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SEMESTER FOUR!! Nursing 214 > Cardiovascular Physical Assessment - Exam 1 > Flashcards

Cardiovascular Physical Assessment - Exam 1 Flashcards

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1
Q

Bradycardia

A

Slow resting heart rate. Less than 60 BPM

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2
Q

Tachycardia

A

Fast resting heart rate. Above 100 BPM

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3
Q

Normal PR interval

A

0.12-0.20 seconds

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4
Q

Normal QRS interval

A

Less than or equal to 0.12 seconds

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5
Q

Normal jugular vein distention (JVD)

A

Less than 3cm at 30 degrees head elevation

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6
Q

Order of assessment

A

Insepction, Palpation, Percussion, Auscultation

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7
Q

Normal PR Interval

A

0.12-0.20 seconds which is 3-5 small boxes

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8
Q

Normal QRS Interval

A

Less than or equal to 0.12 seconds which is 3 boxes or less

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9
Q

S1

A

First heart sound. Soft “Lubb”

Occurs at the end of the QRS interval. The ventricles depolarize, causing them to contract and the M & T valves to snap shut. Happens during Systole.

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10
Q

S2

A

Second heart sound. Sharp “Dubb”

Occurs during the T wave when the ventricles relax and the A & P valves snap shut. Happens during diastole

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11
Q

Normal characteristics for pulses

A

Normally 2+, equal bilaterally, with 0 meaning absent and 4+ being strong and bounding

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12
Q

Apical Pulse

A

Pulse counted for 1 minute at the 5th intercostal mid clavicular line

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13
Q

Normal Characteristics of the Carotid Arteries

A

Pulses equal in rate, rhythm, and strength bilaterally; unchanged by inspiration, expiration, or rotation of the neck

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14
Q

Normal characteristics of heart sounds

A

Regular intervals between each sequence of beats with a distinct pause between the two sounds. AKA lub dub, each lub dub counting as one heart beat.

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15
Q

Normal characteristics of jugular veins

A

3cm or less above the sternal angle is considered normal (angle of Louis)

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16
Q

Point of Maximum Impulse (PMI)

A

Point where apex of the heart is closest to the surface in the thorax (usually 5th intercostal mid clavicular line)

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17
Q

Heaves

A

Sustained lifts of chest wall that can be seen or palpated

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18
Q

Cardiac cell makeup

A

Cell is normally negative and more potassium is inside while sodium is outside. When the cell depolarizes, the cell becomes more positive and sodium rapidly enters the cell. Repolarization is the cell slowly going back to it’s normal state.

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19
Q

Exercise/Stress Testing

A

Used to evaluate the cardiovascular response to physical stress (not used with pacemakers)

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20
Q

What can be a cause of juglar vein distention?

A

Right sided heart failure

21
Q

Orthostatic BP normal results

A

Normal reduction from supine - standing is 20mm Hg and the HR should not increase more than 20 BPM

22
Q

What is the difference between BP taken in the lower extremities VS upper extremities?

A

BP taken in the lower extremities can be expected to be 10 mm Hg higher than in the upper extremities

23
Q

Normal Capillary Refill time

A

Less than 2 seconds

24
Q

Resting ECG

A

Used for: conduction abnormalities, cardiac dysrhythmias, cardiac hypertrophy, pericarditis, myocardial ischemia, site and extent of MI, pacemaker performance, effectiveness of drug therapy

25
Q

Ambulatory ECG Monitoring

A

Diagnostic info over greater amount of time than resting ECG

26
Q

Event Monitor/Loop Recorder

A

Patient starts it when they experience symptoms

27
Q

Systole

A

Ejection of blood from ventricles when ventricles contract.

Represented by QRS on ECG tracing

Sound S1

28
Q

Diastole

A

Relaxation of ventricles and refilling of chambers

Represented by T wave on ECG

S2

29
Q

Where is S1 best heard at?

A

Apex

30
Q

Where is S2 best heard at?

A

Base

31
Q

How many seconds does each small horizontal box represent (ECG)?

A

0.04 seconds

32
Q

How many seconds does each large box represent (ECG)?

A

0.2 second

33
Q

Cardiovascular Inspection

A

Use tangent light

Look for apical impulse - 5th intercoastals mid-clavicular

Alternate position - sit up, lean forward

34
Q

Cardiovascular Palpation

A

Light touch

Point of maximal impulse (apical)

Base of heart (thrills)

Match PMI with carotid pulse

35
Q

Cardiovascular Auscultation

A
  1. Sites: aortic, pulmonic, 2nd pulmoic (3rd intercostal), tricuspid (4th intercostals), mitral (5th intercostal)
  2. Patient may lean forward
  3. Check rhythm and rate
  4. Listen S1 while palpating carotid - begins systole
  5. Listen S2 - begins diastole
  6. Sound at apex S1>S2
  7. Sound at base S2>S1
  8. Neck Auscultation (listen for bruit)
36
Q

Sinoatrial (SA) Node

A

Located in the upper right atrium

Initiates atrial depolarization and thus contraction

The natural pacemaker

Inherent rate of 60-100

37
Q

Atrioventricular (AV) Node

A

Slows the electrical impulse to give ventricles time to fill

Considered the 2nd pacemaker

Inherent rate of 40-60

Begins conduction of the impulse to the ventricles

38
Q

Bundle Branches and the Purkinje Fibers

A

Inherent rate of 20-40 if the SA and AV node stop

Ventricular depolarization and contraction

Any alteration in this conduction system is called a dysrhythmia/arrhythmia

39
Q

Isoelectric Line

A

Area on a normal ECG strip that is electrically neutral

Nothing is happening in the heart at this time (electrically)

40
Q

Normal characteristics of P Waves

A

Small

Rounded

Upright position in Lead II

One for every QRS

All same shape and size

Normal P waves indicate that the electrical impulse originated in the SA node and atrial depolarization occurred

41
Q

Normal characteristics of PR Interval

A

The time it takes for the electrical impulse to leave the SA node and travel through to the Bundle of His

Measured from the beginning of the P wave to the beginning of the QRS complex

A normal PR interval measures 0.12-0.2 seconds or 3-5 small boxes

42
Q

Normal characteristics of QRS complex

A

Represents the time it takes for the electrical impulse to depolarize the ventricles

The QRS is measured as the first wave leaves the baseline to where the last wave of the complex begins to flatten out

A normal QRS measures 0.12 (3 boxes or less)

43
Q

Normal characteristics of T wave

A

The final phase of ventricular repolarization

Normal T waves are round, upright in lead II, smaller than QRS

44
Q

How to measure heart rate from ECG

A

Refers to the ventricular rate. Count the number of R waves in a 6 second strip and multiply by 10

45
Q

How to measure rhythm using an ECG

A

Measure from P to P and R to R - is it regular or irregular? use calipers or a peice of paper

46
Q

Analyzing P waves ECG

A

Look at the P waves- is there one for each QRS, are they nearly identical?

47
Q

Analyzing PR interval ECG

A

Measure the PR interval - is it normal, between 0.12-0.2 seconds?

48
Q

Analyzing the QRS complex

A

Is each QRS preceded by a P wave? Do they all look nearly identical and is the complex less than or equal to 0.12 seconds?

SEMESTER FOUR!! Nursing 214 (52 decks)

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