what is a rale?

A

crackle

55
Q

most important spots to listen to lung sounds?

A

areas 5 and 8 (both right and left)

56
Q

where is the base of the lung?

A

at the bottom

57
Q

what to inspect for with the thorax?

A

any obvious abnormality, asymmetry of movement, sternum, intercostal muscle use, dyspnea

58
Q

what to assess for with cough?

A

frequency, productive or not? (if yes describe color and amount of mucous, smell)

59
Q

what to asses with O2 saturation

A

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
Q

what are the primary areas to check the lungs in assessment?

A

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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