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Health assessment > Exam 3 Cardiovascular > Flashcards

Exam 3 Cardiovascular Flashcards

1
Q

What is the factor characteristics for arterial pulses?

A

Rate
Rhythm
Contour
Amplitude/振幅

Absent
1 = Weak
2 = Normal
3 = Increased, full, bounding　

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2
Q

Pitting vs. non-pitting edema

Pitting?

A

Interstitial spaces contain such excessive amounts of fluid that the skin remains depressed after palpation

Movement of excess interstitial fluid, in response to pressure
Usually unilateral (often DVTs)
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3
Q

The aortic and pulmonic valves are called __________ valves because each of their leaflets is shaped like a half moon.

A

semilunar

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4
Q

Health Promotion and Counseling

Factors

A
  • Smoking
  • Weight control
  • Exercise
  • HTN control
  • DM management
  • Limit alcohol intake
  • Foot care
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5
Q

Myocardium

A

The muscular wall of the heart; it does the pumping

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6
Q

Function of arteries

a) Supply what?
b) What ischemia affect the body?

A

a) Oxygen & essential nutrients to tissues
b) Partial blockage (ischemia) creates an insufficient supply

reduced blood flow

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7
Q

The mitral valve, when closed, prevent blood from back flowing into the??

A

Left atrium

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8
Q

1) Blood from the body’s organs and tissues returns to the heart from the a)________
2) Then empties into the b)________ and travels through the c)________ .

Then into the d)________ which pumps it through the e)________ into the f)________

A

a)superior and inferior venae cava

b) right atrium
c) tricuspid valve

d) right ventricle
e) pulmonary valve
f) pulmonary artery

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9
Q

Physical Examination/Inspection　

A

Apical pulse
Heaves (lift)

Outward movement of the precordium associated with heart failure

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10
Q

The arteries

a) Thicker or thinner?
b) More or less stretch and expand?
c) More or less pressure than the veins?

A

a) Thicker with a greater smooth muscle layer
b) Less ability to stretch and expand from internal pressure
c) Much more pressure than are the veins

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11
Q

Auscultation

Best heard in an area is the anatomic site because the sound is transmitted in the direction of?

A

blood flow

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12
Q

What is the Jugular veins at?

A
  • Two jugular veins present in each side of neck
  • Empty unoxygenated blood directly into superior vena cava
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13
Q

What are Murmurs?

A

A sound when blood volume in the heart increased or its flow altered.

Use bell of the stethscope

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14
Q

The __________ is the heart muscle that does the pumping

A

Myocardium

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15
Q

Assessing for Pitting Edema

Press for how many seconds?

Describe 1 to 4 stages

A

For 5 seconds and release

1+ Mild pitting, slight indentation
2+ Moderate pitting, indentation subsides rapidly
3+ Deep pitting, indentation remains, leg looks swollen
4+ Very deep pitting, indentation lasts long time, leg very swollen

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16
Q

Blood pressure?

Pulse pressure?

Mean arterial pressure?

A

Force of blood pushing against side of wall

Difference between systolic and diastolic pressures

Pressure forcing blood into tissues

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17
Q

The veins

a) More or less sturdy?
b) Veins has valve? T or F?

A

a) Less sturdy and more distensible
Venous return is less forceful than blood flow through the arteries

b) T/valves to keep blood flowing in one direction

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18
Q

Differentiate between murmurs, bruits, heave (lift), and thrill

Thrill?

A
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19
Q

Mediastinum

A

The heart and great vessels are located between the lungs in the middle third of the thoracic cage

(holds the heart & the great vessels)

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20
Q

Venous disease, factor?

A

-Thrombophlebitis

-prolonged immobilization
pregnancy, obese

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21
Q

Inadequate venous return from the legs to the heart is

A

DVT

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22
Q

In __________, left ventricular pressure continues to drop and falls below left atrial pressure

A

diastole

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23
Q

When palpate?

Touch hard or light?

A

Touch lightly
Sensation decreases as you increase pressure and feel for thrills

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24
Q

Position auscultate heart sounds

A

Supine
Sitting
left lateral decubitus position

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25
Q

What does a pulse deficit mean?

A

The apex of the heart is 120bpm
The ridical heart is 98bpm

There are fewer puleses in the arteries than there are heartbeats

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26
Q

When forward flow is restricted in the heart is know as

A

Stenosis

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27
Q

Differentiate between murmurs, bruits, heave (lift), and thrill

Heave (lift)?

A

An abnormal sustained, systolic. outward movement of the precordium associated with heart failure

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28
Q

Murmurs
Cause high outputv demands increase the speed of blood flow

What stiuations? 4

A

Fever
Thyrotoxicosis
Anemia
Pregnancy

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29
Q

What valves are closing the first heart sound(s1)?

A

The mitral and tricuspid valves are sounds of S1

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30
Q

Deep Vein Thrombosis

a) what it causes?
b) Symptoms
c) Objective factor?

A

a) Thrombus(clot)

b) Sudden onset of intense
sharp, deep muscle pain

c) Increased warmth
swelling
redness
tender to palpation

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31
Q

Venous disease

a) Skin change
b) Ulcer

A 
a) thick & hardened skin
 hemosiderin staining (brown/dark skin color)

b) near medial malleolus
irregular shaped
moderate to large drainage

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32
Q

What sounds can the bell detect?

A

Murmurs
Bruits
Extra heart sounds

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33
Q

where the carotid artery at?

A

between the trachea and sternomastoid muscle

- Palpate one carotid artery at a time

located on both sides of your neck that deliver blood to your brain and head

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34
Q

What is the PMI?

A

Point at which the apical impulse is most readily seen or felt
Using one finger pad may need to roll person midway to left to find it

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35
Q

What would cause one leg to be colder than the other?

A

Peripheral artery disease

If the legs and feet aren’t getting enough blood flow to operate correctly

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36
Q

4 valves of heart

A

Tricuspid valve
Mitral valve

Pulmonary valve
Aortic valve

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37
Q

DVT subjective data? 9

A

Leg pain or cramps
Skin changes on arms or legs
Swelling in the calves, legs, or feet
Swelling with redness or tenderness
Intermittent claudication
Cold, numbness, or pallor in the legs; hair loss
Lymph node enlargement
Medications
Smoking history

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38
Q

Effect on the older people

A
  • Systolic blood pressure increase/thickening & stiffening of the arteries
  • Left ventricular wall thickness
  • calcification (arteriosclerosis)
  • ↑ muscle fatigue
  • dyspnea(difficulty brathing)
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39
Q

The stroke volume is 60 and the heart rate is 70.

what is the cardiac output?

A

4200

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40
Q

The cardiac impulse originates in the a)________node
Then spreads through the b)__________

Then c)__________node

Then the impulse travels to d)__________, then, e)_____and then to through f)_____

A

a) SA node(pacemaker)
b) Atria

c)AV node

d) Bundle of His
e) Right and left bundle branches
f) Ventricles

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41
Q

Area of Auscultation at the second ICS and right sternal border

A

Aortic

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42
Q

Endocardium?

A

The thin layer of endothelial tissue that lines the inner surface of the heart

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43
Q

Differentiate between murmurs, bruits, heave (lift), and thrill

Murmurs?

A

Just a word used to describe an abnormal sound

Sound of blood flowing through the heart

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44
Q

What the other names for the MITRAL VALVE?

A

PMI (point of maximal impulse)

Apical pulse

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45
Q

The pulmonary veins _________?

A

Carry oxygenated blood to the left atrium

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46
Q

Aging adult,Peripheral vessels grow more rigid

What is this called?

A

Arteriosclerosis

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47
Q

Lymphatic system

a) What is remove for?
b) What’s absorb for?
c) What’s produce for?

A

a) The removal of excess fluids from body tissues
b) Fatty acids and subsequent transport of fat
c) Immune cells (such as lymphocytes, monocytes, and antibody producing cells called plasma cells)

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48
Q

Peripheral Pulse

A

A pulse that can be palpated over a peripheral artery

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49
Q

Where are the Jugular veins at?

a) Internal jugular
b) External jugular

A

a) lies deep and medial to sternomastoid muscle (usually not visible),
although pulsations may be seen in sternal notch when person is supine

b) vein is more superficial
lies lateral to sternomastoid muscle, above clavicle

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50
Q

Vascular System
Developmental Competence

A

Peripheral vessels grow more rigid (arteriosclerosis)
Arterial walls lose elasticity and vasomotor tone
Calcification and plaque buildup (atherosclerosis)
Loss of lymphatic tissue ↓ in numbers & size lymph nodes

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51
Q

Differentiate between the carotid artery pulsation and the jugular vein pulsation

Jugular vein

A

Lower, more lateral, under or behind sternomastoid muscle
Two visible waves per cycle
varies with respiratio
Level of pulse drops and disappears as person sits up

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52
Q

Why is auscultation in the left lateral decubitus?

A

The left lateral decubitus position increases murmur of mitral stenosis.

53
Q

Still murmurs?

A

In children, adolescents, and especially in young athletes have no apparent cause

54
Q

Lymphatic system

a) Form a major part of the a)________
b) Conserve b)________ and b)________
c) Without lymphatic drainage, it produce c)________

A

a) Immune system defends/the body against diseases

b) Fluid and plasma proteins/ leak out of the capillaries
c) Edema/fluid would build up in interstitial spaces

55
Q

Second heart sound?

A

S2 or Dub
Results from closure of SL valves- can hear S2 over all Precordium, but loudest at base

56
Q

Pericardium?

A

is a tough, fibrous layer that surrounds and protects the heart

57
Q

Pale, shiny skin and loss of hair is a consequence of?

A

Arterial insufficiency

58
Q

Palpate the temperature of both legs and feet use with?

A

With the backs of your hands

59
Q

What is a Pulse Deficit?

A

The difference between a radial & Apex of the heart pulse.

60
Q

Stroke volume is the amount of blood ejected by the ventricle with each heartbeat

True or false

A

True

61
Q

Which has thicker walls: arteries or veins?

A

arteries

62
Q

While assessing an adult client, the nurse detects opening snaps early in diastole during auscultation of the heart. The nurse should refer the client to a physician because this is usually indicative of…

A

mitral valve stenosis

63
Q

Heart Sounds, what are we listing for? 6

A

Rate
Rhythm
S1, S2
Splitting
Extra heart sounds
Murmurs

64
Q

Area of auscultation located at the second ICS and left sternal border

A

pulmonic

65
Q

The dorsalis pedis pules

A

Palpate the dorsum of the foot

66
Q

Stenosis?

A

Narrow valve-forward flow is restricted

67
Q

Functions of veins

A

Drain deoxygenated blood and its waste products from tissues and return it to heart

Drain 排出する

68
Q

What is arteriosclerosis?

A

The build-up of fats, cholesterol, and other substances in and on the artery walls

Older people

69
Q

What does pulse deficit indicate?

A

The volume of blood pumped from the heart may not be sufficient to meet the needs of body’s tissues

70
Q

Diastole

AV valves a)_______ , ventricles b)_______ and c)_______

This process takes up d)_______ of cardiac cycle

A

a) Open
b) Relax
c) Fill of the blood

d) 2/3

71
Q

The femoral pulse?

A

Press deeply below the inguinal ligament and about midway between the anterior superior iliac spine and the symphysis pubis

72
Q

Regurgitation?

A

Incompetent valve-blood flows backward

73
Q

DVT causes?

A

Prolonged bed rest
History of varicose veins
Trauma
Infection
Cancer
Obesity

74
Q

When you auscultate the carotid arteries, what are you assessing for?

A

Bruits

Blowing or swinging sounds that indicate obstraction duering blood flow

75
Q

During contraction, apex beats?

A

Against chest wall, producing an apical impulse - normally at 5th ICS to the left MCL

5th ICS -5th intercostal spac
MCL-midclavicular line

76
Q

What is known as the PACEMAKER of the heart?

A

SA node

77
Q

Which of the following is correct about the LEFT ventricle?

A

It pumps blood into the systemic circuitve

78
Q

The direction of blood flow through the heart is best described by which of these?

A

Right atrium–> right ventricle –>pulmonary artery –>lungs pulmonary vein –> left atrium –>left ventricle

79
Q

Types of Heart murmurs (abnormal findings)

A

Pansystolic
Midsystolic

Diastolic

80
Q

First heart sound?

A

S1 OR Lub

Results from closure of AV valves
Can hear S1 over all Precordium, but loudest at apex

81
Q

The heart lies in the __________ cavity in the mediastinum under the sternum and between the second and fifth intercostal spaces

A

Pericardial

82
Q

Which layer forms the bulk of the heart and is the layer that contract?

A

Myocarium

83
Q

Heart extends from a)_____ to a)_______intercostal cartilages

From b)_____ to c)_____

A

a) 2nd to 5th
b) right sternal border (RSB)
c) left midclavicular line (MCL)

84
Q

Major risk factors for heart disease & stroke

A

HTN
Smoking
High cholesterol
Obesity
Diet
Sedentary lifestyle
Stress
DM

85
Q

What is Raynaud’s Syndrome?

A

Fingers showing cyanosis

86
Q

Differentiate between the carotid artery pulsation and the jugular vein pulsation

Carotid?

A

Higher and medial to muscle
Brisk, localized
One wave per cycle, palpable
No pressure change
Unaffected by position change

87
Q

__________ is the period of ventricular contraction

A

Systole

88
Q

What is the spasm?

A

Involuntary contractions of a muscle, typically harmless and temporary, but can be painful.

けいれん

89
Q

Apical Pulse

A

A pulse that can be ausculated over the apex of the heart

90
Q

Area of auscultation located in the apex and assessing the left ventricle, fourth to fifth ICS at the left midclavicular line

A

Maital

91
Q

Neck Vessels: Inspection

Position

A

Position person supine anywhere from a 30- to a 45-degree angle

92
Q

Older people/Electrical irritability enhanced

What does it mean?

A

Increase fibrosis and sclerosis in the heart valves

fibrosis/thickening or scarring of the tissue

sclerosis/stiffening of a tissue

93
Q

Capillary refill time more than 3 seconds

What this indicate?

A

Arterial insufficiency

94
Q

What part of the autonomic nervous system will stimulate the SA node to increase heart rate & the force of contraction?

A

Sympathetic

Responsible for your “fight or flight”

95
Q

What is a major difference between arteries and veins?

A

Veins have valves

96
Q

What are the Great Vessels?

A

Major arteries and veins connected to heart

Aorta
Pulmonary trunk
Pulmonary veins
Superior vena cava
Inferior vena cava

97
Q

Characteristics of heart sounds 4

A

Frequency (pitch): high, medium or low
Intensity (loudness): S1 loudest at the apex, S2 loudest at the base
Duration: very short for heart sounds; silent periods are longer
Timing: systole and diastole

98
Q

What is the main cause of venous ulcers?

or venous insufficiency?

A

The veins have one-way valves that keep blood flowing up toward the heart

When these valves become weak or the veins become scarred and blocked

Blood can flow backward and pool in the legs

99
Q

Pitting vs. non-pitting edema

Non- pitting?

A

Lymphedema. When it is extremely difficult for lymph fluid to drain as it should, it is often due to a blockage.

cancer treatment

100
Q

The P-wave phase of an ECG represents?

A

when the SA node creates an action potential that depolarizes the atria.

Depolarize reduce or remove the polarization of

101
Q

The semilunar valves are located?

A

At the exit of each ventricle at the beginning of the great vessels

102
Q

Which ABNORMAL conditions may affect the location of the apical impulse?

A

CARDIAC ENLARGEMENT

103
Q

What is arterial ischemia?

A

An injury to the brain or spinal cord
Caused by a lack of oxygen to the area affected
Results from obstruction of blood flow by blood clots
Narrowed or damaged arteries or both

104
Q

Cardiac output?

A

Volume of blood pumped from a heart per minute. Adult heart normally pumps between 4 to 6 L of blood throughout the body/minute.

CO = SV X HR

105
Q

Which sound is louder? S1 or S2?

A

S2 is louder because the larger valves are the Aortic and Pulmonic

106
Q

Raynaud’s syndrome?

A
  • *White,** due to arteriospasm and resulting deficit in supply
  • *Blue**, due to slight relaxation of the spasm that allows a slow trickle of blood through the capillaries and increased oxygen extraction of hemoglobin
  • *Red** (rubor), due to return of blood into the dilated capillary bed or reactive hyperemia
107
Q

Arterial disease

a) Skin change
b) Ulcer

A

a) Pale, shiny, loss of hair
Diminished or absent pulses

b) Tips of toes, foot, or lateral malleolus
Rounded, smooth, looks “punched out”, minimal drainage

Due to lack of arterial blood flow supplying the area of the wound

108
Q

Earliest sign of heart failure

A

Auscultation of S3 Heart sounds

109
Q

Systole
AV valves a)_________, ventricles b)_________,
Pumps blood into c)_________ and c)_________

This takes up d)_________,of cardiac cycle

A

a) close
b) contract
c) pulmonary and systemic arteries
d) 1/3

110
Q

Auscultate bruit with the a)_______ of stethoscope as a b)_______ pitch sound

A

a) bell
b) low

When listening over the carotid vessels, ask the patient to suspend breathing for a few heartbeats so that respiratory sounds do not interfere with auscultation

111
Q

The difference between the systolic and diastolic pressure is

A

Pulse pressure

112
Q

Lymphatic system

Only superficial nodes are palpable

A
113
Q

Arterial disease factor?

A

-Arteriosclerosis
Arterioembolism

-Smoking
DM/Diabetes mellitus
HTN
high chol
Obesity

114
Q

Lymphatic system

During circulation of the blood, more fluid leaves a)________ than b)________ can absorb.

A

a) capillaries
b) veins

115
Q

Differentiate between murmurs, bruits, heave (lift), and thrill

Bruits?

A

Also called vascular murmur
Blowing vascular sounds

116
Q

Where is S1 heard beset?

A

Apex

117
Q

What are cardiac thrills?

A

A palpable murmur
Rushing vibration

Vibratory sensations felt on the skin

118
Q

Physical Examination/palpation

A

Apical impulse
Heaves (lift)
Thrills

119
Q

What subjective dates we want to get?

A

Chest pain
Dyspnea
Edema
Nocturia

Orthopnea
Cough
Fatigue
Cyanosis or pallor

Personal cardiac history
Family cardiac history

120
Q

Auscultation position of heart valves

A,P,T,M

A

A: Second intercostal space
Right sternal border
Aortic area

P: Second intercostal space
Left sternal border
Pulmonic area

T: Third intercostal space
Left sternal border
Second pulmonic area

M: Fifth intercostal space
Left midclavicular line
Apex, Mitral area

121
Q

Define claudication

A

Condition with cramping pain
Commonly in the legs

Caused by too little blood flow
Often indicates peripheral artery disease

122
Q
  • During contraction, a)__________ beats against chest wall
  • Producing an b)__________
  • Normally at b)_____to the b)_____
A

a) apex
b) apical impulse

c) fifth ICS/intercostal cartilages
c) left MCL/left midclavicular line

123
Q

Systolic pressure?

Diastolic pressure?

A

Maximum pressure felt on artery during left ventricular contraction

Resting pressure that blood exerts constantly between each contraction

124
Q

What is the major health problem resulting from a pulse deficit?

A. Bradycardia
B. Activity intolerance
C. Decreased cardiac output
D. Impaired tissue perfusion

　

A

Decreased cardiac output

125
Q

Why do we get nocturia with heart failure?

-Urinating frequently at night

A
  • A weak heart can’t pump blood efficiently, causing fluids to build up in the body
  • The kidneys work to rid the body of excess fluid
  • Causing large amounts of urine production and frequent urination
126
Q

First–Palpate the radial pulse

A

Second–If cannot obtain then feel brachial pulse

127
Q

What should the nurse do when a pulse deficit is suspected?

A

Ask another health care provider to count the radial pulse while the nurse counts the apical pulse.

128
Q

What are the 7 arterial pulses?

A

neck (carotid artery)
the wrist (radial artery)
behind the knee (popliteal artery)
the groin (femoral artery)
inside the elbow (brachial artery)
the foot (dorsalis pedis and posterior tibial artery)
the abdomen (abdominal aorta)

Health assessment (10 decks)

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