Cardiac Assesment

Question 1

Blood flow in the heart

Answer 1

Atrium to ventricle, valves are open, blood keep filling and filling, until the heart beats, right atrium pushes blood into left ventricle, then the valve opens

Question 2

Heart Valves

Answer 2

Atrioventricular-between atria and ventricles
Tricuspid=opens from right atrium to right ventricle
Mitral opens from left atrium to left ventricle

Semilunar=pulmonic and aortic valve

Question 3

Neck Vessels

Answer 3

Carotid artery and jugular artery

Question 4

Subjective data for cardiovascular assessment

Answer 4

Chest pain
Dyspnea
Orthopnea
Cough
Fatigue
Cyanosis or pallor
Edema
Nocturia
Past cardiac history
Family cardiac history
Personal habits

Question 5

Socioeconomicfactors

Answer 5

high blood pressure
smoking
serum cholesterol
obeisity
diabetes

Question 6

Non-modifiable vs modifiable risk factors

Answer 6

Non-modifiable-age, gender, genetic factors, race and ethnicity
Modifiable-high BP, smoking, diabetes mellitus, physical inactivity, obesity, high blood cholesterol

Question 7

Additional health questions

Answer 7

Infants-maternal health, feeding without tiring, growth, milestones
Children-growth, activity, headaches and nosebleeds, respiratory disease
Adult-hyper or hypotension
Older adults-disease, medications, environment

Question 8

Women and heart attacks

Answer 8

often ignored
women minimize symptoms
ovaries decrease estrogen production=increased LDLs, blood pressure and body fat, sugar metabolism affected

Question 9

Objective Assessment

Answer 9

Inspection
Palpation
Percussion
Auscultation

Question 10

Physical Exam

Answer 10

Carottd artery while client is sitting-palpate and auscultate
Assist client to sitting position-inspect anterior chest(deformities, pulsations, skin) then palpate apical impulse, palpate for thrills, repeats laterally because the heart moves spots and blood flow shifts

Question 11

Landmarking the chest

Answer 11

intercostal spaces
Midclavicular line
Sternal border
axillary lines

Question 12

Physical Exam continued

Answer 12

Precordium
Inspect anterior chest, palpate apical impulse, palpate across precordium, percuss outline of cardiac borders

Question 13

Identify auscultatory areas

Answer 13

S1 is louder than S2 at apex
S1 coincides with carotid artery pulse
2ndLCS, RSB (aortic)
2nd LCS, LSB (pulmonic)
5th ICS, LSB (tricuspid)
5th ICS, LMCL (mitral)

Question 14

Auscultory Pneumonic

Answer 14

APe To Man

Question 15

What is split S2

Answer 15

Normal occurrence at the end of inspiration
Inspiration -aortic closes before pulmonary
Dup becomes T-Dup
Expiration-aortic and pulmonic valves close together
Usually heard in pulmonic valve area

Question 16

Murmurs

Answer 16

Blowing/swooshing from turbulent blood flow
Frequently found with a thrill

Question 17

Physical exam of murmurs

Answer 17

timing
loudness
pitch
pattern
quality
location
radiation
posture

Question 18

Extra heart sounds

Answer 18

filling sounds at LLSB in lateral position
S3 and S4
summation gallop S4,S1,S2, S3 together
pericardial friction rub

Question 19

Developmental considerations

Answer 19

Infants-difference in. apical pulse, normal heart rates, murmurs are common
Children-venous hum, innocent heart murmurs
Pregnant women-mammary souffle, changes in BP
Older adults-orthostatic hypotension, avoid pressure on carotid artery, premature ectopic beats

Question 20

Cardiovascular assessment sequence

Answer 20

Palpate and auscultate
Supine position to inspect, palpate and auscultate
Lateral position to auscultate

Question 21

DOs!

Answer 21

Take time
quiet room
warm room
solid visual
Consider what is happening when you listen to the heart

Question 22

Don’ts!

Answer 22

don’t rush
don’t push too hard
don’t forget to turn your stethescope
Don’t tell the patient about their broken heart

Question 23

Veins in peripheral system

Answer 23

Veins run parralel to arteries but there are more veins than arteries in the body, and they lie closwer to the skin so they are easier to palpate
Jugular, arm and leg veins

Question 24

Peripheral developmental considerations

Answer 24

Infants and children-transient acrocyanosis and skin mottling
Pregnant women-diffuse bilateral pitting edema and varicose veins
Older adults-arteriosclerosis, atherosclerosis, DVT, dorsalis pedis

Question 25

Health history subjective data

Answer 25

leg pain or cramps
skin changes on arm or legs
Swelling in arms or legs
Medications
Occupation
Recent travel
Recent surgery

Question 26

Arms-objective data

Answer 26

inspect and palpate skin, profile sign, capillary refill, symmetry, radial pulses, ulnar pulses and brachial pulse

Question 27

Legs- Objective data

Answer 27

inspect and palpate- skin and hair, symmetry, temperature, calf muscle, femoral pulse, popiteal pulse, posterior tibial pulse, dorsalis pedis pulse, pretibial edema, and colour

Question 28

edema

Answer 28

depress skin over bone and release
1+ is mild
2+ is moderate
3+ is swollen and pitting
4+ is very deep

Question 29

Peripheral vascular disease in legs

Answer 29

Chronic arterial insufficiency
Chronic venous insufficiency
Arterial ulcer
Venous ulcer
Diabetic changes
Chronic venous disease
Superficial varicose veins
Deep venous thrombophlebitis

Question 30

Foot care

Answer 30

foot problems are the firs sign of arthritis/diabetes/ nerve or circulatory disorders
check feet daily, dry feet carefully, trim toenails straight across
keep blood flow to feet

Question 31

Abnormal findings

Answer 31

Pain profiles of PAD
Arterial disease
Venous disease

Question 32

Deep Vein Thrombosis

Answer 32

Risk factors-bedrest immobility, surgery
Signs and symptoms-redness, swelling, pain,
Prevention-ealy mobilization, compression stockings