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Health Assessment > Chapter 19 &20 HA > Flashcards

Chapter 19 &20 HA Flashcards

1
Q

How long should the patient rest before performing a ankle-brachial index test?

A

5-10 minutes

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2
Q

What device do you use detect a weak peripheral pulse, to monitor blood pressure in infants or children, or to measure a low blood pressure or blood pressure in a lower extremity.

A

Doppler probe

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3
Q

A highly specific, noninvasive and readily available way to determine the extent of peripheral arterial disease

A

Doppler stethoscope

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4
Q

Which way are you going to measure a doppler probe?

A

counterclockwise

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5
Q

An ABI between 0.91 and 1 is…..

A

borderline cardiovascular risk

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6
Q

ABI Scores:

  1. 90-0.71
  2. 70-0.41
  3. 40-0.30
A

A)Mild PAD
B) Moderate PAD
C) Severe PAD, usually with rest pain except in the presence of diabetic neuropathy

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7
Q

An ABI less than 30 means……

A

Ischemia, with impending loss of tissue

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8
Q

This valve is located in the 2nd right interspace

A

Aortic Valve

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9
Q

What valve is located in the 2nd left interspace?

A

Pulmonic valve area

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10
Q

What valve is located in the left lower sternal border?

A

Tricuspid valve area

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11
Q

Fifth interspace at around left midclavicular line is located where?

A

Mitral valve area

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12
Q

What pattern should you inch your stethoscope

A

Z pattern, from the base of the heart across and down and over to the apex

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13
Q

What does a normal heart rate range from…….

A

50-95

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14
Q

The rhythm varies with the person’s breathing, increasing at the peak of inspiration and slowing with expiration

A

Sinus arrhythmias

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15
Q

When you notice any irregularities in rate or rhythm what should you check?

A

Pulse deficit by auscultating apical beat while palpating the radial pulse

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16
Q

Start of systole and thus serves as the reference point for the timing of all other cardiac sounds.

A

S1

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17
Q

Signals a weak contraction of the ventricles; it occurs with afib, premature beats, and heart failure

A

pulse deficit

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18
Q

Congenital cyanotic heart disease can cause what finding when examining the patients nails?

A

Clubbing

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19
Q

Clubbing of fingers and toes usually does not appear until when, if with severe cyanotic defects.

A

late in the first year

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20
Q

Palpate the apical impulse in the fourth interspace to the left of the midclavicular line until what age?

A

4 years old
4th interspace at midclavicular space (4-6)
5th interspace to right of midclavicular line (7)

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21
Q

A precordial bulge to the left of the sternum with a hyperdynamic precordium signals

A

Cardiac enlargement

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22
Q

What congenital defects does cyanosis occur in?

A

tetralogy of Fallots or transposition of the great arteries

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23
Q

When palpating the apical impulse what should the nurse ask the patient to do?

A

Exhale and hold their breath

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24
Q

How do you localize the apical impulse precisely?

A

by using one finger pad

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25
Q

What might you have the patient do to find the apical impulse

A

roll the person midway to the left

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26
Q

A sustained forceful thrusting of the ventricle during systole. Occurs with ventricular hypertrophy as a result of increased workload.

A

heave or lift

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27
Q

Increased force and duration but no change in location occurs with left ventricular hypertrophy and no dialtion

A

sustained impulse

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28
Q

Not palpable with ______ ______ because of overriding lungs.

A

pulmonary emphysema

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29
Q

Where can you feel apical impulse best?

A

at the end of expiration

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30
Q

What states the apical impulse increases in amplitude and duration

A

high cardiac output (anxiety, fever, hyperthyroidism, anemia)

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31
Q

Which lymphatic duct empties into the left subclavian vein?

A

Thoracic Duct (drains rest of body)

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32
Q

Which lymphatic duct empties into the right subclavian vein?

A

Right lymphatic duct (drains right side of body)

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33
Q

How does lymph flow?

A

contractions of the skeletal muscles

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34
Q

Filters the fluid before it is returned to the bloodstream and filter out microorgansims that could be harmful to the body.

A

Lymph nodes

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35
Q

Destroys RBC to produce antibodies, store RBC and to filter microorganisms from the blood

A

spleen

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36
Q

Located at the entrance to the respiratory and GI tracts and respond to local inflammation

A

tonsils

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37
Q

Is important in developing the L lymphocytes of the immune system in children, and located in the superior mediastinum behind the sternum and in front of the aorta

A

Thymus

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38
Q

Where is the SA node?

A

near the superior vena cava

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39
Q

Specialized cells in SA node near the superior vena cava initiate an……

A

electrical impulse

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40
Q

What is another name for the SA node

A

pacemaker

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41
Q

How many L of blood per minute does the heart normally pump?

A

4-6L

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42
Q

What position should the patient be in to listen to the S3 and S4 heart sounds?

A

Left lateral

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43
Q

What position should the patient be in to to listen to a soft diastolic murmur of aortic regurgitation

A

leaning forward in the sitting position

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44
Q

When doing a pulse assessment on a patient with anxiety, how might you characterize your findings?

A

+3

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45
Q

What force of pulse occurs with shock and peripheral artery disease?

A

weak, “thready”, pulse

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46
Q

Which test has replaced percussion to outline the borders of the heart?

A

chest xray or echocardiogram

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47
Q

What are chest xray’s and echoes are more accurate at detecting…..

A

heart enlargement

48
Q

What non-invasive test is performed to check for valvular incompetency?

A

Doppler ultrasound

49
Q

A split S2 sound is heard only in the _______ valve area

A

pulmonic (2nd left interspace)

50
Q

A split S2 is a normal phenomenon that occurs towards……

A

then end of inspiration in some people

51
Q

When S2 splits, what sound will you hear?

A

T-DUP

52
Q

During _______, synchrony returns and the aortic and pulmonic components fuse together.

A

Expiration

53
Q

Unaffected by respiration; the split is always there

A

fixed split

54
Q

The opposite of what you would expect; the sounds fuse on inspiration and split on expiration.

A

Paradoxical split

55
Q

During systole, happens during mitral valve prolapse, and is the most common extra sounds.

A

midsystolic click

56
Q

This is the muscle wall of the heart?

A

Myocardium

57
Q

A tough, fibrous, double-walled sac that surrounds and protects the hear

A

pericardium

58
Q

Thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves.

A

endocardium

59
Q

A thin-walled reservoir for holding blood, and the thick walled ventricles is the muscular pumping chamber.

A

Atrium

60
Q

What is the main purpose of valves?

A

to prevent backflow of blood

61
Q

Semilunar valves are the pulmonic valves in the _____ side of the hear

A

Right

62
Q

When do the semilunar valves open?

A

During systole

63
Q

Deficiency in which vitamin may increase the risk of cardiovascular disease?

A

Vitamin D

64
Q

Encourage men ages 45 to 79 years and women age 55 to 79 years to use what if potential benefit of preventing MI outweighs the potential risk of GI bleeding?

A

Aspirin

65
Q

Vitamin D deficiency can be associated with what medical conditions?

A

HTN, diabetes, metabolic syndrome, left ventricular hypertrophy, and chronic vascular inflammation

66
Q

To screen for heart disease in infant, what should we observe?

A

fatigue during feeding

67
Q

Which node is in the antecubital fossa and drains the hand and lower arm?

A

Epitrochlear Node

68
Q

In the groin drain most of the lymph of the lower extremity, the external genitalia, and the anterior abdominal wall.

A

Inguinal nodes

69
Q

How do you check the epitrochlear nodes?

A

shake the patient’s hand and reach your other hand under their elbow to the groove between the biceps and triceps muscles

70
Q

Epitrochlear node occurs in what condition?

A

generalized lymphadenopathy

71
Q

When auscultating the carotid artery, you hear a blowing, swishing sound. What is this called?

A

Bruit

72
Q

Bruit increases risk of…..

A

transient ischemic attack and ischemic stroke

73
Q

Radiate tot he neck and must be distinguished from a local bruit

A

aortic valve murmurs (aortic stenosis)

74
Q

A bruit indicates turbulence from a local vascular cause and is a marker for…..

A

atherosclerotic disease

75
Q

A carotid bruit is audible when the lumen is occluded by

A

1/2 to 2/3

76
Q

Auscultate the Carotid Artery using the ____ of the stethoscope.

A

bell

77
Q

Where is S1 heard the loudest at?

A

the apex

78
Q

Occurs with closure of the semilunar valves and signals the end of systole.

A

S2

79
Q

Where is S2 is loudest over?

A

Base of the heart

80
Q

The QRS complex occurs during which part of the cardiac cycle?

A

Depolarization of the ventricle

81
Q

The P wave occurs during which part of the cardiac cycle

A

Depolarization of the atria

82
Q

the time necessary for atrial depolarization plus time for the impulse to travel through the AV node to the ventricles

A

PR inerval

83
Q

A thrill in the 2nd and 3rd RIGHT interspaces occurs with what condition?

A

Aortic stenosis and systemic hypertension

84
Q

A thrill in the 2nd and 3rd LEFT interspaces occurs with what condition?

A

pulmonic stenosis, pulmonic hypertension

85
Q

Pressure overload is found in what conditions?

A

aortic stenosis or systemic hypertension

86
Q

Which artery travels behind the medial malleolus and forms the plantar arteries?

A

posterior tibial artery

87
Q

Major artery of the leg, passes under the inguinal ligament. Travels down the thigh.

A

Femoral artery

88
Q

Deficient supply of oxygenated arterial blood to a tissue caused by obstruction of a blood vessel

A

Ischemia

89
Q

Below the knees what artery is divided

A

popliteal artery

90
Q

Travels down the front of the leg on the dorsum of the foot, where it becomes the dorsalis pedis

A

anterior tibial artery

91
Q

What cardiac sound is best characterized as sounding like sandpaper?

A

Pericardial friction rub

92
Q

What position is the patient in to best hear pericardial friction rub.

A

sitting up and leaning forward and the breath held in expiration.

93
Q

What is claudification?

A

Pain when walking

94
Q

The number of blocks walked or stairs climbed to produce pain.

A

Claudification distance

95
Q

What type of occlusion is associated with erectile dysfunction (Leriche Syndrome)

A

Aortoiliac occlusion

96
Q

Risk factors for Peripheral Vascular Disease (PVD)

A

Diabetes and smoking

97
Q

PND is short for what condition?

A

Paraoxsmal Nocturnal Disorder

98
Q

What does PND occur with?

A

Heart failure

99
Q

A pulmonary disorder but also occurs with mitral stenosis

A

Hemoptysis

100
Q

What increases volume of intrathoracic blood, and the weakened heart cannot accommodate the increased load. Typically the person awakens after 2 hours of sleep with the perception of needing fresh air

A

Lying down

101
Q

Arteries carry freshly oxygenated blood to all body tissues

A

High pressure system

102
Q

Veins drain the deoxygenated blood with its waste products from the tissues and return it to the heart

A

Low pressure system

103
Q

Engorged pulsating neck veins and liver enlargement can be seen with what cardiac condition?

A

Tricuspid regurgitation

104
Q

Stream of blood regurgitates back into LA during systole through incompetent mitral valve. Fatigue, palpitation, orthopnea, PND. Thrill in systole at apex.

A

Mitral Regurgitation

105
Q

Calcification of pulmonic valve restricts forward flow of blood. Thrill in systole at 2nd and 3rd left interspace

A

Pulmonic Stenosis

106
Q

What are the names of the semilunar valves?

A

Aortic and Pulmonic

107
Q

Sudden sharp and stabbing pain relieved often by sitting or leaning forward and worsens by lying down or with inspiration

A

Pericarditis

108
Q

Sharp or stabbing pain worsening with deep breaths.

A

Pulmonary embolism

109
Q

Occurs early in systole at the start of ejection because it results from opening of the SL valves. Open silently, but in the presence of stenosis

A

Ejection Click

110
Q

Severe narrowing of teh descending aorta, usually at the junction of the ductus arteriosus and the aortic arch, just distal to the origin of the left subclavian artery.

A

Coarctation of the Aorta

111
Q

Occurs with occlusion of a deep ven. Occurs with lympatic obstruction.

A

Unilateral edema

112
Q

Occurs with arterial deficit, especially……

A

diabetes

113
Q

Episodes of abrupt, progressive tricolor change of the fingers in response to cold, vibration, or stress

A

Raynaud Phenomenon

114
Q

Buildup of fatty plaques on intima (atherosclerosis) plus hardening, calcification of arterial wall (arteriosclerosis).

A

Arterial (Ischemic) Ulcer

115
Q

After acute DVT or chronic incompetent valves in deep veins. Account for 80% of lower leg ulcers.

A

Venous (Stasis) Ulcer

116
Q

Normal leg veins have dilated as a result of chronic increased venous pressure (obesity, multiple pregnancies) and incompetent valves that permit reflux of blood back toward leg instead of forward toward heart.

A

Superficial Varicose Veins

Health Assessment (7 decks)

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