cardiovascular assessment

Question 1

What are the key landmarks in this assessment?

Answer 1

Third costal cartiliage, sixth costal cartilage, second intercoastal space, fith intercoastal space, midclavicular line.

Question 2

What does tachy/brachycardia mean?

Answer 2

A fast or slow heart rate.

Question 3

What does odema mean?

Answer 3

Swelling caused due to excess fluid accumulation in the body tissues

Question 4

What are the four main components of this inspection?

Answer 4

Inspection, palpatation, percussion, auscultation - IPPA

Question 5

Before performing IPPA , what should we do?

Answer 5

End of bed assessment

Question 6

What are we looking for in the end of bed assessment?

Answer 6

How does the patient look? - positioning, eye contact, cynosis, clammy/ sweaty, pale or grey, increased work to breath, reduced level of consciousness, environmental factors.

Question 7

What would you do after conducting the end of bed assessment?

Answer 7

Gain consent and conduct the primary survey

Question 8

After the primary survey, what do you look at?

Answer 8

Hands

Question 9

What are we looking for when looking at the hands?

Answer 9

The colour (cynosis may indicate hypoxaemia), finger clubbing, conduct a capillary refill time test, Janeway lesions, splinter hemorrhage (trauma to the nails).

Question 10

What should you look for when feeling for the radial pulse?

Answer 10

Assess the rate, rhythm and volume. Feel both pulses simultaneously (are they equal)

Question 11

What are we inspecting for on the chest?

Answer 11

Bruising, redness, rashes, scars (pacemaker?), swelling.

Question 12

Is there anything to percuss when completing this assessment?

Answer 12

No

Question 13

Why do we palpate the chest?

Answer 13

For any pain or tenderness or any abnormalities.

Question 14

Where do you palpate?

Answer 14

The apex beat, this is the most lateral and inferior position where the heart can be felt.

Question 15

Where is the apex beat located?

Answer 15

It is located in the 5th intercostal space on the midclavicular line

Question 16

What are palpable heart murmurs beneth the chest wall and feel like small vibrations called?

Answer 16

“Thrills”

Question 17

Where would you palpate for thrills?

Answer 17

Placing your hand across the patients chest - in the center

Question 18

Why would you auscultate the lung bases?

Answer 18

To assess for any fluid which may indicate signs of heart failure

Question 19

Where do you auscultate for the different heart sounds

Answer 19

Aortic - 2nd intercostal space, right side sternal border. Pulmonary - 2nd intercostal space, left side sternal border. Tricuspid - 4th intercostal space, left lower border/ Mitral - 5th intercostal space, mid clavicular.

Question 20

What do normal heart sounds do?

Answer 20

Make noise when they close but not when they open

Question 21

What would you assess the abdomen for?

Answer 21

A pulsatile mass - this could be a abdominal aortic aneurysm. Ascites - fluid in the peritoneal cavity, can be a sign of heart failure

Question 22

When looking at the legs what are we looking for?

Answer 22

Peripheral odema (accumulation of excessive fluid in the interstitial tissues) - leaves an indentation when you apply pressure with your finger. Assessing the limbs for adequete bloof supply (pain, pallir, paralysis, parathesia, pulsess, perishing cold). Deep venous thrombosis

Question 24

When looking at the hands what are we checking for?

Answer 24

Cap refill time, the colour of the hands (cyanosed), clubbing, splinter haemorrhaging, janewsy lesions