Cardiac Assessment

Question 1

Normal troponin value

Answer 1

less than .1

Question 2

MI troponin level

Answer 2

.4

Question 3

Troponin level to check with MD

Answer 3

.1-.4

Question 4

Apical Pulse

Answer 4

palpate at 5th interspace, midclavicular vertical line

Question 5

Femoral Pulse:

Answer 5

Palpate over femoral artery in inguinal area

Question 6

Popliteal

Answer 6

palpate over popliteal artery, behind the knee with the knee flexed slightly

Question 7

Pedal

Answer 7

palpate over dorsalis pedis artery, dorsal medial aspect of foot; used to monitor lower extremity circulation

Question 8

Tachycardia

Answer 8

> 100bpm

Question 9

Bradycardia

Answer 9

< 60bpm

Question 10

Postural Tachycardia Syndrome

Answer 10

Sustained heart rate increase > or equal 30 bpm within 10 mins of standing (> or equal 40bpm in teens)

Question 11

Irregular Pulse

Answer 11

Variations in force and frequency; my be due to arrhythmias, myocarditis

Question 12

Weak, Thready Pulse

Answer 12

May be due to low stroke volume, cardiogenic shock

Question 13

Bounding, Full Pulse

Answer 13

May be due to shortened ventricular systole and decreased peripheral pressure; aortic insuffiency

Question 14

Normal MAP

Answer 14

70-110 mmHg

Question 15

Aortic area

Answer 15

Near 2nd intercostal space just right of sternum

Question 16

Pulmonic area

Answer 16

2nd intercostal space just to the left of the sternum

Question 17

Tricuspid area

Answer 17

Lower left sternal border 4th intercostal space

Question 18

Bicuspid/Mitral area

Answer 18

5th intercostal space medial to the midclavicular line

Question 19

S1: “LUB”

Answer 19

Normal closure of mitral and tricuspid valves
Marks beginning of systole
Decreased in 1st degree heart block

Question 20

S2: “DUB”

Answer 20

Normal closure of aortic and pulmonary valves
Marks end of systole
Decreased in aortic stenosis

Question 21

Gallop Rhythm

Answer 21

An abnormal heart rhythm with 3 sounds in each cycle; resembles the gallop of a horse

Question 22

1st Heart Sound

Answer 22

S1 (the lub of the lub-dub)
Associated with the closure of the mitral and tricuspid valve
Corresponds with onset of ventricular systole

Question 23

The 2nd Heart Sound

Answer 23

S2 (the dub of the lub-dub)
Associated with the closure of the aortic and pulmonary valves
Corresponds with the end of systole
Has greatest intensity when auscultated at aortic or pulmonary regions

Question 24

3rd Heart Sound

Answer 24

Occurs early in diastole while the ventricle is rapidly filling
Immediately following S2 and sounding like lub-dub-dub
Low pitched and must be auscultated with bell
Best performed with patient laying on left side so apex is closest to chest wall

Question 25

S3: Ventricular Gallop

Answer 25

Kentucky” – “Lub-Dub-Dee” “Slosh-in-in”
May be audible after S2
Low pitched sound near apex (Bell)
Normal in healthy children, young adults, & athletes
Represents diastolic dysfunction or reduced ventricular compliance

Question 26

S4 “Tennessee”

Answer 26

Heard in patients with:
Hypertensive heart disease
CAD
Cardiomyopathy

Question 27

Jugular Vein Distention

Answer 27

Positive if vein distends above level of the clavicle

Sign of: Right sided heart failure

Question 28

Right Sided Heart Failure:

Answer 28

Swollen legs/feet
Upset stomach
Loss of appetite
Nausea/vomiting
Low BP 
Sudden weight gain of 10+ pounds

Question 29

Left Sided Heart Failure:

Answer 29

SOB
Cough
Pink Frothy tinged sputum
Difficulty breathing lying down