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NSG 316 TOPIC 1-5 > 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

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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
orthopnea question
How many pillows do you use when sleeping or lying down?
26
cyanosis or pallor question
have you ever noticed your facial skin turn blue or ashen?
27
nocturia question
do you awaken at night with an urgent need to void? How long has this been occurring?
28
edema question
Do you have any swelling of your feet and legs? Onset?
29
cardiac history questions
o Cardiac medical history o Cardiac family history o Nutrition o Smoking o Medications/drugs o Alcohol o Exercise o Environment
30
why do we palpate the carotid artery?
Yields important information on cardiac function
31
what do we auscultate for in middle/older aged people in the carotid artery?
presence of bruit
32
what side of the stethoscope should you use to auscultate the carotid artery?
bell
33
when using the bell of the stethoscope to auscultate the carotid artery what should the nurse remember?
· Avoid compressing the artery · Ask person to take a breath, exhale, and hold
34
aortic valve location
2nd right intercostal space
35
pulmonic valve location
2nd left intercostal space
36
tricuspid valve location
Left lower sternal border 4th intercostal space
37
mitral valve location
5th intercostal space mid clavicular line
38
heave/lift
precordial movements that are visible and/or palpable pulsations of the chest wall
39
how is a heave/lift best felt
with the heel of the hand at the sternal border
40
thrill
vibratory sensation on your hand
41
arteriosclerosis
hardening of the arteries
42
atherlosclerosis
plaque build up in arteries
43
Trophic changes associated with arterial insufficiency may be seen
- Thin, shiny skin - Thick, ridged nails - Loss of hair on lower legs
44
what is the strongest risk factor associated with PAD
smoking
45
who does the AHA reccommend get screened for PAD
all people over the age 70 and/or who are between ages 50 and 69 who have a history of smoking or diabetes
46
what do you use to detect early clubbing
profile sign (viewing finger from side
47
what is the normal nail bed angle
160 degrees
48
capillary refill is an index of
peripheral perfusion and cardiac output
49
normal color returns in how many seconds fro capillary refill
2-3 seconds
50
what conditions can skew findings for capillary refill
A cool room, decreased body temperature, cigarette smoking, peripheral edema, and anemia
51
Pulse grading scale
3+, increased, full, bounding 2+, normal 1+, weak 0, absent
52
what is the modified allen test used for
to evaluate collateral circulation prior to cannulating radial artery
53
if the femoral artery is weak or diminished, what should you do?
auscultate site for a bruit
54
the popliteal pulse is
almost impossible to palpate
55
where do you palpate the posterior tibial pulse
between the malleolus and Achilles tendon
56
how do you palpate the dorsalis pedis pulse
Requires very light touch, it is just lateral to and parallel with extensor tendon of big toe
57
Pitting Edema Scale
· 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
arterial circulation deficit worsens with...
elevation of the legs causing pallor
59
dark-skinned person's feet
are more difficult to evaluate, but soles should reveal extreme color change
60
what is the dopple ultrasonic probe?
a device to detect a weak peripheral pulse (measure low BP or BP in lower extremity)
61
Costal cartilages are calcified with aging leads to a
less mobile thorax
62
the aging lung is more rigid which means...
its harder to inflate
63
atelectasis
small airway close/collapse of alveoli
64
decrease in alveoli means
less surface area for gas exchange lung base becomes less ventilated
65
cough questions
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
SOB questions
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
chest pain with breathing questions
o Any chest pain with breathing? Please point to exact location o Is the pain burning or stabbing?
68
history if respiratory infection question
o Any past history of breathing trouble or lung disease, such as bronchitis, emphysema, asthma, or pneumonia? o Smoking history
69
environmental exposure question
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
self-care behavior
-TB skin test, chest x-ray study -Pneumonia or influenza immunization
71
Anteroposterior (AP) diameter should be ______ than transverse diameter
less
72
what is tactile fremitus
palpable vibrationhow do you assess for tactile fremitus
73
what factors affect normal intensity of tactile fremitus
- Thickness of chest wall - Pinch and intensity - Increase density of lung tissue make a better conducting medium for sound-increase tactile fremitus
74
what is most important when listening to breath sounds
side to side comparison
75
how do you minimize noise on a hairy chest
press harder or wet the hair with a damp cloth
76
whatare the normal breath sounds
o Bronchial (tracheal or tubular) o Bronchovesicular o Vesicular
77
adventitous breath sounds
o Added sounds not normally heard in the lungs
78
Atelectatic crackles:
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
79
voice sounds
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
80
Note shape and configuration of chest wall
Ribs slope down with symmetric interspaces
81
crepitus
o crackling, crinkling, grating feeling under the skin (rice crispies) - Air under skin of chest wall from the neck or lung
82
Measurement of pulmonary function status
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 TOPIC 1-5 (13 decks)

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