Cardiovascular assessment Flashcards
Where are the carotid arteries found?
Both sides of the neck, between the sternomastoid muscle and the trachea
What does the pulse of the carotid artery coincide with?
ventricular systole
Where do the jugular veins empty directly into?
the superior vena cava
What do the jugular veins reflect?
the filling pressure and volume changes
What landmarks can you find on the chest where the heart begins and ends?
the heart extends from the 2nd intercostal space to the 5th intercostal space
Where can we find the apical pulse?
the 5th intercostal space
Why can we find the apical pulse?
the apex of the heart beats against the chest wall during contraction
What is systole?
contraction of the heart
Atrioventricular valves close
blood flows from ventricle to artery
What is diastole?
heart relaxes
Atrioventricular valves open
blood flows from atria to ventricle
What is S1?
closing of AV valves in systole
LUB sound
What is S2?
Closing of the semilunar valves
the DUB sound
What is Cardiac output?
volume of blood in each systole
What is preload?
venous return that builds ip during diastole
What is afterload?
opposing pressure that the ventricle must generate to open Aortic valve against Aortic pressure
What is there to consider in the Health history during a CVS assessment?
Chest pain SOB Orthopnea Cough Fatigue Cyanosis Edema Nocturia Cardiac History Family cardiac history Personal habits
In what order do you perform a CVS assessment?
- Pulse and BP
- Extremities
- Neck vessels
- Precordium
When you are inspecting the neck vessels, what are you anticipating to see?
Bilateral pulsation of the carotid arteries
if you palpate the patient’s carotid artery near the jaw line for too long, what can happen?
You could block the sinuses and cause a drop in BP and the patient can loose consciousness
what should you feel when palpating the carotids arteries?
Carotids should feel smooth and have a force
what part of the stethoscope do you use to auscultate the neck vessels?
the bell of the stethoscope
What position is the patient in when auscultating the patient’s neck vessels?
in supine position
what should you hear when auscultating the carotid arteries?
a swishing sound
where do you palpate on the pericordium? what should you expect to feel?
palpate the 2nd to 4th intercostal space. Should be smooth and not feel anything
Why would you not be able to hear the apical pulse on a patient?
Apical pulse may be difficult to find on patients who are obese or have a thick chest wall
what do the general areas of auscultation of the pericordium represent?
Where the 4 valves of the heart are best heard
What are the 5 areas of auscultation of the pericordium? Where are they located?
- Aortic valve: right side, 2nd intercostal space
- Pulmonic valve: left side, 2nd intercostal space
- Erb’s point: left side, 3rd intercostal space
- Tricuspid valve: Left side, 5th intercostal space near sternal border
- Mitral valve: left side, 5th intercostal space,4 inches from sternal border
To auscultate the pericordium, what pattern do you auscultate?
The Z pattern
what part of the stethoscope do you use to auscultate the pericordium?
the diaphragm
When assessing apical pulse, what do you document?
rhythm, identify S1 and S2,
When inspecting and palpating arms, what assessments do you perform?
capillary refill presence of scars or lesions skin colour hair distribution moisture Palpate radial pulses bilaterally palpate brachial pulses bilaterally
what does a score of 2+ mean for a pulse?
normal
What does a score of 0 mean for pulse?
absent
what score would you give if a pulse is full or bounding?
3+
what score would you give if a pulse was weak?
1+
When inspecting the legs in a peripheral vascular exam, what would you document?
lesions
skin colour
hair distribution
varicose veins
When inspecting the legs in a peripheral vascular exam, what do you assess?
palpate with backs of hands for equal temperature
palpate femoral artery, popliteal artery, posterior tibial and dorsalis pedis
what is one method to assess pulseintead of palpating?
using a doppler machine
what are the 8 P’s of Peripheral Vascular Assessment?
- Pain
- Pallor
- Pulselessness
- Parethesia (prickling sensation)
- Paralysis
- Poikilothermic (extremities are cold)
- Pinkies
- Puffiness (edema)
How do you assess for edema?
use thumb and press over tibia. of you have an indentation, you must grade it
