Ch. 11 Heart

Question 1

adult heart size and position is reached at what age?

Answer 1

7

Question 2

pregnant women it is common to hear _ and _ and _ splitting

there is a _ to _ % increase in heart rate

A _ _ murmur is also common in 90% of pregnant women

Answer 2

S3
S1 and S2 splitting after 20 weeks of gestation

10-30%

systolic ejection

Question 3

During the third trimester _ and _ increase because of the position of the uterus

observe for:

Answer 3

dyspnea and orthopnea

Paroxysmal nocturnal dyspnea, hemoptysis, syncope with exertion and chest pain.

Question 4

percussion is not normally formed on

Answer 4

cardiac system

Question 5

systole is when ventricles contract causing the _ and _ to close this make the sound of _

Answer 5

tricuspid and mitral valves

S1. (lub).

Question 6

S2 sound is when the _ and _ valves close

Answer 6

pulmonic and aortic. (dub)

Question 7

Levine sign is

Answer 7

clenched fist to explain chest pain

Question 8

sequence of cardiac assessment is first

Answer 8

inspect, palpate, percuss then auscultate.

Question 9

PMI in children is where?

Answer 9

4th intercostal space medial to the nipple in children.

Question 10

Diaphragm is best used to hear (firm pressure)

Bell is best used to hear

Answer 10

higher frequency sounds

lower frequency sounds (light pressure)

Question 11

S2 split heard when

Answer 11

increased with inhalation in all auscultatory area

Question 12

Listen to all 5 areas of heart with patient sitting up to detect

left lateral recumbent listen to all 5 best for

Answer 12

high pitched murmurs with diaphragm.

diastole low pitched filling sounds.

Question 13

S2 is _ than S1 at the base of the heart

Answer 13

louder

Question 14

S1 is when the _ and _ valves close

Best heard at the _

Answer 14

mitral and tricuspid

apex of the heart

Question 15

S4 is commonly heard in _

a loud s4 always suggests pathology and deserves additional evaluation.

Answer 15

elderly, but also caused by (HTN , prego, thyrotoxixosis).

A loud S4 sound is abnormal in a prego

Question 16

a _ _ _ can be mistaken for cardiac sounds

Answer 16

pericardial friction rub.

Question 17

the most common source of significant murmurs is the anatomic disorders of the _ _

Answer 17

heart valves

Question 18

S3 and S4 are commonly heard in _’

_ are also common until 48 hours

Answer 18

infants

murmurs

Question 19

Kawasaki disease accounts for most acquired _ in infants and children

Answer 19

murmurs

Question 20

a _ _ murmur may be heard over the pulmonic area in about 90% of prego patients

Should not be greater than _ murmur

(Presence of cyanosis, clubbing, or neck vein distention or diastolic murmur suggests abnormality)!!!

Answer 20

systolic ejection

II

Question 21

frailty syndrome characterized by signs and symptoms of being frail: such as

Answer 21

weakness, slowing, decreased energy, lower activity, unintended weight loss.

can lead to hospitalization falls, death fracture

Question 22

With an MI which heart sound is usually present?

Distant heart sounds occurs and thready pulse

Soft systolic blowing apical murmur common

Answer 22

S4

Question 23

normal jugular venous pressure is

Answer 23

less than 9 cm H20

Question 24

Hepatojugular reflex is used when suspect

Place pressure on _ region for _ seconds

Answer 24

right sided heart failure

midepigastric region, 10 seconds

Question 25

bounding pulse in an infant can mean capillary refill time for an infant and child up to 2 years old is _

Answer 25

patent ductus arteriosus 1 second (longer than 2 means dehydration or hypovolemic shock).

Question 26

coarctation of aorta pulse will be different between

Answer 26

femoral and radial. femoral may be absent

Question 27

Peripheral edema and varicose veins is normal in elderly less likely to find the pulses in the _ _ and veins may appear

Answer 27

pregnant women dorsalis pedis, posterior tibial pulses tortuous and distended