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Assessment Quiz 3 > Cardio Flash Cards 2 > Flashcards

Cardio Flash Cards 2

1
Q

What things are you asking for in a cardiac health history?

A

Activity level, lifestyle choices, chest pain, palpitations, shortness of breath, and edema

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2
Q

What things are you focusing on in the activity level portion of the assessment?

A

current activity level, amount of exercise (daily, weekly, monthly), lack of exercise (preference vs. inability), pain, and sudden onset of changes in tolerable activity level

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3
Q

What are some lifestyle choices that you should ask in heart?

A

smoking, caffeine intake, alcohol use & # of drinks, and prescription or illicit drug use

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4
Q

How do you calculate pack history?

A

number of packs per day X number of years smoked

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5
Q

What kind of things do you ask about chest pain?

A

chronic/acute onset, onset & duration, aggravating relieving factors, quality, radiation to shoulder jaw, back, and neck

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6
Q

What do women typically complain of ?

A

Upper back pain rather than chest pain

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7
Q

What are the types of pain?

A

pressing, viselike, severe, and ripping

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8
Q

What do you assess in palpitations?

A

unpleasant awareness of heartbeat, described as skipping, racing, fluttering, pounding; may be due to anxiety; may be acute or chronic; associated symptoms, and aggravating or alleviating factors

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9
Q

What is dyspnea?

A

difficulty with inspiration or expiration. Sudden onset may be due to pulmonary embolism, pneumothorax (lung collapse) or anxiety

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10
Q

What is orthopnea?

A

Difficulty breathing when lying down. May be due to congestive heart failure (CHF)

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11
Q

What is paroxysmal nocturnal dyspnea?

A

Difficulty breathing and awakening during sleep. May be due to heart failure or asthma

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12
Q

What is a cough?

A

Can be productive or non-productive. May indicate congestive heart failure or coexisting pulmonary infection

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13
Q

What is edema?

A

Excessive fluid in interstitial space

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14
Q

What is dependent edema?

A

Located in feet or ankles. May be due to CHF or vascular insufficiency, norm in preggers, may have darkening around ankles, and presences of sores that don?t heal on lower extremities

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15
Q

What is periorbital edema?

A

edema in tissues surrounding eyes ( rarely a normal finding), may be due to renal or liver failure, or pre-eclampsia in preggers

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16
Q

What parts of the body are included in a heart assessments, besides the heart?

A

eyes, neck, chest, arterial pulses, venous return, blood pressure, heart rate, and pulse pressure

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17
Q

What do you assess in the neck?

A

right jugular vein pressure to estimate central venous pressure ( not used in infants and children < 12)

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18
Q

What do you assess in the chest?

A

inspection of chest wall, auscultation of sounds, palpations for PMI, or thrills

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19
Q

What does a peripheral arterial pulse tell you?

A

indicates degree of perfusions, apical pulse and radial pulse comparison

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20
Q

What does the peripheral venous system indicate?

A

Degree of return of flow to heart

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21
Q

What does the carotid pulse assessment tell you?

A

circulation to head and neck, bruits may be detected by listening w/ stethoscope.

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22
Q

What must you never do when palpating the carotid?

A

NEVER palpate both carotids at once!

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23
Q

In the examination of the neck, what are you assessing in the Jugular Venous Pressure?

A

right atrial pressure, central venous pressure, right ventricular end pressure, and easy noninvasive low-tech assessment tool for use in outpatient settings

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24
Q

What does a change in JVP indicate?

A

fluctuations in volume status, right and left ventricular function, tricuspid and pulmonic patency, pericardial pressure, and arrhythmias

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25
Q

What does a low JVP indicate?

A

hypovolemia (blood loss or extreme dehydration)

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26
Q

What does an elevated JVP indicate?

A

heart failure, pulmonary hypertension, tricuspid stenosis, and pericardial compression

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27
Q

What is the appropriate JVP Procedure?

A

raise bed/head to 30*, turn pt head to the left to view the RIGHT side, place a centimeter ruler upright on the sternal angle, identify the highest point of pulsation in the jugular vein, place a card/tongue blade horizontally from the top of the jugular vein to the ruler, make a right angle, and measure the distance above the sternal angle in centimeters. Normal is 3 to 4 cm elevation

28
Q

What are the surface landmarks for Cardio?

A

Midsternal line- MSL, Midclavicular Line-MCL, Anterior axillary line-AAL, and Midaxillary line-MAL

29
Q

Blood flows through the heart from _ to _

A

Right to Left

30
Q

What happens during a systole?

A

ventricles contract, pulmonic & aortic (semilunar) valve open

31
Q

What happens during a diastole?

A

ventricles relax, tricuspid and mitral valve is open

32
Q

What are you palpating for in the chest?

A

point of maximal impulse (PMI)- point where apex of heart taps against chest wall during systole, usually the 5th ICS at MCL

33
Q

What do you auscultate for in the chest?

A

rate and rhythm, quality and timing of valve closure, extra sounds and turbulence

34
Q

Pulsations in the chest and neck may indicate what?

A

aneurysms (ballooning of vascular walls)

35
Q

Thrills may be palpated if ??

A

a grade 3 or greater murmur is noted

36
Q

If palpation of chest wall reproduces pain, what is the most likely cause?

A

musculoskeletal factors

37
Q

What is s1?

A

closure of the atrioventricular (AV) or mitral & tricuspid valves, marks onset of ventricular contraction, and systole. Felt by palpating the carotid artery, just b4 the carotid pulse

38
Q

What is s2?

A

closure of the semilunar, aortic and pulmonic valves (creating a single sound), Diastole, 2x as long as systole (creates the lub/dub pause pattern)

39
Q

Splitting of s2 may be due to what?

A

pulmonary stenosis or pulmonary hypertension

40
Q

What is s3?

A

low frequency sound occurring early in diastole as a result of turbulence created by atrial emptying against a noncompliant left ventricular wall

41
Q

What is s4?

A

low frequency sound occurring late in ventricular diastole as a result of turbulence created by resistance to filling by ventricular noncompliance

42
Q

What are some examples of ejection sounds?

A

high frequency, sharp, clicking, sounds occurring during ventricular systole due to stenotic semilunar (aortic and pulmonic) valve closure

43
Q

When should you use the diaphragm?

A

For high pitched sounds. S1, S2, S4, and most murmurs

44
Q

When should you use the bell?

A

Low pitched sounds- S3, and rumble sound of stenosis

45
Q

Where is the aortic valve?

A

2nd right ICS along sternal border

46
Q

Where is the pulmonic valve?

A

2nd left ICS along sternal border

47
Q

Where is the tricuspid valves?

A

4th or 5th left ICS along sternal border

48
Q

Where is the mitral valve?

A

4th or 5th ICS at MCL

49
Q

What are murmurs?

A

extra sounds in the heart that are longer than s1 and s2 and have a different sound quality

50
Q

What may a murmur sound like?

A

blowing, roaring, swishing, and may have a thrill

51
Q

What is a thrill?

A

palpable findings that resemble a cat purring, rumbling, or vibration sensation in the chest wall

52
Q

How would you describe the murmur?

A

systolic or diastolic. If murmur coincides with cardiac upstroke, it’s a systolic murmur. Note duration (early, middle or late systolic/diastolic)

53
Q

What is the grading of intensity of murmurs?

A

Grade 1- Faint, may not be heard with each heart contraction, Grade 2- Quiet but may be heard easily, Grade 3- Moderately loud and heard easily, Grade 4- Loud with palpable thrill, Grade 5- Loud with thrill may be heard with stethoscope partially off chest wall, and Grade 6- Loud with thrill, heard with stethoscope off chest

54
Q

What components are apart of the peripheral vascular system?

A

Arteries, veins, lymph nodes, and lymphatic ducts.

55
Q

What are the common symptoms of the peripheral vascular system?

A

pain or cramping in arms/legs, intermittent claudication, cold, numbness, pallor in legs, hair loss, swelling in calves, legs, or feet, color change in fingertips or toes in cold weather, and swelling with redness or tenderness

56
Q

In the examination of extremities, what do you look for in the arms?

A

size, symmetry, skin color, radial pulse, brachial pulse, epitrochlear lymph nodes

57
Q

In the examination of extremities, what do you look for in the legs?

A

size, symmetry, skin color, femoral pulse, inguinal lymph nodes, popliteal, dorsalis pedis, posterior tibial pulses, and peripheral edema

58
Q

During a pulse palpation, what should you do?

A

compare side to side except on carotids, assess presence, quality, rate and regularity of pulse, use index and second fingertips on all except carotid, and apical pulse assessed with stethoscope

59
Q

What are the grading system for pulses?

A

3+ Bounding, 2+ Brisk (normal), 1+ diminished (weaker than expected), and 0 absent (unable to palpate)

60
Q

What are superficial veins?

A

located in subcutaneous tissues, poorly supported by tissues, great saphenus and small saphenus veins, and perforating veins connect superficial and deep vein systems.

61
Q

What are deep veins?

A

carry 90% of venous return from lower extremities, well supported by tissues, and valves within vein lumen propel blood back to heart, prevent pooling, venous stasis, and backflow

62
Q

What do you assess in the veins?

A

redness, tenderness, edema, distension, increased warmth, compare for symmetry in body, observe for recent trauma (IV or immobilization), measure limbs and compare, do not massage the areas, and distention may be due to superficial varicosities

63
Q

What are the assessing for in edema?

A

compare one foot and leg with the other, check for pitting edema, note severity 1+ -4+ scale, and skin darkening at ankle

64
Q

What is normal for lymph nodes?

A

round, oval, bean shaped, vary in size according to locations

65
Q

What is the important role in body’s immune system?

A

cells in lymph nodes engulf cellular debris/bact. And produce antibodies

Assessment Quiz 3 (2 decks)

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