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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
Q

Define Erb’s Point

A

traditional auscultatory area in the 3rd left intercostal point

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26
Q

Define 1st Heart Sound (S1)

A

occurs with closure of the atrioventicular valves signaling the beginning of systole

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27
Q

Define 4th Heart Sounds (S4)

A

S4, gallop, atrial gallop; very soft, low-pitched ventricular filling sound that occurs in late diastole

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28
Q

Define Gallop Rhythm

A

the addition of a 3rd or a 4th heart sound; makes the rhythm sound like the cadence of a galloping horse

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29
Q

Define Inching

A

technique of moving the stethoscope incrementally across the precordium thru the auscultatory areas while listening to the heart sounds

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30
Q

Define Left Ventricular hypertrophy (LVH)

A

increase in thickness of myocardial wall that occurs when the heart pumps against chronic outflow obstruction (ex: aortic stenosis)

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31
Q

Define Midclavicular line (MCL)

A

imaginary vertical line bisecting the middle of the clavicle in each hemithorax

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32
Q

Define Mitral regurgitation

A

mitral insufficiency; incompetent mitral valve allows regurgitation of blood back into left atrium during systole

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33
Q

Define Mitral Stenosis

A

calcified mitral valve impedes forward flow of blood into left ventricle during diastole

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34
Q

Define Mitral Valve

A

left atroventricular valve separating the left atrium and ventricle

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35
Q

Define Palpitation

A

uncomfortable awareness of rapid or irregular heart rate

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36
Q

Define Pericardial friction rub

A

high-pitched, scratchy extra-cardiac sound heart when the precordium is inflamed

37
Q

Define Paradoxical splitting

A

opposite of a normal split S2, so that the split is heard in expiration, & in inspiration the sounds fuse to one sound

38
Q

Define Physiologic splitting

A

normal variation in S2 heard as two separate components during inspiration

39
Q

Define Precordium

A

area of the chest wall overlying the heart and great vessels

40
Q

Define Pulmonic regurgitation

A

pulmonic insufficiency; backflow of blood through incompetent pulmonic valve into the right ventricle

41
Q

Define Pulmonic stenosis

A

calcification of pulmonic valve that restricts forward flow of blood during systole

42
Q

Define Pulmonic Valve

A

right semilunar valve separating the right ventricle & pulmonary artery

43
Q

Define 2nd Heart Sound (S2)

A

occurs with closure of the semilunar valves, aortic & pulmonic; signals the end of systole

44
Q

Define Summation gallop

A

abnormal mid-diastolic heart sound heard when both the pathologic S3 & S4, are present

45
Q

Define Syncope

A

temporary loss of consciousness due to decreased cerebral blood flow (fainting); caused by ventricular asystole, pronounced bradycardia, or ventricular fibrillation

46
Q

Define Systole

A

the heart’s pumping phase

47
Q

Define Tachycardia

A

rapid heart rate, >95 bpm in the adult

48
Q

Define 3rd Heart Sound (S3)

A

soft, low-pitched ventricular filling soun that occurs in early diastole (S3 gallop) and may be an early sign of heart failure

49
Q

Define Thrill

A

palpable vibration on the chest wall accompanying severe heart murmur

50
Q

Define Tricuspid Valve

A

right atrioventricular valve separating the right atrium and ventricle

51
Q

What are the major landmarks associated with heart & neck vessels?

A
  1. precordium
  2. mediastinum
  3. base
  4. apex
52
Q

What is the Precordium?

A

area on anterior chest overlying the heart & great vessels

53
Q

What is the mediastinum & when is it located?

A

midthoracic cavity that contains the heart & great vessels; located: 2nd to 5th ICS, right sternal border to left (MCL)

54
Q

Where is the Apex of the heart located?

A

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
Q

What are the 4 structures associated with heart & neck vessels?

A
  1. Pericardium
  2. Epicardium
  3. Myocardium
  4. Endocardium (houses electrical activity)
56
Q

What is the pericardium attached to?

A

attached to vessel, esophagus, sternum & pleura; anchored to the diaphragm

57
Q

What direction do the valves of the heart & neck vessels go? How do the open & close?

A

unidirectional; open & close passively

58
Q

What is the left atrioventricular valve called?

59
Q

What is the right atrioventicular valve called

60
Q

What is the right semilunar valve called?

61
Q

What is the left semilunar valved called?

62
Q

To auscultate murmurs, what would you do?

A

listen over the valve sites & note any radiation across the precordium

63
Q

To auscultate gallops, what would you do?

A

turn patient to left side; often more pronounced over apex

64
Q

When are valves sounds best heard?

A

aortic valve sounds are best heard with the patient sitting & leaning forward

65
Q

Where is the S2 sound the loudest?

A

at the base

66
Q
  1. Where is the S1 sound the loudest?
  2. Corresponds with ___ wave on ECG?
  3. What type of sounds would you hear?
A
  1. loudest at apex
  2. corresponds with R wave on ECG
  3. diminished sounds (pericardial effusion, obesity, & emphysema)
67
Q

The first heart sound (S1) is produced by the:

A

closure of the semilunar valves

68
Q

What are some cardiac alterations that occurs during pregnancy?

A
  1. increase in cardiac volume & a decrease in blood pressure
  2. increase in pulse rate 10-15 bpm
69
Q

The leaflets of the tricuspid and mitral valves are anchored by __________________ to the _________________, which are embedded in the ventricular floor.

A

chordae tendieae; papillary muscles

70
Q

The ability of the heart to contract independently of any signals or stimulation is due to:

A

automaticity

71
Q

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:

A

an expected sound caused by non-closure of the ductus arteriosus

72
Q

A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by:

A

turbulent blood flow through the carotid artery

73
Q

The jugular venous pressure is an indirect reflection of the:

A

heart’s efficiency as a pump

74
Q

The semilunar valves separate the:

A

ventricles from the arteries

75
Q

The atrioventricular valves separate the

A

atria & ventricles

76
Q

The septum separates the

A

right atria from the left aria

77
Q

What would a nurse expect to find when assessing a patient with emphysema?

A

barrel chest

78
Q

Lung Sounds: inspiration > expiration

79
Q

Lung Sounds: moist bubbling sounds

80
Q

Lung Sounds: loud crowing sound

81
Q

Define Crepitus

A

crunching feeling under the skin caused by air leaking into SQ tissue

82
Q

A client has been diagnosed with pericarditis. Which layers of the heart are affected with this illness?

A

pericardium & myocardium

83
Q

The nurse is listening to a client’s heartbeat and is focusing on the second heart sound. Which heart valves produce this sound?

A

aortic & pulmonic

84
Q

What might an increased blood pressure indicate in a pregnant female?

A

preclampsia

85
Q

1st landmark for auscultating the heart?

A

Aortic.
Right Sternal Border
2nd Intercostal Space

86
Q

2nd landmark for auscultating the heart?

A

Pulmonic.
Left Sternal Border
2nd IS

87
Q

3rd landmark for auscultating the heart?

A

Erb’s Point
LSB
3rd IS

88
Q

4th landmark for auscultating the heart?

A

Tricuspid
LSB
4th IS

89
Q

5th landmark for auscultating the heart?

A

Mitral
LSB
5th IS

Chamberlain College of Nursing (6 decks)

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