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NSG 316 > Exam 3 Bolded Terms > Flashcards

Exam 3 Bolded Terms Flashcards

1
Q

First heart sound S1 signals…

A

beginning of systole

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2
Q

First heart sound S1 is loudest at…

A

the apex

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3
Q

Second heart sound S2 occurs with…

A

closure of semilunar valves
*aortic and pulmonic

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4
Q

Second heart sound S2 is loudest at…

A

the base

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5
Q

Third heart sound S3 occurs…

A

immediately after S2, when AV valves open and atrial blood first pours into ventricles

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6
Q

Third heart sound S3 is abnormal in…

A

-adults may indicate heart failure
-persons over age 35

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7
Q

what happens during the Fourth heart sound S4?

A

Atria contract and push blood into noncompliant ventricle

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8
Q

murmurs

A

Gentle, blowing, swooshing sound (turbulent blood flow) that can be heard on chest wall

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9
Q

what are the characteristics of sound?

A

frequency or pitch
intesity or loudness
duration
timing

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10
Q

frequency or pitch

A

described as high pitched or low pitched

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11
Q

intensity or loudness

A

loud or soft

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12
Q

duration

A

very short for heart sounds: silent periods are longer

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13
Q

timing

A

systole or diastole

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14
Q

what kind of artery is the carotid artery?

A

a central artery, closr to the heart

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15
Q

the carotid artery timing closely coincides with…

A

ventricular systole

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16
Q

where is the carotid artery pulse located?

A

in groove between trachea and sternocleidomastoid muscle

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17
Q

why is it difficult to isolate the “aging process” of the cardiovascular system?

A

because it is so closely interrelated with lifestyle, habits, and diseases

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18
Q

What is attributes to the aging process alone related to the cardiovascular system?

A

-Increase in systolic BP due to thickening and stiffening of the arteries
-No change in heart rate or cardiac output at rest

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19
Q

what are the caused of CVD

A

interaction of genetic, environmental, and lifestyle factors

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20
Q

Modifiable risk factors

A

evidence shows they contribute to majority of cardiac risk; treatment and control of these help to lessen risk

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21
Q

Non-modifiable risk factors

A

race, ethnicity, gender, socioeconomic status, and educational level carry an excess burden of CVD

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22
Q

Hypertension is 2 to 3 times more common among women taking

A

oral contraceptives

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23
Q

hypertension is highest in what group?

A

African/African American

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24
Q

Chest pain questions

A

o Any chest pain or tightness? (Onset, location, character, PQRST?)
o Any associated symptoms?
o Any shortness of breath? (Onset, duration?)
o Do you have a cough? (Duration, frequency, type?)

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25
Q

orthopnea question

A

How many pillows do you use when sleeping or lying down?

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26
Q

cyanosis or pallor question

A

have you ever noticed your facial skin turn blue or ashen?

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27
Q

nocturia question

A

do you awaken at night with an urgent need to void? How long has this been occurring?

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28
Q

edema question

A

o Do you have any swelling of your feet and legs? Onset?

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29
Q

cardiac history questions

A

o Cardiac medical history
o Cardiac family history
o Nutrition
o Smoking
o Medications/drugs
o Alcohol
o Exercise
o Environment

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30
Q

why do we palpate the carotid artery?

A

Yields important information on cardiac function

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31
Q

what do we auscultate for in middle/older aged people in the carotid artery?

A

presence of bruit

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32
Q

what side of the stethoscope should you use to auscultate the carotid artery?

A

bell

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33
Q

when using the bell of the stethoscope to auscultate the carotid artery what should the nurse remember?

A

· Avoid compressing the artery
· Ask person to take a breath, exhale, and hold

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34
Q

aortic valve location

A

2nd right intercostal space

35
Q

tricuspid valve location

A

Left lower sternal border 4th intercostal space

36
Q

pulmonic valve location

A

2nd left intercostal space

37
Q

mitral valve location

A

5th intercostal space mid clavicular line

38
Q

heave/lift

A

precordial movements that are visible and/or palpable pulsations of the chest wall

39
Q

how is a heave/lift best felt

A

with the heel of the hand at the sternal border

40
Q

thrill

A

vibratory sensation on your hand

41
Q

arteriosclerosis

A

hardening of the arteries

42
Q

atherlosclerosis

A

plaque build up in arteries

43
Q

Trophic changes associated with arterial insufficiency may be seen

A
  • Thin, shiny skin
  • Thick, ridged nails
  • Loss of hair on lower legs
44
Q

what is the strongest risk factor associated with PAD

A

smoking

45
Q

who does the AHA reccommend get screened for PAD

A

all people over the age 70 and/or who are between ages 50 and 69 who have a history of smoking or diabetes

46
Q

what do you use to detect early clubbing

A

profile sign (viewing finger from side)

47
Q

what is the normal nail bed angle

A

160 degrees

48
Q

capillary refill is an index of

A

peripheral perfusion and cardiac output

49
Q

normal color returns in how many seconds fro capillary refill

A

2-3 seconds

50
Q

what conditions can skew findings for capillary refill

A

A cool room, decreased body temperature, cigarette smoking, peripheral edema, and anemia

51
Q

Pulse grading scale

A

3+, increased, full, bounding
2+, normal
1+, weak
0, absent

52
Q

what is the modified allen test used for

A

to evaluate collateral circulation prior to cannulating radial artery

53
Q

if the femoral artery is weak or diminished, what should you do?

A

auscultate site for a bruit

54
Q

the popliteal pulse is

A

almost impossible to palpate

55
Q

where do you palpate the posterior tibial pulse

A

between the malleolus and Achilles tendon

56
Q

how do you palpate the dorsalis pedis pulse

A

Requires very light touch, it is just lateral to and parallel with extensor tendon of big toe

57
Q

Pitting Edema Scale

A

· 1+ mild pitting, slight indentation, no perceptible swelling
· 2+ moderate pitting, indentation subsides rapidly
· 3+ deep pitting, indentation remains, leg looks swollen
· 4+ very deep pitting, indentation lasts a long time, leg very swollen

58
Q

arterial circulation deficit worsens with…

A

elevation of the legs causing pallor

59
Q

dark-skinned person’s feet

A

are more difficult to evaluate, but soles should reveal extreme color change

60
Q

what is the dopple ultrasonic probe?

A

a device to detect a weak peripheral pulse (measure low BP or BP in lower extremity)

61
Q

Costal cartilages are calcified with aging leads to a

A

less mobile thorax

62
Q

the aging lung is more rigid which means…

A

its harder to inflate

63
Q

atelectasis

A

small airway close/collapse of alveoli

64
Q

decrease in alveoli means

A

less surface area for gas exchange
lung base becomes less ventilated

65
Q

cough questions

A

o Do you have a cough?
o When did is start? Gradual or sudden?
o Cough up any blood?
o Describe your cough: hacking, dry, barking, hoarse, congested, bubbling?

66
Q

SOB questions

A

o Ever had any shortness of breath or hard-breathing spells?
o Do episodes seem to be related to food, pollen, dust, animals, season, or emotion?

67
Q

chest pain with breathing questions

A

o Any chest pain with breathing? Please point to exact location
o Is the pain burning or stabbing?

68
Q

history if respiratory infection question

A

o Any past history of breathing trouble or lung disease, such as bronchitis, emphysema, asthma, or pneumonia?
o Smoking history

69
Q

environmental exposure question

A

o Are there any environmental conditions that may affect your breathing?
-Where do you work? At a factory, chemical plant, coal mine, farming, outdoors in a heavy traffic area

70
Q

self-care behavior

A

-TB skin test, chest x-ray study
-Pneumonia or influenza immunization

71
Q

Anteroposterior (AP) diameter should be ______ than transverse diameter

A

less

72
Q

what is tactile fremitus

A

palpable vibration

73
Q

how do you assess for tactile fremitus

A

o Use base of fingers or ulnar edge of one hand
- Touch person’s chest while he or she repeats the words, “ninety-nine” or “blue moon”
- Start over lung apices and palpate from one side to another

74
Q

what factors affect normal intensity of tactile fremitus

A
  • Thickness of chest wall
  • Pinch and intensity
  • Increase density of lung tissue make a better conducting medium for sound-increase tactile fremitus
75
Q

what is most important when listening to breath sounds

A

side to side comparison

76
Q

how do you minimize noise on a hairy chest

A

press harder or wet the hair with a damp cloth

77
Q

whatare the normal breath sounds

A

o Bronchial (tracheal or tubular)
o Bronchovesicular
o Vesicular

78
Q

adventitous breath sounds

A

o Added sounds not normally heard in the lungs

79
Q

Atelectatic crackles:

A

adventitious sound, is not pathologic; short, popping, crackling sound like fine crackles but do not last beyond a few breaths
§ Heard the periphery only
§ Disappear after a few first breaths or after a cough

80
Q

voice sounds

A

o Voice can be auscultated over the chest wall
o Eliciting voice sounds usually not done in routine examination
o These are supplemental maneuvers that are performed if you suspect lung pathology on basis of earlier data

81
Q

Note shape and configuration of chest wall

A

Ribs slope down with symmetric interspaces

82
Q

crepitus

A

o crackling, crinkling, grating feeling under the skin (rice crispies)
- Air under skin of chest wall from the neck or lung

83
Q

Measurement of pulmonary function status

A

o Normal between 97% to 98%
o The 6-minute walk test is a safer, simpler, inexpensive, clinical measure of functional status in aging adults

NSG 316 (9 decks)

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