Cardio, breast, axillae Flashcards
what are the central pulse sites?
carotid
femoral
(brachial for a pediatric patient)
if youre able to palpate a radial puse, what is the least systolic number you have?
90
if you can only get a carotid, what is their systolic bp probably around?
70
under 60 bpm
bradycardia
over 100 bpm
tachycardia
when the patient is sitting a a 30 degree angle (high fowlers) and you see a vein stick out
Jugular vein distention JVD
JVD is usually associated with some type of?
heart failure
cramping/sores is sometimes associated with?
blood clot
pale
plae lips or blue lips
redness around pacemaker
abnormal skin color
HGB and hematocrit (usually linked), anything less then ___ usually qualifies them to get blood products
8
body hair distribution on the legs that is lacking can be because of?
artery or vein return problem
when patient is runing a temp, they usually also have?
tachycardia
left side heart failure is usually associated with ?
lungs
right side heart failure is usually associated with?
JVD
clubbed fingers or toes could mean?
lack of oxygen or a cardiac issue
how do you asses for JVD?
elevate HOB to 45 to 90 degrees
locate sternal notch
visualize internal jugular vein
use flashlight to create shadow that highlight venous pulse
locate highest point where you can see pulsations
measure distance from sternal notch to highest point
DOCUMENT
is JVD is detected, what do you do?
expand assessment:
chest pain/pressure
SHOB
pale skin or pallor
bluish lips or fingernails
diaphoretic
difficulty breating/tachpnea
tachycardia
fatigue weakness
change in Level of consciousness
where are the five places you’re going to listen to cardiac sounds on the anterior chest?
All Pigs Eat Too Much
Aorta
Pulmonic
Erbs point
Tricuspid
Mitral area/apex
intercostal spaces
2-2
3
4
5
what are the valves youre going to assess?
aortic
pulmonic
tricuspid
mitral
sound like Ken-TUCK-y
S3 heart sounds
can be normal for:
young children
adults under 40
trained athletes
S3 heart sounds
what three positions are you going to listen to their heart in?
supine (HOB 30-45 degrees)
Left side lying
sitting up, leaning forward slightly
if they are sitting up and leaning forward, you are listening for ?!
HIGH PITCHED MURMUR
left lateral recumbent you are listening for?
left side low murmors
this position traps air in the hear if they somehow have an air embolis
left lateral recumbent
where is the only place bruits are normal to hear at?
fistulas
a blowing swishing sound
bruit
results from turbulent blood flow in the carotid artery
bruit
what side of your stethoscope do you use to assess for carotid bruits?
bell side
what does your patient need to do when you’re assessing for bruits?
hold their breath
is an abnormal vibration that is turbulent blood flow in the vessels
thrill
how do you assess for thrills?
palpation
ultrasonic vascular device to detect weak pulses
doppler
what is the scale for grading pulses?
0 to 4+
skin that is dry thigh and shiny, or diaphoretic is?
abnormal
absence of body hair can occur with ?
decreased arterial blood flow
cyanosis, pallor, or coolness can indicate?
poor cardiac output/perfusion
decreased or absent pulses
skin cool, pale, shiny, cecreased hair in spots
possible pain in legs and feet
thick ridged nail
toe ulcerations
these can indicate?
arterial insufficiency
pitting edema
pulse present but difficult to find
anke ulcerations
brown pigmentation
chronic venous insufficiency
chronic venous insifficiency
arterial insufficiency
may indicate heart failure or venous insifficiency
edema
may result from varicosities or thrombophlebitis
edema
what are the two types of edema?
pitting and non pitting edema
is due to fluid coagulation
non pitting edema
where skin feels unusually tight and firm, appears shiny
nonpitting edema
venous ulcer, results from venous hypertension because blood cannot return
happen in lower leg
result from progressive atherosclerois or emboli. due to insufficient blood flow to tissue. hairlesness, pale skin, diminished pulses, cool, clammy skin. are found at the distal ends of arterial branches
arterial ulcers
arterial ulcers
are when capillaries are compressed by thickened tissues and occludes blood flow to skin
lymphatic ulcers
occur secondary to lymphedema
lymphatic ulcers
lymphatic ulcer
after age 40 S3 is correlated with ?
ventricular dysfunction or volume overload
is Ten-ne-see
S4
indicates increased resistance to filling of the left or right ventricle
S4
can be a cuase of a myocardial attack or ischemia
S4
scratchy rubbing sound
pericardial friction rub
why are antibiotics given for bacterial strep throat?
to prevent pericarditis
t/f: pericarditis can be either really loud or really muffled?
true
if troponin is high, it can indicate?
a heart attack that is not picked up by EKG
abnormal enlargement of male breasts that can be caused by leukemia, alcohol use, and rapid weight gain/loss
gynecomastia
painful movable cyst
fibrocystic disease
you cant have anything fresh (fruit or flowers) on this diet
neutropenic fever/diet
