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Cardiac Vascular Certification > Cardiac and Vascular Assessment > Flashcards

Cardiac and Vascular Assessment Flashcards

1
Q

What should be included in focused cardiovascular history?

A

History, common symptoms, triggers, psychosocial status, PQRST

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2
Q

PQRST Pain Acronym

A

Provoking, Quality, Region, Severity and Timing

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3
Q

What does the nurse ALWAYS evaluate first on initial survey of patient?

A

A - airway
B - breathing
C - circulation

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4
Q

Where on the chest does the nurse hear the aortic valve?

A

2nd and 3rd right interspace

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5
Q

Where on the chest does the nurse hear the pulmonic valve?

A

2nd and 3rd left interspace

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6
Q

Where on the chest does the nurse hear the tricuspid valve?

A

left sternal border

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7
Q

Where on the chest does the nurse hear the mitral valve?

A

apex (just to the right and slightly below left nipple)

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8
Q

Definition of pulse pressure

A

difference between systolic and diastolic

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9
Q

Definition of orthostatic BP

A

drop of 20 mmHg in systolic, drop of 10 mmHg in diastolic with standing

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10
Q

Definition of pulse deficit

A

difference between pulse rate and heart rate seen with arrhythmias

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11
Q

How do you assess pulse deficit

A

assess apical and radial pulse simultaneously for 1 minute

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12
Q

ankle-brachial index definition

A

ratio of BP at the ankle and upper arm; normal 0.9-1.3

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13
Q

What does a low ankle brachial index indicate?

A

occluded arteries caused by PVD

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14
Q

What does a high ankle-brachial index indicate?

A

abnormally hardened blood vessels

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15
Q

What is a normal range for ankle-brachial index?

A

0.9-1.3

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16
Q

Prehypertension begins at what systolic range?

A

120-130

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17
Q

Stage 1 hypertension begins at what systolic and diastolic range?

A

130-140 systolic, 80-90 diastolic

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18
Q

Stage 2 hypertension beings at what systolic and diastolic range?

A

140 - 180+ systolic, 90-120+ diastolic

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19
Q

3 categories of Glascow Coma Scale

A

Eye Opening, verbal response, motor response

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20
Q

PERRLA is assessing what cranial nerves

A

CN III, IV and VI via pupils

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21
Q

PERRLA acronym

A

P - pupils
E - equal
R - round
R - react
L - light
A - accommodation

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22
Q

Cranial Nerve I and assessment

A

Olfactory - have patient close eyes and smell

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23
Q

Cranial Nerve II and assessment

A

Optic - have patient read and assess periphery

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24
Q

Cranial Nerve III and assessment

A

Oculomotor - pupil response; follow finger with eyes making an “H”

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25
Q

Cranial Nerve IV and assessment

A

Trochlear - follow finger moving towards nose to assess downward eye movement

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26
Q

Cranial Nerve V and assessment

A

Trigeminal - Sensation of forehead, cheeks and jaw - have clench teeth

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27
Q

Cranial Nerve VI and assessment

A

Abducens - have patient look towards each ear to check sideways eye movement

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28
Q

Cranial Nerve VII and assessment

A

Facial - assess symmetry of face and puff cheeks

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29
Q

Cranial Nerve VIII and assessment

A

Vestibulocochlear - assess hearing and equilibrium

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30
Q

Cranial Nerve IX and assessment

A

Glossopharyngeal - gag reflex check and sour/sweet taste on tongue

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31
Q

Cranial Nerve X and asssessment

A

Vagus - swallow while speaking, say “ah” (sensory and motor)

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32
Q

Cranial Nerve XI and assessment

A

Accessory - shrug shoulders and turn head against resistance

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33
Q

Cranial Nerve XII and assessment

A

Hypoglossal - have patient stick out tongue and move side to side

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34
Q

Mnemonic for cranial nerves

A

Oh Oh Oh Those Trippy Alien Fruit Vines Generate Visions And Hallucinations

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35
Q

Mnemonic for cranial nerves - motor sensory or both

A

Some Say Marry Money, But My Brother Says Big Brains Matter More

36
Q

When percussing lungs, what does the tone indicate?

A

indicates where lungs are solid and filled with air or fluid

37
Q

The nurse describes your percussed lung sounds as RESONANT - what does this mean?

A

normal air-filled lung sounds

38
Q

What does DULL percussed lung sounds indicate?

A

fluid/tissue filled cavities - often pneumonia

39
Q

what does HYPERRESONANT (drum-like) percussed lung sounds indicate?

A

air filled tissues - seen with emphysema and pneumothorax

40
Q

Kussmaul breathing and associated state

A

hyperventilation with deep labored breathing; associated with metabolic acidosis

41
Q

Cheyne Stokes breathing and associated issue

A

deep breathing alternating with apnea OR faster rate; associated with L heart failure or sleep apnea

42
Q

Where are vasicular breath sounds heard?

A

over the lungs

43
Q

Wheezing

description, etiology and disease process

A
  1. musical-like
  2. forced air through narrow airway
  3. COPD, asthma
44
Q

Rhonchi

description, etiology and disease process

A
  1. low pitched, coarse rattles
  2. secretions in airway
  3. pneumonia and cystic fibrosis
45
Q

Stridor

description, etiology and disease process

A
  1. high pitched, wheezing sound
  2. air through UPPER airway is obstructed/narrow
  3. aspiration or larygnospasm
46
Q

Rales (crackles)

description, etiology and disease process

A
  1. rattling - can be coarse or fine
  2. fluid in small airways of lung
  3. pulmonary edema, pneumonia
47
Q

Pleural Friction Rub

description, etiology and disease process

A
  1. grating/creaking sound
  2. inflamed pleural tissue
  3. pleuritis/pulmonary embolism
48
Q

Diminished Lung Sounds

description, etiology and disease process

A
  1. decreased intensity due to lack of airflow
  2. air or fluid in lungs/blocked airway
  3. pleural effusion, pneumothorax
49
Q

Egophony

description, etiology and disease process

A
  1. “e” sound heard as a “a”
  2. due to increased resonance of sound traveling across fluid
  3. pleural effusion, pneumonia
50
Q

Bronchophony

description, etiology and disease process

A
  1. increased volume of spoken voice over area of lung consolidation
  2. fluid in lungs
  3. pleural effusion, pneumonia
51
Q

Whispered Pectoriloquy

description, etiology and disease process

A
  1. increased volume of whispered voice over areas of lung consolidation
  2. fluid in lungs
  3. pleural effusion, pnuemonia
52
Q

Patient position to check carotid arteries

A

position patient at 45 degree angle with head turned away

53
Q

How to inspect and palpate jugular veins?

A

relax sternomastoid muscle so pulsation can be seen in internal jugular

54
Q

Positive JVD = elevated _____?

A

CVP

55
Q

Cardiac auscultation mnemonic

A

A PET Monkey (aortic, pulmonic, Erb’s point, tricuspid, mitral)

56
Q

Location of PMI

A

Point of Maximal Intensity = apex of heart (very bottom tip of heart)

57
Q

Where is the best place to hear the mitral valve?

A

5th LEFT intercostal space at midclavicular line

58
Q

Where is the best place to hear the tricuspid valve?

A

5th intercostal space at LEFT sternal border

59
Q

Where is the best place to heart the Erb’s Point?

A

3rd LEFT intercostal space at left sternal border

60
Q

Where is the best place to hear the pulmonic valve?

A

2nd LEFT intercostal space at left sternal border

61
Q

Where is the best place to hear the aortic valve?

A

2nd RIGHT intercostal space at right sternal border

62
Q

This sound is caused by the closure of the atrioventricular valves

A

S1

63
Q

This sound is caused by the closure of the semilunar valves

A

S2

64
Q

Other name for S3 sound and what causes this?

A

ventricular gallop
rush of blood into ventricles that is normal in children/young adults

65
Q

What cardiac conditions are related to S3 sounds?

A

ventricular dysfunction or volume overload in the ventricles
MI, systolic HF, dilated cardiomyopathy, mitral valve regurgitation

66
Q

What is the other name for S4 sound and what causes this?

A

atrial gallup; atrial contraction into a noncompliance ventricle

67
Q

when is S4 heard?

A

before S1

68
Q

What cardiac conditions are related to S4 sounds?

A

decreased ventricular compliance - hypertrophic cardiomyopathy, hypertension, aortic stenosis

69
Q

What is a carotid bruit?

A

heard over carotid artery and is caused by turbulent blood flow - indicates carotid artery disease

70
Q

Where is pericardial friction rub heard and describe sound?

A

fourth intercostal space with patient leaning forward
high pitched, leathery sound

71
Q

What cardiac sound is associated with pericarditis?

A

pleural friction rub

72
Q

systolic murmur occurs when?

A

occurs during ventricular contraction

72
Q

systolic murmur occurs when?

A

occurs during ventricular contraction

72
Q

systolic murmur occurs when?

A

occurs during ventricular contraction

73
Q

diastolic murmur occurs when?

A

during ventircular filling

74
Q

systolic murmur causes

A

anemia, pregnancy, hyperthyroidism, fever, exercise

75
Q

Name for loud, rumbling sounds caused by shifting fluid/gas in bowel?

A

Borborygmi

76
Q

Do you palpate the painful part of the abdomen FIRST or LAST?

A

LAST!

77
Q

Tympanic abdominal percussion indicated what?

A

air-filled intestines

78
Q

Dull sounds on percussion of abdomen indicate?

A

organomegaly, masses or fluid

79
Q

high pitched bowel sounds can indicate?

A

early bowel obstruction

80
Q

term for redness of skin caused by inflammation

A

Rubor

81
Q

what causes shiny skin on extremities

A

peripheral vascular disease

82
Q

What is hemosiderin staining?

A

brown skin color caused by iron deposits within cells
seen with venous insufficiency and iron overload

83
Q

what is clubbing and what causes this?

A

def: enlargement of tissue at distal phalange which occurs over long periods of time from chronic cardiovascular/respiratory disorders

Cardiac Vascular Certification (6 decks)

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