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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
Q

On what percussion of the heart, what should you anticipate?

A

Dull sounds

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26
Q

What is normal blood pressure, pre HTN, and HTN?

A

Normal: below 120/80
Pre HTN: 120/80-139/89
HTN: 140/90 and above

27
Q

Who has the higher incidence of HTN?

A

African Americans

28
Q

What are the locations of the pulse?

A

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
Q

Describe an ECG

A

Electrical presentation of the cardiac cycles that are documented by the deflection on recording paper

30
Q

Where does electrical initiation of the heart occur?

A

The SA node known as the pacemaker of the heart, fires 60-100 joules/ minute

31
Q

How many joules does the AV node fire?

A

60 joules/ minute

32
Q

How many joules do bundle branches fire?

A

40-60 joules/ minute

33
Q

When does cardiac depolarization occur?

A

When cardiac current from the SA Node spread across the atria causing cardiac contraction. The cardiac cells are + charged.

34
Q

When does repolarization occur in the heart?

A

Cardiac cells are relaxed. The cardiac cells are negatively charged.

35
Q

What do imbalance in electrolytes do to cardiac conduction and which are they?

A

Na, Potassium, & Calcium can result in dysregulation of the the cardiac conduction system

36
Q

Describe P-wave

A

Atrial depolarization or contraction

37
Q

Where is Atrial Repolarization?

A

Hidden behind the QRS complex

38
Q

Describe QRS

A

Ventricular Depolarization or contraction

39
Q

Describe T-wave

A

Ventricular Repolarization or relaxation

40
Q

Describe Ventricular Fibrillation

A

Total absence of regular heart rhythm

41
Q

Describe Ventricular tachycardia

A

rapid rhythm, regular heartbeat as high as 200 beat/ minute

42
Q

Describe Heart Block

A

Slow heart rate, 20-40 beats/ minute. Conduction b/w the atria & the ventricles is disrupted

43
Q

Describe the S/S of a heart failure

A

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
Q

Describe severe aortic regurgitation

A

Synchronous heartbeat and head bobbing

45
Q

What does thin red lines or splinter hemorrhages on the nails of a client indicate?

A

Ineffective Endocarditis

46
Q

Describe Arterial Insufficiency

A

Legs are cold & no more hair growth on the legs

47
Q

Describe Venous Insufficiency

A

Legs are warm with pain from prolonged sitting or standing

48
Q

Describe Raynaud’s Syndrome

A

Fingers and hands have intermittent skin pallor and cyanosis

49
Q

Describe Allen’s Test

A

Test used to determine the patency of the radial & ulnar arteries

50
Q

When does varicosities not appear?

A

When the legs are elevated

51
Q

What causes JVD over 3 cm?

A

1) Increased central venous pressure
2) Fluid overload
3) Pressure at the SVC

52
Q

What is smoking attributed to?

A

Cardiovascular disease

53
Q

What is the use of cocaine attributed to?

A

HTN, MI, and ruptured Aorta

54
Q

S3 & S4 are more common in clients with…?

A

Clients with cardiac anomalies such as MI, CHF, Angina, and Ventricular Hypertrophy

55
Q

When does S3 or Ventricular Gallop occur and where is this sound heard?

A

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
Q

When does S4 or Atrial Gallop occur and where is this sound heard?

A

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
Q

Describe Tetralogy of Fallot

A

4 cardiac defects:
1) dextroposition of the Aorta
2) Pulmonary stenosis
3) Right ventricular hypertrophy
4) Ventricular Septal defect

58
Q

Describe Patent Foramen Ovale

A

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
Q

What percentage of children will have innocent cardiac murmurs? How does this happen?

A

70% of children will have innocent cardiac murmurs which arise from high blood pressure flow across the normal heart structures

60
Q

Describe Patent Ductus Arteriosus

A

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
Q

What increases cardiac murmurs in children?

A

Conditions that increase metabolism & anemia will increase cardiac murmurs in children

62
Q

How many times does the heart beat in a 24-hour period for adults?

A

100,000 times

63
Q

Describe Therapeutic Communication

A

1) Open ended questions
2) Active listening
3) Lean toward patient
4) Eye Contact
5) Open posture

64
Q

Describe Non-therapeutic communication

A

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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