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Health Assessment > Module 6 > Flashcards

Module 6 Flashcards

1
Q

what personal habits should be asked about in relevant history

A

Smoking
Diet
Exercise
Alcohol intake

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2
Q

what family history should be asked about in relevant history

A

Diabetes
Hypertension
CAD
Hyperlipidemia

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3
Q

Fainting; transient loss of consciousness

A

syncope

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4
Q

Profuse sweating

A

Diaphoresis

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5
Q

what are possible causes of chest pain

A 
Cardiac
Aortic
Musculoskeletal
Pleural
Gastrointestinal
Pulmonary
Psychoneurotic
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6
Q

what are the four chambers of the heart

A

Right atria
Right ventricle
Left atria
Left ventricle

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7
Q

what are the four valves of the heart

A

Two atrioventricular
Tricuspid and Mitral
Two semiluunar
Pulmonic and Aortic

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8
Q

what is the full circulation

A

Superior and Inferior vena cava
Right atrium Tricuspid valve Right ventricle Pulmonic valve Pulmonary arteries Lungs Pulmonary veins Left atrium Mitral valve Left ventricle Aortic valve Aorta Head and Body

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9
Q

what occurs during systole

A

Ventricles contract and atria relax
Pressure in the ventricles rises
Blood is ejected

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10
Q

what occurs during diastole

A

Atria contract and ventricles relax
As ventricular pressure falls below atrial pressure
Blood flows in a relatively passive manner
Then the atria contract to eject the remaining blood

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11
Q

what equipment do you need

A

Marking pencil
Centimeter ruler
Stethoscope with bell and diaphragm
Sphygmomanometer

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12
Q

what techniques are used

A

Inspection
Palpation
Percussion
Auscultation

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13
Q

what do you look for in the general assessment

A

Color- General and Lips and mucus membranes
Ease of respirations
Signs of distress
Blood Pressure- Both upper extremities in at least two positions

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14
Q

what do you inspect for in the extremities

A 
Color
Temperature
Hair distribution
Capillary refill
Skin turgor
Skin integrity
Venous pattern
Nails
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15
Q

Dilated and swollen

Evaluate venous incompetence- Trendelenburg test

A

Varicose Veins

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16
Q

how do you Assess Jugular Venous Distension

A

Place person in supine position
Note the jugular vein
Gradually raise the head of the bed until the jugular vein is no longer visible in the neck

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17
Q

Sharp, quick dorsiflexion of the foot with the knee slightly bent
Positive sign is calf pain

A

Homan’s sign

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18
Q

what do you assess the peripheral pulse for

A

rhythm, contour, amplitude, and symmetry

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19
Q

what are the peripheral pulse locations

A 
Carotid
Brachial
Radial
Femoral
Popliteal
Dorsalis pedis
Posterior tibial
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20
Q

Generally the larger the artery

A

the greater the expected amplitude

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21
Q

Low-pitched bowing sound over a peripheral vessel

Usually indicates a narrowed vessel

A

bruit

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22
Q

how do you check the carotid arteries

A

Listen for bruits

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23
Q

what do you inspect the chest for

A

Contour
Heaves or lifts
Pulsations

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24
Q

what do you palpate the chest for

A

Thrills
Pulsations
PMI

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25
Q

2nd RICS @ SB

A

aortic

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26
Q

2nd LICS @ SB

A

pulmonic

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27
Q

3rd-5th LICS @ SB

A

right ventricle

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28
Q

5th LICS @ or just medial to the LMCL

Normal location of PMI in an adult

A

apical

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29
Q

do you generally percuss the chest

A

no

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30
Q

how do you auscultate the chest

A

Make sure room is warm
Make sure stethoscope is warm
Take time to isolate each sound and each pause in the cycle
Avoid “jumping the stethoscope from one site to another

31
Q

how is sound transmitted

A

the direction of blood flow

32
Q

where are specific sounds heard best

A

over areas where the blood flows after it passes through a valve

33
Q

auscultation should be performed..

A

in at least the five cardiac areas

34
Q

what are cardiac auscultation areas named for

A

the locations where the valves are best heard

35
Q

how should assessment be processed

A

in an systematic order
From the base of the heart to the apex OR
From the apex of the heart to the base

36
Q

what is the base of the heart

A

Aortic area

Pulmonic area

37
Q

what is the apex of the heart

A

Mitral area

38
Q

2nd RICS @ RSB

A

aortic

39
Q

2nd LICS @ LSB

A

pulmonic

40
Q

3rd LICS @ LSB

A

Erb’s point

41
Q

4th or 5th LICS @ LSB

A

tricuspid

42
Q

5th LICS in LMCL

A

mitral

43
Q

how to remember the cardiac areas

A

All people enjoy their meals

44
Q

describe S1 sounds

A

Closure of mitral and tricuspid valves at the beginning of systole
Heard loudest at the apex: Mitral area
Almost synchronous with carotid pulsation
May be “split”

45
Q

describe S2 sounds

A

Closure of aortic and pulmonic valves at the beginning of diastole
Heard loudest at the base: Upper precordium
May have a physiologic split

46
Q

when is S3 normal

A

< 30 yoa

Pregnancy

47
Q

when is S3 abnormal

A

Fluid overload

Mitral or tricuspid regurgitation

48
Q

Variation during first rapid filling phase during diastole

Heard best at apex

A

S3

49
Q

Sound:
Ken - tuc-ky
Slosh-ing in

A

S1-3

50
Q

Variation during 2nd rapid filling phase

Heard best at apex

A

S4

51
Q

Sound
Ten-nes-see
A stiff wall

A

S1, S2, S4

52
Q

when is S4 abnormal

A

Hypertension
Left venticular hypertrophy
Mitral or tricuspid regurgitation

53
Q

Mitral valve opening snap

A

Valvular stenosis

54
Q

Ejection clicks

A

semilunar valves

55
Q

Inflammation of the pericardium

Grating sound heard with the heartbeat

A

pericardial friction rub

56
Q

Relatively prolonged extra sounds heard during systole or diastole

A

heart murmurs

57
Q

what are causes of heart murmurs

A

Increased blood flow across normal valves
Forward flow through a stenosed valve
Backward flow through an incompetent valve

58
Q

how do you describe heart murmurs

A 
Location
Timing and duration
pitch
character
intensity
59
Q

what are the intensity grades of heart murmurs

A 
I: very faint
II: faint
III: moderately loud
IV: loud
V:very loud
VI: very loud
60
Q

what is normal for infants

A

HR very fast
Apical impulse usually in 4th LICS just left of the MCL
Murmurs are frequent in the newborn in the first 48 hours

61
Q

when is Acrocyanosis normal

A

in infants is normal
Bluish coloration of hands and feet
Disappears within a few days after birth

62
Q

what should you watch for in children

A

squatting

63
Q

what is common in children

A

venous hum

Caused by turbulent blood flow in the internal jugular veins

64
Q

is a physiologic event in childhood

Heart rate varies in a cyclic pattern, usually faster on inhalation and slower on exhalation

A

sinus arrhythmia

65
Q

where is the apical impulse in children(<7)

A

in 4th LICS just left of the MCL until around age 4

66
Q

what increases throughout pregnancy

A

Pulse rate gradually increases throughout

At term is 10-15 bpm faster

67
Q

what gradually falls in the first 16-20 weeks

A

BP

68
Q

what are heard in 90% of pregnant women

A

Grade II systolic ejection murmurs

69
Q

what is the norm in pregnant women

A

Dependent edema

70
Q

what may you hear in pregnant women

A

audible S3

71
Q

what is more common in the elderly

A

S4 and soft murmurs

72
Q

what are difficult to find in elderly

A

Dorsalis pedis and posterior tibial pulses

73
Q

what may increase in older adults

A

Systolic blood pressure

74
Q

what does not respond as readily in older adults

A

heart rate during exercise

Health Assessment (28 decks)

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