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N142 Happy Thoughts > Module 11: Pt. 1 Cardiovascular assessment > Flashcards

Module 11: Pt. 1 Cardiovascular assessment Flashcards

1
Q

What are the resting pulse rates of infants like compared to adults

A

MUCH FASTER

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2
Q

Does blood pressure get higher as we age?

A

Yes, especially in women

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3
Q

Explain diastole

A

Ventricles relax, fill with blood
AV valves open
-2/3 of the cycle

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4
Q

Explain Systole

A

Fills the pulmonary and systemic arteries

-1/3 of the cycle

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5
Q

Where does the first heart sound occur closest to?

A

Its loudest in the Apex

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6
Q

The second heart sound is loudest where?

A

the base

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7
Q

How is the heart of an infant postitioned differently

A

It is more horizontal, the apex is more in the 3rd -4th iICS
by age 7 It’s the same location as an adults

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8
Q

What are you listening for in murmurs?

A
  • Timing
  • Loudness
  • Pitch
  • Quality
  • Location
  • Radiation
  • if posture changes the murmur
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9
Q

Developmental considerations for older adults

A

Gradual rise in systolic BP

  • Orthostatic hypotension
  • avoid pressure on carotid
  • Difficult to find apical pulse
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10
Q

What is S3?

A

-Ventircular filling that creates vibrations and sound

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11
Q

What is S4?

A

End of diastole (Presole)

resistant to filling, atria contract push blood into non compliant ventricle `

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12
Q

What is causing murmurs?

A

Turbulence of blood
-Increase velocity of blood flow
-If you get the murmur during exercise = thyrotoxicosis
2) decrease in viscosity of blood (anemia)
3) Structural defects in valves/ unusual chamber openings
(narrow or incompetent valve, Dilated chamber wall defect)

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13
Q

How much blood does the heart pump per minute

A

4-6 L

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14
Q

What is cardiac output

A

Volume of blood in each systole (stroke volume) times the number of beats per minute (rate)

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15
Q

Where is the carotid artery located

A

Medial, Between trachea and sternocleidomastoid

central artery

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16
Q

How many jugular veins are there

A

4

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17
Q

What are the 5 components of a jugular vein pulse

A
  • A Wave: Reflects atrial contraction
  • C wave: reflects back flow from the bulging upward of the tricuspid valve
  • X Decent: atrial relaxation
  • V Wave: passive atrial filling
  • Y DEsecnt- reflects passive atrial filling when tricustpid valve opens
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18
Q

When does the fetal heart start

A

week 3

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19
Q

Developmental considerations for pregnant women

A
  • Blood volume increases
  • Most rapid during 2nd trimester
  • increased stroke volume, cardiac output, pulse rate
  • arterial BP down as a result of peripheral vasodilation
  • Arterial BP lowest in second trimester then it rises
  • varies with position
20
Q

Developmental considerations for older adults

A

Smoking, Diet, alcohol, exercise patterns, stress have an influence on coronary artery disease and cardiovascular disease
-stifferning of larger arteries bc of calcification
increased pulse wave velocity
-Not much diastolic change
-increase ventricular wall thickness
-no change in resting heart rate
-decreased ability to augment cardiac ability, but the output does not change at rest
-Arrhythmias increase with age
-Ectopic beats common in older adults, asymptomatic in older ppp
-tachycardia is not tolerated well by old folks
-decrease in cerebral blood flow so they pass out easier
-S4 is normal
-s3 indicates heart disease after 40

21
Q

What is arteriosclerosis

A

Calcifying of vessel walls that occurs with aging

22
Q

Cultural and social considerations

A

there are decreased CVD deaths but more CVD

  • Primary killer of canadian women
  • heart disease and stoke are higher in african
23
Q

What are the risk factors for CVD

A

Food insecurity, income, high BP, smoking, high cholesterol, oral contraceptives and post menopause hormones

24
Q

Who has more hypertension

A

Women 55+, worse in atlantic provinces

25
Q

Additional subjective questions for infants

A

1) maternal health
2) feeding (if any cyanosis)
3) Growth
4) activity (naps? tired? milestones)

26
Q

additional subjective for children

A

1) Growth
2) Activity (blue spells, any tiring?)
3) Joint pain and fever
4) Headache and nosebleed
5) Respiratory disease
6) Family history ( sibling with heart defect)

27
Q

Additional questions for pregnant women

A

1) any hypertension (bp before and during pregnancy)(Treatment)
2) any hypotension (faint or dizziness)

28
Q

Additional questions for older adults

A

1) disease
2) medications
3) environment

29
Q

how should the patient be positioned to palpate and auscultate carotid arteries

A

-sit up

30
Q

How should the patient be for the jugular and precordium

A

supine with head and chest slightly elevated

31
Q

What is a innocent murmur

A

No valvular or other pathological cause, common in children (disappears with different posture)

32
Q

What is a functional murmur

A

caused by increased blood flow to the heart

- anemia, fever, pregnancy, hyperthyroid

33
Q

When do the fetal shunts close

A

10-15 hr after birth but up to 45

34
Q

Extracardiac signs that may reflect heart status

A

liver size, skin, resp status

35
Q

Are respiratory crackles important in children?

A

No its mostly just for adults

36
Q

What happens with cardiac enlargement

A

heart shifts to the left

37
Q

what could indicate pneumothorax

A

heart moves away from affected side

38
Q

What could indicate a diaphragmatic hernia

A

shifts usually to the right

39
Q

what is dextrocardia

A

heart of right side of chest

40
Q

What is trachycardia and bradycardia considered in new borns

A

200+ for T
Less than 90 for B
*HR is best auscultated because the radial pulse is hard to count
*expect sinus arrhythmia
-splitting of S2 is common
-neonatal murmors common for first 2-3 days

41
Q

Indicators of heart disease in children

A

poor weight gain, developmental delay, tachycardia, tachypnea, dyspnea on exertion, cyanoisis, clubbing of nails, huge apical impulse, cardiac enlargement

42
Q

Venous hum

A

Turbulence of blood flow in jugular venous system, common not back

43
Q

Considerations for pregnant women

A
  • Higher resting pulse
  • lower BP
  • mild hyperemia
  • apical pulse higher and lateral
  • exagerated splitting of s1, increased loudness of s2
  • loud S3
  • systolic murmur that usually diapers after delivery
44
Q

ischemia

A

inadequate delivery of oxygen/nutrients to cells

45
Q

Embolus

A

blood clot that breaks loose

N142 Happy Thoughts (12 decks)

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