Assessing the Heart and Cardiovascular System Flashcards
How many chambers are there in the heart and what are they
4
right atrium, right ventricle, left atrium, left ventricle
How many valves does the heart have and what are they
4
aortic, tricuspid, pulmonary, mitral
How are the heart valves controlled
through blood pressure changes
Veins
carry deoxygenated blood to the heart
Where are veins
close to the surface
Arteries
carry oxygenated blood to the body
Where is the heart positioned
on the left side between the 2nd and 5th intercostal spaces
perfusion
a continuous supply of oxygenated blood through blood vessels to the vital organs
What two phases fill and empty the heart’s chambers
systole and diastole
Systole
contraction of the ventricles (emptying)
Diastole
relaxation of the ventricles (filling)
What are the central vessels
carotid arteries, jugular veins
What do jugular veins do
return blood from the vein to the superior vena cava
What are the peripheral vessels
arteries and veins
What do diseases in the vascular system cause
problems with the delivery of O2 and nutrients to tissues, and elimination of CO2 and wastes from cellular metabolism
What does the pressure from each heartbeat cause
arteries to expand and recoil
what questions should you obtain regarding a clients cardiovascular history (6)
demographic data, health history, family history, cardiovascular history, nutrition history, lifestyle/health promotion activities
What do you listen for during cardiovascular assessments (5)
cardiac rate, rhythm, abnormal heart sounds, S1-S4, murmurs
Where do you listen to heart sounds
aortic, pulmonic, erb’s point, tricuspid, mitral
How long do you listen to heart sounds
1 minute in each spot
What is a cardiovascular assessment used for
help identify significant factors that influence cardiovascular health
Should the cardiovascular exam be done as a part of each head-to-toe exam
yes
What part of the stethoscope should you be using to listen to heart sounds
both the diaphragm and bell
What is the vascular assessment used for
to identify signs and symptoms of peripheral vascular disease
What do you do during a vascular assessment (3)
inspect skin/mucous membrane color, general appearance, palpate pulse/skin/temperature/capillary refill/edema/areas of tenderness
What are the 8 pulse sites
temporal, carotid, brachial, radial, dorsalis pedis, femoral, popliteal, posterior tibial
Describe the aortic valve
2nd intercostal space, right sternal border, hear S2 noise best here (diastole)
Describe the pulmonic valve
2nd intercostal space, left sternal border
Describe Erb’s point
3rd intercostal space, left sternal border
Describe tricuspid valve
4th intercostal space, left sternal border
Describe mitral valve (apical pulse)
5th intercostal space, midclavicular line, hear S1 sound best here (systole)
Describe the S1 sound
Lub, created by the closure of the mitral and tricuspid valves, beginning of systole, dull low pitched sound
Describe the S2 sound
Dub, created by the closure of the aortic and pulmonic valves, beginning of diastole, high pitched and shorter than S1
Describe the S3 sound
An extra sound heard after S1, gallop cadence (KenTUCKy), best heard at the apical site in a side laying position
Describe the S4 sound
An extra sound heard before S1, FLOrida, best heard at apical site using bell in a side-laying position
What is a normal heart rate
60-100 bpm
When are heart sounds louder
as a child
What is a normal capillary refill time
less than 3 seconds
Describe a heart murmur
turbulent blood flow with a swooshing or blowing sound when listening,
What do you do if a heart murmur is detected
do further assessment
Thrill
vibration felt while checking the pulse
Bruit
audible sound blood makes as it moves through arteries
What are the pulse strengths
0: absent
+1: weak
+2: normal
+3: strong
+4: bounding
Developmental differences in infants/children for heart and vascular system
-Cyanosis when feeding? Crying?
-Poor feeding?
-Keep up with other kids?
-Blue spells?
-What are naps like?
-Joint pain? Fever?
Developmental differences in older adults
-Stopped taking any medications?
-Does illness interfere with ADLs?
-Stairs in home?
-The pain perception is going to be different and diminished
