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NURS 6220 Health Assessment > CV/PV/Pulm/ABD > Flashcards

CV/PV/Pulm/ABD Flashcards

1
Q

What is the angle of Louis?

A

Known at the sternal angle/notch (2nd ICS)

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2
Q

Which valves are tricuspid valves?

A

Tricuspid, pulmonic, and aortic valves

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3
Q

What valve is bicuspid?

A

Mitral valve

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4
Q

What is preload?

A

Volumes of blood and stretch in the RV at the end of diastole

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5
Q

What is afterload?

A

Pressure needed to overcome for ejection of blood from the LV

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6
Q

When are coronary arteries perfused?

A

Diastole

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6
Q

What is contractility?

A

Ability of cardiac muscle fibers to shorten; requires well-oxygenated cells

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7
Q

What is the pacemaker of the heart?

A

SA Node (60-100)

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8
Q

What is the backup pacemaker?

A

AV Node (40- 60 BPM)

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9
Q

What is a conduction delay through the bundle of his to the ventricles?

A

Bundle Branch Block

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9
Q

Inferior Leads

A

II, III, aVF

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9
Q

Lateral Leads

A

I, aVL, V5, V6

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10
Q

Septal Leads

A

V1, V2

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10
Q

Anterior Leads

A

V3, V4

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11
Q

Risk factors for CAD

A

Smoking, DM (metabolic syndrome), HTN, HLD, age, males, obesity, lifestyle choices (ETOH, diet, inactivity, family history (man <55 and women <65)

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12
Q

Used in calculations to determine CV Risk

A

Framingham, Reynold’s Score

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12
Q

What part of the stethoscope do you use for high-frequency sounds?

A

Diaphragm

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13
Q

What is claudication?

A

Pain in the muscles of the legs while active, which is relieved by resting

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14
Q

What part of the stethoscope do you use for low-frequency sounds?

A

Bell

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14
Q

What is Levine’s Sign?

A

Gesture where a person clenches their fist and holds it over their chest to indicate ischemic chest pain

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15
Q

Where do you auscultate the aortic valve?

A

2nd ICS, RSB

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15
Q

Where do you auscultate the pulmonic valve?

A

2nd ICS, LSB

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16
Q

Where do you auscultate the tricuspid valve?

A

4th/5th ICS LSB

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17
Q

Where do you auscultate the mitral valve?

A

5th ICS, MCL

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18
Q

What are heaves?

A

Abnormally forceful and sustained systolic pulsation in the heart- signifies RV enlargement

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18
Q

Where is your PMI?

A

Same as Mitral Valve auscultation (5th MCL)

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19
Q

What does JVP estimate?

A

RA pressure and preload

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20
Q

PAD symptoms:

A

painful legs, claudication, pallor, cold extremities, weak pulses

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20
Q

What is a normal JVP?

A

<8 cm H20

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21
Q

PVD symptoms:

A

LLE swelling (DVT=unilateral), distended veins, poor wound healing, loss of hair, skin discoloration

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22
Q

What is ABI?

A

A non-invasive test that compares the BP in the ankle to the BP in the arm (This number should be equal in a healthy person)

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23
Q

Grading pulses

A

3+ bounding/not normal, 2+ brisk/expected, 1+ diminished/weaker than expected, 0 absent to palpation (need doppler)

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24
Q

What are the major veins of the legs?

A

Great saphenous and femoral

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24
Q

What is Allen’s Test?

A

Ulnar patency- evaluates the collateral flow of the hand (Needed before ABG or cardiac cath)

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25
Q

What percent of venous return do the lower extremities provide?

A

90%

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25
Q

What is pectus excavatum?

A

a chest wall deformity that causes the sternum and ribs to grow abnormally, resulting in a caved-in or sunken appearance of the chest

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26
Q

Atherosclerosis anywhere=

A

Atherosclerosis everywhere

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27
Q

What is pectus carinatum?

A

a deformity of the chest wall in which the breastbone and ribs are pushed outward

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28
Q

What does tactile fremitus assess?

A

Presence of effusions, consolidation, or thickening

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29
Q

What does subcutaneous air indicate?

A

Presence of pneumothorax (rice krispy sensation)

30
Q

Percussive lung sound for normal healthy lung tissue?

A

Resonance

31
Q

Percussive lung sound in the presence of a pleural effusion or bone is?

A

Dull

32
Q

Percussive lung sound produced with the presence of an air-filled bullous

A

Tymphany

33
Q

Lung sounds that are soft and low pitched. They are heard throughout inspiration, continue without pause through expiration, and then fade away about one third of the way through expiration.

A

Vesicular

34
Q

Inspiratory and expiratory sounds about equal in length, are at times separated by a silent interval. Detecting differences in pitch and intensity is often easier during expiration.

A

Bronchovesicular

35
Q

Lung sounds that are louder, harsher and higher in pitch, with a short silence between inspiratory and expiratory sounds. Expiratory sounds last longer than inspiratory sounds.

A

Bronchial

36
Q

What age group is more likely to have an NSTEMI?

A

Elderly

36
Q

S1Q3T3 means?

A

Deep S wave in lead I, deep Q wave in lead III, and inverted T wave in lead III (PE on ECG w/ right axis deviation)

36
Q

Lung sounds that are loud harsh sounds heard over the trachea in the neck.

A

Tracheal

37
Q

What age group is more likely to have a STEMI?

A

Young adults

38
Q

What type of coronary infarctions cause hypotension?

A

Right- decreases preload, decreases stroke volume

39
Q

Who should you always screen for PVD?

A

Smokers

40
Q

What does the peritoneum do?

A

Provides insulation, lubrication structure, blood/lymph/nerve supply, and immunity

41
Q

What organs are in the RUQ?

A

Ascending colon, duodenum, gallbladder, right kidney, Liver, pancreas(head), transverse color and right ureter

42
Q

What organs are in the RLQ?

A

Appendix, ascending colon, bladder, cecum, rectum, ovary/uterus/fallopian tube, prostate/spermatic cord, small intestine, right ureter

43
Q

What organs are in the LLQ?

A

Bladder, ascending colon, ovary/uterus/fallopian tube, prostate/spermatic cord, small intestine, sigmoid colon, left ureter

44
Q

What organs are in the LUQ?

A

Descending colon, left kidney, pancreas (body and tail), spleen, stomach, transverse colon, and left ureter

45
Q

What are the 9 regions when a complaint doesn’t fit in quadrants?

A

R/L hypochondrium, R/L lumbar, R/L illiac region, Epi/hypogastric, and umbilical region

46
Q

How long is chronic abdominal pain classified?

A

> 12 weeks

47
Q

How short is acute abdominal pain classified?

A

<12 weeks

48
Q

What is dysphagia?

A

Difficulty swallowing

49
Q

What is odynophagia?

A

Painful swallowing

50
Q

What is globus sensation?

A

Lump or something stuck in your throat

51
Q

What are common middle age abdominal issues?

A

Colon cancer, hemorrhoids, uterine fibroids, AAA, hernias

51
Q

New confusion in elderly needs?

A

UTI evaluation

52
Q

What are common elderly abdominal issues?

A

Constipation, polypharmacy, appendicitis, incontinence, BPH, nocturia, UTI, POOP (pain out of proportion), SBO, weight loss (RED FLAG), epigastric pain (inf. MI)

52
Q

What are common pregnancy-associated abdominal issues?

A

Issues with constipation, appendix, gallbladder, frequent urination

53
Q

Pain that is difficult to localize, usually near midline, varies in quality

A

Visceral (organ)

54
Q

Pain that indicates peritonitis, steady/aching, more precisely localized, aggravated by coughing/movement

A

Parietal (Somatic)

55
Q

What is striae?

A

Stretch marks

56
Q

In what illness would you see a protuberant abdominal contour?

A

Someone who has ascities (Pregnancy too)

57
Q

What are the 9 Fs?

A

Fat, Fatal, Feces, Fetus, Fibroids, Flatus, Fluid

58
Q

In what illness would you see a scaphoid abdominal contour?

A

Anorexia

59
Q

What two signs can indicate hemorrhagic pancreatitis?

A

Cullen’s Sign and Grey Turner Sign

60
Q

What does positive CVA tenderness mean?

A

Inflamed kidney

60
Q

What is a positive Carnett’s sign?

A

Abdominal pain worsens when the abdominal wall is tensed, suggesting abdominal wall pain (somatic)

60
Q

What does tympany assess the presence of?

A

Air

60
Q

What disease process is a venous hum is associated with? (bowel sound)

A

Portal HTN

61
Q

Hepatic friction rub is concerning for?

A

Cancer

62
Q

What is a negative Carnett’s sign?

A

Abdominal pain is caused by an intra-abdominal issue, suggesting visceral pain

63
Q

How large is the liver?

A

6-10 cm (4-6 at tail)

63
Q

What is the second largest organ?

A

Liver

64
Q

What is a positive Murphy’s sign?

A

Pain on inspiration (breathing stops short of full inspiration) liver essentially drops down during inspiration and makes contact with an infected gallbladder

65
Q

What percent of the population will get an appendectomy?

A

7%

66
Q

What are the classic signs of appendicitis?

A

No appetite (Pain starts periumbilical the pain localizes once inflammation extends to the peritoneum)

67
Q

What happens when an appendix ruptures?

A

Relief of pain and sepsis

68
Q

Where is McBurney’s Point located?

A

One-third of the way from the navel to the right anterior superior iliac spine (ASIS), which is the bony projection of the right hip bone

69
Q

What is the psoas sign?

A

Elicited by having the patient lie on his or her left side while the right thigh is flexed backward. Pain may indicate an inflamed appendix overlying the psoas muscle.

69
Q

What is the Rovsing’s Sign?

A

Press on LLQ and pain is elicited in RLQ

70
Q

What is the iliopsoas sign?

A

Ask the patient to lift the right leg against the resistance of your hand. This motion causes friction of the psoas muscle over the inflamed appendix, causing pain

71
Q

What is the obturator test?

A

Pain on passive internal rotation of the hip when the right knee is flexed. It is present when the inflamed appendix is in contact with the obturator internus muscle.

72
Q

What are the three Fs for cholecystitis?

A

Fat, Fair, Forty

73
Q

Results from gallstones (40-70%), ETOH abuse, pancreatic cancer, hypertriglyceridemia, medications (rare)

A

Acute Pancreatitis

74
Q

Results from history of several acute episodes, chronic ETOH abuse (50%)/smokers, genetic disorder, idiopathic

A

Chronic Pancreatitis

75
Q

What disease process has symptoms that include pain, clay-colored stools, diarrhea/oily stools, N/V, severe back pain, weight loss, or elevated glucose/new onset of DM

A

Pancreatitis

76
Q

Tricks for reading axis deviation

A
77
Q

Murmur Grading

A
78
Q

Percussion Tones

A
79
Q

Red Flag Signs

A

NURS 6220 Health Assessment (2 decks)

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