Cardiovascular Assessment Abormalities

Question 1

Inspect-JVD

Answer 1

• distended jugular veins at 45 deg

- elevated R atrial pressure, R-sided HF

Question 2

central cyanosis

Answer 2

• blue/purple tinge (tongue, conjuctivae, inner surface of lips)
• inadequate O2 sat of arterial blood r/t to cardiac/pulm disorders (congenital)

Question 3

peripheral cyanosis

Answer 3

• blue/purple in extremeties or in nose & ears

- reduced blood flow r/t to HF, vasoconstriction, cold environment

Question 4

splinter hemorrhages

Answer 4

• small red/black streaks under fingernails

- infective endocarditis (infection of endocardium-cardiac valves)

Question 5

clubbing of nails

Answer 5

• obliteration of normal angle between base of nail and skin

- endocarditis, congenital defects, prolonged O2 deficiency

Question 6

color changes in extremities with postural change

Answer 6

• pallor, cyanosis, mottling of skin after limb elevation/ reddish- blue, glossy skin
• chronic decreased arterial perfusion

Question 7

ulcers

Answer 7

1. venous-necrotic, crater, lower leg- slow wound healing r/t poor venous return, varicose veins, incomp venous valves
2. arterial- pale, ischemic , well-defined edges; toes, heals r/t arteriosclerosis, DM

Question 8

varicose veins

Answer 8

• visible dilated , discolored, tortuous vessels in lower extremities
• incompetent valves

Question 9

bounding pulse

Answer 9

• sharp, brisk pounding pulse

- r/t hyperkinetic state (anxiety, fever), anemia, hyperthyroidism

Question 10

thready pulse

Answer 10

• weak, slowly rising easily obliterated by pressure

- r/t blood loss , decreased CO, aortic valve disease, peripheral arterial disease

Question 11

irregular pulse

Answer 11

• irreg/irreg or reg/irreg, skipped beats

- r/t cardiac dysryhthmias

Question 12

pulsus alternans

Answer 12

• reg rhythm, but strength varies with each beat

- r/t HF, cardiac tamponade

Question 13

absent pulse

Answer 13

-r/t atherosclerosis, trauma, embolus

Question 14

thrill pulse

Answer 14

• vibration of vessel or chest wall

- r/t aneurysm, aortic regurgitation, arteriovenous fistula

Question 15

pulse rigidity

Answer 15

• stiffness or inflexibility of vessel wall

- r/t atherosclerosis

Question 16

Tachycardia > 100bpm

Answer 16

exercise, anxiety, shock , need for increased output. hyperthyroidism

Question 17

bradycardia < 60 bpm

Answer 17

-rest or sleeping, SA or AV node dmg, athletic conditioning, SE of drugs, hypothyroidism

Question 18

displaced pt of maximal impulse, apical

Answer 18

-cardiac enlargement r/t CAD, HF, cardiomyopathy

Question 19

unusually warm extremities(hands, feet)

Answer 19

-possible thyrotoxicosis

Question 20

cold extremities

Answer 20

• external covering necessary comfort

- intermittent claudication, peripheral arterial disease, low CO, severe anemia

Question 21

pitting edema of the LE or sacral area

Answer 21

-interruption of venous return to the heart, R-sided HF

Question 22

abnormal capillary refill

Answer 22

• blanching of nail bed ≥2 sec

- possible reduced arterial capillary perfusion, anemia

Question 23

asymmetry in limb circumference

Answer 23

• measurable swelling of limb

- venous thromboembolism, varicose veins, lymphedema

Question 24

pulse deficit

Answer 24

• apical exceeds peripheral

- r/t cardaic dysrhythmias, atrial fibrillation/flutter or prenmature ventricular contractions

Question 25

arterial bruit

Answer 25

• turbulent flow sound in peripheral artery

- r/t arterial obstruction or aneurysm

Question 26

third heart sound (S3)

Answer 26

• extra heart sound , low pitched, heard in early diastole, gallop
• LV failure, volume overload, mitral aortic or tricuspid regurgitation, HTN

Question 27

fourth heart sound (S4)

Answer 27

• extra heart sound, low pitched, heard in late diastole, gallop
• forceful atrial contraction from resistance to ventricular filling (LV hypertrophy, aortic stenosis, HTN, CAD)

Question 28

heart murmurs

Answer 28

• turbulent sounds occurring between normal heart sounds: loudness, pitch, shape, quality, duration, timing
• heart valve disorder, abnormal blood flow patterns

Question 29

pericardial friction rub

Answer 29

• high-pitched, scratchy scound heard during s1 and s2 at the apex: best when sitting and leaning forward, while holding breath at the end of expiration
• pericarditis