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Assessment Test 2 > Cardiovascular 2 > Flashcards

Cardiovascular 2 Flashcards

1
Q

focused health history

A

Chest pain; Palpitations, syncope, edema, fatigue, vascular changes in extremities; Risk factors for CAD; Allergies; Family; Psychosocial—activity, stress, diet, habits; Review of Systems

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2
Q

risk factors for CAD

A

obesity, smoking, high cholesterol

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3
Q

inspect Precordium

A

Aortic area—2nd ICS RSB; Pulmonic area—2nd ICS LSB; Anterior precordium—lower half of sternum at LSB & RSB; Apex—5th ICS LMCL (PMI/apical impulse; Epigastric area

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4
Q

inspecting neck vessels

A

Carotid Artery - Bruits; Jugular Veins - Jugular Vein distention (JVD)

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5
Q

inspect carotid arteries

A

look at intemaljugular veins to see how full they are, if prominent then have black flow; then palpate one at a time; feel for up stroke of pulse; note consistency and rhythm

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6
Q

Carotid Arteries Alterations

A

Pulse is Bounding; Diminished either unilaterally or bilaterally; Diminished or thready; Bruits (heard during auscultation)

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7
Q

ausculate carotid artery

A

w/ bell (lower pitched sound) have pt hold breath and listen for “swooshing” bruits; ausculate on both sides

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8
Q

5 areas for auscultation

A

Aortic (2nd ICS RSB); Pulmonic (2nd ICS LSB); Erb’s point (3rd ICS LSB) sometimes called 2nd pulmonic area; Tricuspid (4th ICS LSB or left lower sternal border SB); Mitral (5th ICS LMCL)

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9
Q

heart sounds

A

S1 (lub) closure of AV valves; S2 (dub) closure of Semilunar valves; Physiological split S1 and S2

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10
Q

s3

A

(early diastole) rapid ventricular filling; S3 may hear normally in children and young adults

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11
Q

s4

A

(late diastole) non-compliant ventricle

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12
Q

decrease in pulse

A

reduced fluid volume so decrease cardiac output

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13
Q

Characteristics of Murmurs

A

Intensity—graded 1 through 6; Placement in the cardiac cycle—systolic or diastolic; Location—best heard; Quality—blowing, harsh, musical; Pitch (frequency)—high, low

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14
Q

diastolic murmurs

A

Mitral stenosis- stiffness of value; Aortic regurgitation - floppy value

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15
Q

systolic murmurs

A

Aortic stenosis - high pitch blowing; Mitral regurgitation - floppy value

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16
Q

s1 s2 s3

A

slooshing in lub dub da; fluid building up , indicates heart failure

17
Q

s4 s1 s2

A

a stiff wall; atrical contraction before s1, if ventricle non-compliant causes fluttering of valve; s4 indicates MI

18
Q

Friction Rubs—

A

pericarditis, pleural effusion; grading of harsh sounds

19
Q

clicks and snaps

A

usually stenosis of valveor mitral valve prolapse; or mechanical valve replacement have to stay on coumadin

20
Q

angina pectoris

A

chest pain from myocardial ischemia

21
Q

Congestive Heart Failure (CHF)

A

heart does not pump sufficiently to meet demands of body/cells

22
Q

Coronary Artery Disease (CAD)

A

narrowing of coronary arteries R/T atherosclerosis

23
Q

Pericarditis

A

Inflammation of pericardial sac

24
Q

listen to rushing of blood flow

A

usually graded 1 - 6 ; 1 - usually soft and hard to hear; 6 - very loud, harsh; location base A,P; apex M,T

25
Q

normal JVD measurement normal

A

less than 3 cm

26
Q

Peripheral Vascular

A

Inspection, Palpation, Auscultation; Clubbing of nail beds; Capillary refill < 3 sec; Grading of Pulses (+1 to +4); Homan’s sign; Allen’s test

27
Q

Pitting Edema

A

1+ mild (2mm depression)—disappears rapidly, no distortion; 2+ moderate (4mm depression)—disappears in 10-15 seconds, no distortion; 3+ deep (6mm depression)—last > minute, extremity looks swollen; 4+ frank/severe (8mm depression)—last 2-3

28
Q

pulse amplitude

A

0 absent, no palpable + 1 Weak, Thready; + 2 Normal; + 3 full, increased; + 4 Bounding

29
Q

Arterial insufficiency

A

Return to color taking longer or persistent-dependent rubor (redness); Ankle-brachial Index (ABI); Systolic Ankle pressure/Systolic brachial pressure = _____ %; Results > 1.0 or greater is normal; Results < .90 or less = Arterial insufficiency

30
Q

age related considerations

A

Arterial Circulation; Cardiac Function; Blood pressure changes; Activity Change (DVT, Venous stasis

31
Q

holostolic

A

occurring during all systole

32
Q

holodistolic

A

occurring during all diastole

33
Q

crescendo

A

increasing in intensity

34
Q

descendo

A

decreasing in intensity

35
Q

plateau

A

remain constant

36
Q

continuous murmur

A

begin in systole and continue through s2

37
Q

tricuspid stenosis

A

loudest in mid-distole; increase with inspirations; has a rumbling quality

Assessment Test 2 (8 decks)

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