Lab 9: Cardiovascular and Peripheral Vascular Assessment Flashcards
What does the cardiovascular (CV) system consist of?
The heart and blood vessels of the body (eg. pulmonary, coronary and neck arteries and vein).
What does the peripheral vascular (PV) system consist of?
- Anything not critical to the heart
- Arteries and veins distal to the central vessels, extending all the way to the brain and to the extremities
What are the lifespan considerations when assessing the Heart and Central Vessels for Infants?
- physiological splitting of S2
- normally have sinus arrhythmia
- murmurs often heard in newborns
- PMI=4th intercostal space just left of midclavicular line
What are the lifespan considerations when assessing the Heart and Central Vessels for children?
- heart sounds loud due to thinner chest wall.
- S3 is present in 1/3 of kids
- PMI higher and more medial 8yo and younger
What are the lifespan considerations when assessing the Heart and Central Vessels for older adults?
- cardiac output and strength of contraction decreases
- heart rate takes longer to get to norm
- S4 sometimes heard
- sudden emotional and physical stresses can result in cardiac arrhythmias and heart failure.
What are the lifespan considerations when assessing the Heart and Central Vessels for older adults?
- cardiac output and strength of contraction decreases
- heart rate takes longer to get to norm
- S4 sometimes heard
- sudden emotional and physical stresses can result in cardiac arrhythmias and heart failure.
Precordium
- area of the chest overlying the heart
- Inspect and palpate for abnormal pulsations or lifts or heaves (rising along the sternal border with each heartbeat)
Lift
- abnormal anterior movement of chest due to enlargement of left ventricle
Heave
- abnormal lateral movement related to enlargement of left vent.
Perfusion
-blood supply to an area or tissue
Systole
- ventricular contraction; begins with the first heart sound and ends at the second heart sound; typically shorter than diastole
- Silent
Diastole
- ventricular relaxation; starts with the second sound and ends with the first sound of the next cycle
- Heard best at the apical site
- Best heard over the aortic and pulmonic areas associated with the closure of the corresponding valves
What is S1 and S2?
S1 “lub” - AV valves closing; Dull, lower pitch, and longer than S2; Best heard over the apex
S2 “dub” - semilunar valves closing; Higher pitch and shorter
Bruit
- a blowing or swishing sound
-Auscultate with diaphragm
i-Created by turbulence of blood flow created by either narrowed arterial lumen or to a condition (eg. anemia or hyperthyroidism that elevates cardiac output)
Thrill
- vibrating sensation, (like cat purr)
- Often accompanies a bruit
- Indicates turbulent blood flow
Mrs. Smith is attending your health and wellness clinic and you will be conducting a CV assessment. How will you position Mrs. Smith?
- semi-reclined (Fowler’s position is 45 - 60*)
- start @ 45* then raise after auscultation to about 90*
- Mrs. Smith is attending your health and wellness clinic and you will be conducting a CV assessment. b. What questions might you ask her?
- family history (heart disease, high cholesterol levels, high bp, stroke, obesity, arterial disease, congenital heart disease, rheumatic fever and hypertension, and age at which event occurred)
- Client’s past history (rheumatic fever, heart, heart attack, varicosities, murmur, or heart failure)
- Symptoms of heart disease (fatigue, dyspnea, edema, orthopnea, cough, palpitations,syncope, hypertension, chest pain, wheezing, hemoptysis);
- Diseases affecting heart (obesity, diabetes, lung disease, endocrine disorders);
- Lifestyle habits (smoking, alcohol intake, eating and exercise patterns, areas and degree of stress perceived)
- You have finished the CV assessment for Mrs. Smith. It is now time to conduct a PV assessment. What questions might you ask her?
- Inquire if the client has a past history of
- Heart disorders, varicosities, arterial disease, and hypertension;
- Lifestyle habits (exercise patterns, activity patterns and tolerance, smoking, use of alcohol)
- What are the peripheral pulse sites?
Carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibial
- All peripheral pulses on both sides of the body are palpated simultaneously, except which one? Why?
- Do not palpate the two carotid pulses simultaneously as that is the only blood source to the brain and it is a sensitive area that requires constant blood flow for its functioning
- We don’t massage carotid to avoid dislodging a potential clot in the area (which could lead to a stroke)
- When inspecting and palpating your client’s peripheral perfusion what are you assessing and what would you include in your assessment?
- Palpation of peripheral pulses, inspection of peripheral veins, and inspection of the skin and tissues to determine perfusion to the extremities
- Veins should be smooth and bounding; no pain or discomfort present (if pain could indicate deep vein thrombosis
