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NURS 190-Physical Assessment > Quiz #4 Concepts Review > Flashcards

Quiz #4 Concepts Review Flashcards

Cardiac & Peripheral Vascular

1
Q

Define Precordium

A

Area of chest where you listen to the heart sounds

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2
Q

Where does blood flow in a healthy person?

A

Unidirectionally

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3
Q

When cardiac valves are pathologic..?

A

forward flow of the blood is restricted resulting in regurgitation and heart murmurs

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4
Q

What are cardiac murmurs associated with?

A

Tricuspid regurgitation, Tricuspid stenosis, Mitral regurgitation, Mitral stenosis, and Aortic regurgitation

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5
Q

How are cardiac murmurs graded?

A

Graded 1-6
1/6 barely audible & 6/6 being the loudest

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6
Q

Why is the S1 (lub) first heartbeat heard?

A

Due to the closure of the AV valves (Tricuspid/ Mitral valves) when ventricles are filled, heard loudest at the apex of the heart

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7
Q

Why is the S2 (dub) second heartbeat heard?

A

Due to the closure of the semi-lunar valves (aortic/ pulmonary valves) when ventricles empty blood to the Pulmonic Artery & Aorta, heard loudest at the base of the heart

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8
Q

What does the interatrial septum separate?

A

The right and left atrium

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9
Q

What does the interventricular septum separate?

A

The right and left ventricle

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10
Q

Describe pulse grading

A

Pulse grading 0-4+
0= no pulse
+1= weak and thready
+2= normal
+3= Brisk
+4= Bounding

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11
Q

What are the aortic landmarks?

A

2nd ICS, RSB (S2 louder than S1)

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12
Q

What are the pulmonic landmarks?

A

2nd ICS, LSB (S2 louder than S1)

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13
Q

What are the Erb’s Point landmarks?

A

3rd ICS, LSB (S1=S2)

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14
Q

What are the Tricuspid landmarks?

A

4th ICS, LSB (S1 louder than S2)

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15
Q

What are the Mitral landmarks?

A

5th ICS, LMCL (S1 louder than S2)

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16
Q

What are the 5 major risk factors of heart disease?

A

1) Hypertension
2) Smoking
3) DM
4) Obesity
5) High Cholesterol

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17
Q

How are the heart sounds interpreted?
PDIP

A

1) Pitch
2) Duration
3) Intensity
4) Phase

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18
Q

Where is the angle of Louis?

A

Between the manubrium & the body of the sternum, in-line with the 2nd rib

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19
Q

How are the ICS named?

A

By the rib above

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20
Q

What are the cardiac nerves?

A

1) Sympathetic Cardiac nerves
2) Parasympathetic Cardiac Nerves

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21
Q

What are the Sympathetic Nerves?

A

Cardiac nerves, responsible for stimulation of the heart, increase heart rate, increase dilation of the coronary arteries

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22
Q

What are the parasympathetic nerves?

A

Cardiac nerves, responsible for decrease in stimulation of the heart, decreased HR, and decreased dilation of the coronary arteries

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23
Q

Where is the PMI heard the loudest?

A

Adults- 5th ICS, LMCL (can be palpated or auscultated)
Infants- 4th ICS, LMCL, because their heart is horizontally positioned

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24
Q

What is a newborns heart rate?

A

160-180/ minute, then gradually reduces to 112 to 120/ minute 6-8 hours after birth

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25
On what percussion of the heart, what should you anticipate?
Dull sounds
26
What is normal blood pressure, pre HTN, and HTN?
Normal: below 120/80 Pre HTN: 120/80-139/89 HTN: 140/90 and above
27
Who has the higher incidence of HTN?
African Americans
28
What are the locations of the pulse?
1) Dorsalis Pedis- top of feet, lateral to the big toe 2) Popliteal pulses- behind the knees medially 3) Femoral Pulse- inguinal areas 4) Posterior Tibialis- at the grooves behind the medial malleolus and Achilles tendon 5) Radial Pulses- lateral wrist, in line with thumb 6) Ulnar Pulses- medial wrist in line with the small fingers
29
Describe an ECG
Electrical presentation of the cardiac cycles that are documented by the deflection on recording paper
30
Where does electrical initiation of the heart occur?
The SA node known as the pacemaker of the heart, fires 60-100 joules/ minute
31
How many joules does the AV node fire?
60 joules/ minute
32
How many joules do bundle branches fire?
40-60 joules/ minute
33
When does cardiac depolarization occur?
When cardiac current from the SA Node spread across the atria causing cardiac contraction. The cardiac cells are + charged.
34
When does repolarization occur in the heart?
Cardiac cells are relaxed. The cardiac cells are negatively charged.
35
What do imbalance in electrolytes do to cardiac conduction and which are they?
Na, Potassium, & Calcium can result in dysregulation of the the cardiac conduction system
36
Describe P-wave
Atrial depolarization or contraction
37
Where is Atrial Repolarization?
Hidden behind the QRS complex
38
Describe QRS
Ventricular Depolarization or contraction
39
Describe T-wave
Ventricular Repolarization or relaxation
40
Describe Ventricular Fibrillation
Total absence of regular heart rhythm
41
Describe Ventricular tachycardia
rapid rhythm, regular heartbeat as high as 200 beat/ minute
42
Describe Heart Block
Slow heart rate, 20-40 beats/ minute. Conduction b/w the atria & the ventricles is disrupted
43
Describe the S/S of a heart failure
1) JVD over 3 cm at 45-degree elevation 2) Low BP 3) Fatigue 4) Heart rate over 120/ minute 5) Weak peripheral pulses 6) S3 7) SOB 8) Ankle edema
44
Describe severe aortic regurgitation
Synchronous heartbeat and head bobbing
45
What does thin red lines or splinter hemorrhages on the nails of a client indicate?
Ineffective Endocarditis
46
Describe Arterial Insufficiency
Legs are cold & no more hair growth on the legs
47
Describe Venous Insufficiency
Legs are warm with pain from prolonged sitting or standing
48
Describe Raynaud's Syndrome
Fingers and hands have intermittent skin pallor and cyanosis
49
Describe Allen's Test
Test used to determine the patency of the radial & ulnar arteries
50
When does varicosities not appear?
When the legs are elevated
51
What causes JVD over 3 cm?
1) Increased central venous pressure 2) Fluid overload 3) Pressure at the SVC
52
What is smoking attributed to?
Cardiovascular disease
53
What is the use of cocaine attributed to?
HTN, MI, and ruptured Aorta
54
S3 & S4 are more common in clients with...?
Clients with cardiac anomalies such as MI, CHF, Angina, and Ventricular Hypertrophy
55
When does S3 or Ventricular Gallop occur and where is this sound heard?
When there is vibration, when AV valves open and blood goes to the ventricles. Heard after S2. May also be heard in 1) healthy children, 2) healthy young adults, 3) 3rd trimester of pregnancy
56
When does S4 or Atrial Gallop occur and where is this sound heard?
When atrial contraction and ejection of blood to the ventricles in late diastole. This sound is heard before S1. May be heard in 1) Healthy children, 2) Athletes, 3) Elderly
57
Describe Tetralogy of Fallot
4 cardiac defects: 1) dextroposition of the Aorta 2) Pulmonary stenosis 3) Right ventricular hypertrophy 4) Ventricular Septal defect
58
Describe Patent Foramen Ovale
Passageway b/w the right & left atria. Should close shortly after birth. If it does not close, cardiac murmurs can be heard on auscultation.
59
What percentage of children will have innocent cardiac murmurs? How does this happen?
70% of children will have innocent cardiac murmurs which arise from high blood pressure flow across the normal heart structures
60
Describe Patent Ductus Arteriosus
Opening between the pulmonary artery & descending aorta. Should close within 24-48 hours after birth. If it does not close, cardiac murmurs can be heard on auscultation.
61
What increases cardiac murmurs in children?
Conditions that increase metabolism & anemia will increase cardiac murmurs in children
62
How many times does the heart beat in a 24-hour period for adults?
100,000 times
63
Describe Therapeutic Communication
1) Open ended questions 2) Active listening 3) Lean toward patient 4) Eye Contact 5) Open posture
64
Describe Non-therapeutic communication
1) "why" questions 2) Give opinion 3) Give advice 4) Close ended questions 5) False reassurance

NURS 190-Physical Assessment (7 decks)

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