Skills Check 3 Flashcards
aortic valve?
right 2nd IC space
pulmonic?
left 2nd IC space
tricuspid?
right 4th IC space
mitral?
left 5th IC space
Erb’s?
left 3rd IC space
aortic stenosis?
sounds like hoves clapping, quick
pulmonic stenosis?
sounds like breathing, 1 sound together
mitral stenosis?
very faint
split S2?
quick bang like a drum
What is S3?
heard in early diastole, lub dub “dub”, ventricular failure
better heard with bell and can be present in young w/o pathology
What position is S3 best heard in?
left sidelying apex/mitral
What is S4?
heard in late diastole, “la” lub dub
exaggerated atrial contraction due to increased ventricular flow and resistance
likely with CAD, HTN, MI
What is pericardial rub?
leathery sound
indicative of pericarditis
best heard in supine at Erb’s
Where do you mark for girth measurements?
between met heads, btwn maleoli, 6 cm above maleoli, 6 cm above that and apex of patella
What is pitting edema scale?
After 5 seconds:
1+-indent barely visible
2+ slight indent returns in 15 sec
3+ deeper indent returns in 30 sec
4+ indent last longer than 30 sec
How to do cap filling time?
compress fleshy part of big toe with pt in supine for 5 seconds and release
color should return in 3-4 seconds
How long does pt need to be in supine for before taking an ABI?
10 minutes
How do you interpret ABI results?
- 2 = calcified arteries, likely diabetes
- 95- 1.19 normal
- 75-0.95- mild PAD, caution with compression
- 5- 0.74- mod PAD, contraindiction for compression with slight claudication
below 0.5- severe PAD
What are BMI numbers?
25 plus is overweight
30 plus- obese
40 plus morbid obese
What are waist circumference measurements?
over 102 cm or 40 inches for males
over 85 cm or 35 inches for females
