cardiovascular assessment Flashcards
What are the key landmarks in this assessment?
Third costal cartiliage, sixth costal cartilage, second intercoastal space, fith intercoastal space, midclavicular line.
What does tachy/brachycardia mean?
A fast or slow heart rate.
What does odema mean?
Swelling caused due to excess fluid accumulation in the body tissues
What are the four main components of this inspection?
Inspection, palpatation, percussion, auscultation - IPPA
Before performing IPPA , what should we do?
End of bed assessment
What are we looking for in the end of bed assessment?
How does the patient look? - positioning, eye contact, cynosis, clammy/ sweaty, pale or grey, increased work to breath, reduced level of consciousness, environmental factors.
What would you do after conducting the end of bed assessment?
Gain consent and conduct the primary survey
After the primary survey, what do you look at?
Hands
What are we looking for when looking at the hands?
The colour (cynosis may indicate hypoxaemia), finger clubbing, conduct a capillary refill time test, Janeway lesions, splinter hemorrhage (trauma to the nails).
What should you look for when feeling for the radial pulse?
Assess the rate, rhythm and volume. Feel both pulses simultaneously (are they equal)
What are we inspecting for on the chest?
Bruising, redness, rashes, scars (pacemaker?), swelling.
Is there anything to percuss when completing this assessment?
No
Why do we palpate the chest?
For any pain or tenderness or any abnormalities.
Where do you palpate?
The apex beat, this is the most lateral and inferior position where the heart can be felt.
Where is the apex beat located?
It is located in the 5th intercostal space on the midclavicular line
What are palpable heart murmurs beneth the chest wall and feel like small vibrations called?
“Thrills”
Where would you palpate for thrills?
Placing your hand across the patients chest - in the center
Why would you auscultate the lung bases?
To assess for any fluid which may indicate signs of heart failure
Where do you auscultate for the different heart sounds
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.
What do normal heart sounds do?
Make noise when they close but not when they open
What would you assess the abdomen for?
A pulsatile mass - this could be a abdominal aortic aneurysm. Ascites - fluid in the peritoneal cavity, can be a sign of heart failure
When looking at the legs what are we looking for?
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
When looking at the hands what are we checking for?
Cap refill time, the colour of the hands (cyanosed), clubbing, splinter haemorrhaging, janewsy lesions
