Cardiovascular Flashcards
How to inspect the anterior chest apical impulse
Look for pulsations at the fifth ICS at midclavicular line
Expected finding for anterior chest apical impulse
Usually not visible, but seen easier in children and thin adults
If apical impulse is visible in an adult it may indicate ___
Ventricular hypertrophy (enlargement)
If a person isn’t orientated x3, they may not be ____
Getting enough oxygen to their brain
How to assess jugular vein distention
Inspect patient’s neck when they are sitting up at least 45°, and have them turn their neck
Expected finding for jugular vein distention
JVD is seen while patient is laying flat, but not seen when patient sitting upright
If you can see JVD when the person is sitting upright, they could have ____
Right sided heart failure
Mucous membranes of the eyes
Conjunctiva
Lack of oxygen in the blood
Hypoxemia
If a patient has pallor, they could be ___
Anemic
If patient skin and nail color is as expected, they have ___ ___
Adequate perfusion
How to perform apical impulse palpation
Turn patient on left side, place hand at the fifth intercostal, ask client to exhale, and feel for pulsation
Expected finding for apical impulse palpation
Not palpable in ___ or ___ people
You may feel it.
Not palpable in obese people or in thick chest-walled people
If we are able to feel the apical impulse during palpation, it may indicate what?
Enlargement of the heart
Name 7 pulses locations
Carotid, brachial, radial, femoral, popliteal, dorsalis pedis, posterior tibial
In the interior of the elbow lies which pulse?
Brachial pulse
What pulse is in the wrist closest to the thumb? 
Radial
What pulse is behind the knee?
Popliteal, and you’re not supposed to be able to feel it
Where does the posterior tibial pulse lie?
Inner ankle
Where does the dorsalis pedis pulse lie?
On top of the foot
When we are unable to palpate a pulse, we use the __
Doppler
When we use a Doppler, we cannot document ___
Amplitude
Force or pumping action of the blood
Amplitude
What is the number scale for amplitude and each number’s meaning?
3+ increased, full, bounding
2+ expected
1+ weak, thread (shock)
0 absent
Expected finding for amplitude?
2+
What does an amplitude of 1+ tell me about my patient?
May have low blood pressure due to low blood volume or a narrow vessel
What does an amplitude of +3 tell me about my patient? Name 4
Patient may have increased blood volume, is anxious, has a fever, or they just exercise
Electrical conduction system of the heart
Rhythm
What does rhythm tell me about my patient’s heart rate?
If the heart rate is irregular
An irregular heartbeat can be caused by ___ ___, most common is ___ ___
Cardiac dysrhythmias; atrial fibrillation
Normal heart rate for an adult is
60-100 BPM
____ is an expected finding for the pulse, because we have 2 of each
Symmetry
What does symmetry tell me about my patient?
Patient’s vessels (vasculature) are the same on both sides, no narrowing on either side
Use backside of hands when assessing persons ___ ___
Skin temperature
How do you assess if the patient has good skin turgor?
Lightly pinch skin below clavicle, hold for a few seconds and do a quick release
What is the expected finding for skin turgor? 
Skin should snap back to its normal position
Used to test hydration status
Skin turgor
Patient is dehydrated and has poor skin turgor
Tenting
Depressing nail bed until it turns white during capillary refill assessment
Blanching
What tells me the most distal corporal perfusion is intact?
Assessing capillary refill. Patient is getting circulation all the way down to their fingertips
Fluid that seeps into the tissues and doesn’t return to the cardiovascular space
Edema
Indicates heart failure or liver disease
Edema
Edema scale 1+ (name 4)
Less than 2 mm indentation, slight pitting, no visible swelling, disappears rapidly
Edema scale 2+ (name 2)
2-4 mm indentation, takes 10-15 seconds to disappear
Edema scale 3+ (name 2)
4-6 mm indentation, 1 or more minutes to disappear
Edema scale 4+ (name 3)
6-8 mm indentation, 2-5 minutes or more to go away, grossly distorted
An extreme case of edema where the legs are very large, shiny, and taught (tight)
Anasarca
Extremity inspection (SEE)
Skin color/condition, edema, equal
Extremity palpation (PEET)
Pain, edema, equal, temperature
Lack of hair growth indicates what?
Lack of arterial blood flow to the hair follicle
Lack of arterial blood flow to the hair follicle is caused by what?
Narrow blood vessel
When assessing carotid bruit, use ___ of stethoscope. Name 3 places to auscultate
Bell;
Angle of jaw, mid cervical area, and base of neck just above clavicle
Expected finding when auscultating for a carotid bruit
NO swishing sounds
You would either hear nothing for a feint heartbeat
If you hear a carotid bruit, this means there is a narrowing in the carotid artery, maybe due to ___
Atherosclerosis
Patient is not getting sufficient blood to the brain and they are more likely to have a stroke if they have ___
Atherosclerosis
___ is not needed for the cardiac assessment
Percussion
Name 5 heart sounds
Aortic, pulmonic, erb’s point, tricuspid, mitral
Use the ___ of the stethoscope when auscultating the heart
Diaphragm
Systole, lub, loudest at apex
S1
Diastole, dub, loudest at base
S2
S1 is the closure of which valves?
Mitral and tricuspid
S2 is the closure of which valves?
Aortic and pulmonary
If heart rhythm is irregular, there is a ___ problem
Conduction
If you hear a swish sound on S1 or S2, this could be a ___ problem 
Valve
Unexpected findings when auscultating apical heart rate? (Name 3)
Bradycardia, tachycardia, or an irregular heartbeat
Auscultating the apical heart rate tells us if our patient has ___, ___, or ___
Bradycardia, tachycardia, or an irregular heartbeat
Stage one hypertension in adults
130-139 / 80-89 mmHg
Stage two hypertension in adults
Anything greater or equal to 140 (systolic) / 90 (diastolic)
High blood pressure
Hypertension (HTN)
Low blood pressure
Hypotension
Heart rate for infant
120 to 160
Heart rate for a toddler
90 - 140
Heart rate of a preschooler
80 - 110
Heart rate of a school-aged child
75 - 100
Heart rate of an adolescent
60 - 90
Heart rate of an adult
60 - 100
The younger the age, the ____ that the heart rate is
Higher
The school- aged child is also close to the ___ and the ___ age categories
Adolescent; adult
The adolescent heart rate range is most like which other age category?
Adult
When auscultating the apical pulse, which point do you use?
Mitral or erb’s point, whichever you hear best
Name two reasons a nurse should take an apical pulse
When patient is on a cardiac medication and it is mandatory to listen to a full minute and when a patient has an irregular heart rate
Left to ___, right to ___
Limbs; respiratory
If left side of heart is not working, there is a back up in the ____
Respiratory system (crackles)
If right side of heart is not working, there is a back up in
The limbs (edema, JVD)
Bilateral edema indicates
Heart failure
Unilateral edema indicates
Lymph edema or a blood clot
