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Chamberlain College of Nursing > NR 302: Health Assessment 1 Exam 3 (Ch. 19) > Flashcards

NR 302: Health Assessment 1 Exam 3 (Ch. 19) Flashcards

1
Q

Define Pericardium

A

area on the anterior chest overlying the heart and great vessels

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2
Q

Define Angina pectoris

A

acute chest pain that occurs when myocardial demand exceeds its oxygen supply

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3
Q

Define Aortic regurgitation

A

(aortic insufficiency) incompetent aortic valve that allows backward flow of blood into left ventricle during diastole

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4
Q

Define Aortic stenosis

A

calcification of aortic valve cusps that restricts froward flow of blood during systole

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5
Q

Define Aortic valve

A

the left semilunar valve separating the left ventricle and the aorta

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6
Q

Define Apex of the Heart

A

tip of the heart pointing down toward the 5th left intercostal space

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7
Q

Define Apical Impulse

A

point of maximal impulse (PMI): pulsation created as the left ventricle rotates against the chest wall during systole; normally at the 5th left intercostal space in the midclacivular line

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8
Q

Define Base of the Heat

A

broader area of heart’s outline located at the 3rd right and left intercostal spaces

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9
Q

Define Bell (of stethoscope)

A

cup-shaped endpiece used for sot, low-pitched heart sounds

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10
Q

Define Bradycardia

A

slow, heart-rate

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11
Q

Define Clubbing

A

bulbous enlargement of distal phalanges of fingers and tows that occurs with chronic cyanotic heart and lung conditions

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12
Q

Define Coarctation of Aorta

A

severe narrowing of the descending aorta, a congenital heart defect

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13
Q

Define Cor Pulmonale

A

right ventricular hypertrophy and heart failure due to pulmonary hypertension

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14
Q

Define Cyanosis

A

dusky blue mottling of the skin and mucous membranes due to excessive amount of reduced hemoglobin in the blood

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15
Q

Define Diaphragm (of the stethoscope)

A

flat endpiece of the stethoscope used for hearing relatively high-pitched heart sounds

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16
Q

Define Diastole

A

the heart’s filling phase

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17
Q

Lung Sounds: Tracheal

A

Harsh, high-pitched and located over the trachea

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18
Q

Lung Sounds: Bronchial

A

loud, high-pitch, located next to the trachea

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19
Q

Lung Sounds: Bronchocesicular

A

medium loudness, medium pitched, located between the sternal border & scapula

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20
Q

Lung Sounds: Vesicular

A

soft, low-pitch, located in the remainder of the lungs

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21
Q

Rales/Crackles are heard when? and what are the 2 types?

A

end of Inspiration
Fine- do not clear with cough; high-pitched short; crackling
Coarse- do not clear with cough; loud, moist, low-pitched, bubbling
Causes- collapsed or fluid filled alveoli open

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22
Q

Define Dyspnea

A

difficult, labored breathing

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23
Q

Define Edema

A

swelling of legs or dependent body part due to increased interstitial fluid

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24
Q

Lung Sounds: Stridor

A

occurs on inspiration; loud, high-pitched, crowing sound

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25
Define Erb's Point
traditional auscultatory area in the 3rd left intercostal point
26
Define 1st Heart Sound (S1)
occurs with closure of the atrioventicular valves signaling the beginning of systole
27
Define 4th Heart Sounds (S4)
S4, gallop, atrial gallop; very soft, low-pitched ventricular filling sound that occurs in late diastole
28
Define Gallop Rhythm
the addition of a 3rd or a 4th heart sound; makes the rhythm sound like the cadence of a galloping horse
29
Define Inching
technique of moving the stethoscope incrementally across the precordium thru the auscultatory areas while listening to the heart sounds
30
Define Left Ventricular hypertrophy (LVH)
increase in thickness of myocardial wall that occurs when the heart pumps against chronic outflow obstruction (ex: aortic stenosis)
31
Define Midclavicular line (MCL)
imaginary vertical line bisecting the middle of the clavicle in each hemithorax
32
Define Mitral regurgitation
mitral insufficiency; incompetent mitral valve allows regurgitation of blood back into left atrium during systole
33
Define Mitral Stenosis
calcified mitral valve impedes forward flow of blood into left ventricle during diastole
34
Define Mitral Valve
left atroventricular valve separating the left atrium and ventricle
35
Define Palpitation
uncomfortable awareness of rapid or irregular heart rate
36
Define Pericardial friction rub
high-pitched, scratchy extra-cardiac sound heart when the precordium is inflamed
37
Define Paradoxical splitting
opposite of a normal split S2, so that the split is heard in expiration, & in inspiration the sounds fuse to one sound
38
Define Physiologic splitting
normal variation in S2 heard as two separate components during inspiration
39
Define Precordium
area of the chest wall overlying the heart and great vessels
40
Define Pulmonic regurgitation
pulmonic insufficiency; backflow of blood through incompetent pulmonic valve into the right ventricle
41
Define Pulmonic stenosis
calcification of pulmonic valve that restricts forward flow of blood during systole
42
Define Pulmonic Valve
right semilunar valve separating the right ventricle & pulmonary artery
43
Define 2nd Heart Sound (S2)
occurs with closure of the semilunar valves, aortic & pulmonic; signals the end of systole
44
Define Summation gallop
abnormal mid-diastolic heart sound heard when both the pathologic S3 & S4, are present
45
Define Syncope
temporary loss of consciousness due to decreased cerebral blood flow (fainting); caused by ventricular asystole, pronounced bradycardia, or ventricular fibrillation
46
Define Systole
the heart's pumping phase
47
Define Tachycardia
rapid heart rate, >95 bpm in the adult
48
Define 3rd Heart Sound (S3)
soft, low-pitched ventricular filling soun that occurs in early diastole (S3 gallop) and may be an early sign of heart failure
49
Define Thrill
palpable vibration on the chest wall accompanying severe heart murmur
50
Define Tricuspid Valve
right atrioventricular valve separating the right atrium and ventricle
51
What are the major landmarks associated with heart & neck vessels?
1. precordium 2. mediastinum 3. base 4. apex
52
What is the Precordium?
area on anterior chest overlying the heart & great vessels
53
What is the mediastinum & when is it located?
midthoracic cavity that contains the heart & great vessels; located: 2nd to 5th ICS, right sternal border to left (MCL)
54
Where is the Apex of the heart located?
5th ICS, 7 to 9 cm left of midsternal line (MCL); the heart is rotated so that right side is anterior & the left side is posterior
55
What are the 4 structures associated with heart & neck vessels?
1. Pericardium 2. Epicardium 3. Myocardium 4. Endocardium (houses electrical activity)
56
What is the pericardium attached to?
attached to vessel, esophagus, sternum & pleura; anchored to the diaphragm
57
What direction do the valves of the heart & neck vessels go? How do the open & close?
unidirectional; open & close passively
58
What is the left atrioventricular valve called?
mitral
59
What is the right atrioventicular valve called
tricuspid
60
What is the right semilunar valve called?
Pulmonic
61
What is the left semilunar valved called?
Aortic
62
To auscultate murmurs, what would you do?
listen over the valve sites & note any radiation across the precordium
63
To auscultate gallops, what would you do?
turn patient to left side; often more pronounced over apex
64
When are valves sounds best heard?
aortic valve sounds are best heard with the patient sitting & leaning forward
65
Where is the S2 sound the loudest?
at the base
66
1. Where is the S1 sound the loudest? 2. Corresponds with ___ wave on ECG? 3. What type of sounds would you hear?
1. loudest at apex 2. corresponds with R wave on ECG 3. diminished sounds (pericardial effusion, obesity, & emphysema)
67
The first heart sound (S1) is produced by the:
closure of the semilunar valves
68
What are some cardiac alterations that occurs during pregnancy?
1. increase in cardiac volume & a decrease in blood pressure 2. increase in pulse rate 10-15 bpm
69
The leaflets of the tricuspid and mitral valves are anchored by __________________ to the _________________, which are embedded in the ventricular floor.
chordae tendieae; papillary muscles
70
The ability of the heart to contract independently of any signals or stimulation is due to:
automaticity
71
When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a continuous sound that mimics the sound of a machine. This finding most likely indicates:
an expected sound caused by non-closure of the ductus arteriosus
72
A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by:
turbulent blood flow through the carotid artery
73
The jugular venous pressure is an indirect reflection of the:
heart's efficiency as a pump
74
The semilunar valves separate the:
ventricles from the arteries
75
The atrioventricular valves separate the
atria & ventricles
76
The septum separates the
right atria from the left aria
77
What would a nurse expect to find when assessing a patient with emphysema?
barrel chest
78
Lung Sounds: inspiration > expiration
vesicular
79
Lung Sounds: moist bubbling sounds
crackles
80
Lung Sounds: loud crowing sound
stridor
81
Define Crepitus
crunching feeling under the skin caused by air leaking into SQ tissue
82
A client has been diagnosed with pericarditis. Which layers of the heart are affected with this illness?
pericardium & myocardium
83
The nurse is listening to a client's heartbeat and is focusing on the second heart sound. Which heart valves produce this sound?
aortic & pulmonic
84
What might an increased blood pressure indicate in a pregnant female?
preclampsia
85
1st landmark for auscultating the heart?
Aortic. Right Sternal Border 2nd Intercostal Space
86
2nd landmark for auscultating the heart?
Pulmonic. Left Sternal Border 2nd IS
87
3rd landmark for auscultating the heart?
Erb's Point LSB 3rd IS
88
4th landmark for auscultating the heart?
Tricuspid LSB 4th IS
89
5th landmark for auscultating the heart?
Mitral LSB 5th IS

Chamberlain College of Nursing (6 decks)

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