Assessing cardiovascular Flashcards
steps
1) ppe/hand hygiene
2) ID Patient
3) close curtains explain reason for visit
4) help patient undress, put on gown. Assist the patient to a supine position with the head elevated about 30 to 45 degrees, if possible, and expose the anterior chest. use blanket.
5) use blanket to cover
6) If not performed previously with the assessment of the head and neck, inspect and palpate the left and then the right carotid arteries. Palpate only one carotid artery at a time. Note the strength of the pulse and grade it as with peripheral pulse
7) Inspect the neck for distention of the jugular veins
8) Inspect the precordium for contour, pulsations, and heaves (Figure 1). Observe for the apical impulse at the fourth to fifth intercostal space (ICS) at the left midclavicular line
9) Using the palmar surface, with the four fingers held together, gently palpate the precordium for pulsations. Remember that hands should be warm. Palpation proceeds in a systematic manner, with assessment of specific cardiac landmarks—the aortic, pulmonic, tricuspid, and mitral areas and Erb’s point (Refer to Figure 1). Palpate the apical impulse in the mitral area (Figure 2). Note size, duration, force, and location in relationship to the midclavicular line
10) Auscultate heart sounds. Ask the patient to breathe normally. Use the diaphragm of the stethoscope first to listen to high-pitched sounds. Then use the bell to listen to low-pitched sounds. Focus on the overall rate and rhythm of the heart and the normal heart sounds (Table 3-3). Begin at the aortic area, move to the pulmonic area, then to Erb’s point, then the tricuspid area, and finally listen at the mitral area
11) help patient up. PPE/hand hygiene
