Quiz 2/Pratical review Flashcards
Aortic
right second IC space
lateral to sternum
diaphragm
Pulomonic
left second IC space
lateral to sternum
diaphragm
Tricuspid
left fourth IC space
diaphragm
Mitral
fifth IC space
midclavicular line
apex
diaphragm
Erb’s point
left third IC space
bell
Murmurs
left third IC space
bell
S1
mitral
left 5th IC space
diaphragm
being of ventrical systole
S2
Aortic or Pulomonic
diaphragm
start of ventricle diastole
S3
apex of heart (mitral space) left sidelying; flexed to 45 degrees bell early diastole Kentucky
S4
apex of heart
bell
late diastole
Tennessee
Clinical manifestations of right ventricular failure
- Dependent edema
- JVD
- Weight gain
- Liver engorgement, abdominal pain
- Ascites
- Anorexia, nausea, bloating
- Cyanosis
- Right sided S3
Signs and symptoms of left ventricular failure:
pulmonary congestion
low cardiac output
Signs and symptoms of pulmonary congestion
- Dyspnea, dry cough
- Orthopnea
- Paroxysmal nocturnal dyspnea
- Pulmonary rales, wheezing
- s/s of acute pulmonary edema (dyspnea, pallor or cyanosis, diaphoresis, tachycardia, anxiety, agitation)
Signs and symptoms of low cardiac output
- Hypotension
- Tachycardia
- Lightheadedness, dizziness
- Fatigue, weakness
- s/s of peripheral hypoperfusion (weak, thready pulse, vasoconstriction)
- poor exercise tolerance
- S3 and sometimes S4 (3rd heart sound or ventricular gallop, 4th heart sound or atrial gallop)
Signs and Symptoms of CHF
rales heart sounds (S3) jugular venous distention changes in extremities weight gain sinus tachycardia pulsus alternans peripheral edema
Treatment of stage 1 hypertension
thiazide diuretics, ACE inhibitor, angiotensin II receptor blockers, B blocker, calcium channel blocker
(one drug)
Treatment of stage 2 hypertension
two-drug combo: thiazide and ACE or other
What does insulin do?
suppresses glucose production by the liver and promotes glucose transport across the cell membrane
• Plays a role in synthesis of glycogen, fat and protein
Four types of diabetes:
Type 1
Type 2
Gestational
Result of secondary causes
Prevention/treatment of venous thrombosis or PE for INR
2.0-3.0
Prosthetic heart valves for INR:
2.5-3.5
Prevention of recurrent MI for INR
2.5-3.5
S1
Event – closing of tricuspid and mitral valve
Corresponding event – onset of ventricular systole
Location to auscultate – tricuspid ( 4th and 5th intercostal space, L sternal border) mitral (L 5th intercostal space midclavicular line)
Best heard with – diaphragm
S2
Event – closing of the aortic and pulmonic valves
Corresponding event – start of ventricular diastole
Location to auscultate – aortic (2nd intercostal space at R sternal border) pulmonic (2nd intercostal space at L sternal border)
Best heard with – diaphragm
S3
abnormal “ventricular gallop”
Event – possible CHF indicative of ventricular dysfunction
Corresponding event – early diastole
Location to auscultate – apex of the heart (pt L sidelying 45 deg forward)
Best heard with – bell
S4
abnormal “atrial gallop”
Event – increase resistance to ventricular filling
Corresponding event – late diastole (just before S1)
Location to auscultate – apex of the heart
Best heard with – bell
