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Flashcards in Assessment: CV & PV Deck (87)
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1

Name 4 activities we ask about in a person's personal history that could affect heart disease.

Smoking/tobacco use, alcohol use, diet, exercise

2

What is syncope?

Fainting; transient loss of consciousness

3

What is dyspnea?

Difficulty breathing

4

What is diaphoresis?

Excessive sweating

5

What is paroxysmal nocturnal dyspnea?

A sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position

6

What is orthopnea?

The sensation of breathlessness in the recumbent position, relieved by sitting or standing.

7

What is likely happening when we see numbness or pain in the extremities?

Blood can't get to extremities or can't return to heart.

8

Name 6 possible causes of chest pain

➢ Cardiac
➢ Musculoskeletal
➢ Pleural
➢ Gastrointestinal
➢ Pulmonary
➢ Psychoneurotic

9

With pulmonary chest pain, what are 2 possibilities of what could be happening?

Clot, ulcer

10

What might be a cause of psychoneurotic chest pain?

Hyperventilation from anxiety attack

11

True or false: Chest pain in children and adolescents is seldom due to a cardiac problem

True, often respiratory in nature

12

What should you assume the underlying issue is with chest pain in adults?

Cardiac until proven otherwise

13

Name the four valves of the heart.

• Pulmonary Valve
• Tricuspid Valve
• Mitral Valve
• Aortic Valve

14

Name the 5 main vessels of the heart.

•Superior Vena Cava
•Inferior Vena Cava
•Pulmonary Artery
•Pulmonary Vein
•Aorta

15

Which valve separates the left atrium from the left
ventricle?

Mitral

16

Which valve separates the right atrium from the right
ventricle?

Tricuspid

17

The apex is the bottom/top of the heart and the base is the bottom/top of the heart.

Apex is bottom, base is top

18

What heart sound is systole (pumping)?

S1

19

What heart sound is diastole (filling)?

S2

20

Where is S1 the loudest?

Apex

21

Where is S2 the loudest?

Base

22

When the first heart sound, "lub" occurs, the _______________ close.

atrioventricular

23

When the second heart sound, "lup" occurs, the _______________ close.

semilunar

24

The sound of S1 = closure of ______ and ______ valves

tricuspid and mitral

*increase in intraventricular pressure during contraction exceeds the pressure within the atria, causing a sudden closing of the tricuspid and mitral valves

25

The sound of S2 = closure of ______ and ______ valves

aortic and pulmonic

*At the end of systole, the ventricles begin to relax,
the pressures within the heart become less than that in the aorta and pulmonary artery, and the pulmonary and aortic valves snap shut.

26

What bpm reading would be considered tachycardia?

>100 bpm in an adult

27

What bpm reading would be considered bradycardia?

< 60 bpm

28

What is the order of the cardiovascular assessment?

Inspection, palpation, auscultation

29

Where is the suprasternal notch?

A large, visible dip in between the neck in humans, between the clavicles, and above the manubrium of the sternum.

30

Where is the angle of Louis (also called the Manubriosternal angle)?

Also called the sternal angle, this is the synarthrotic joint formed by the articulation of the manubrium and the body of the sternum.

31

What are intercostal spaces?

Spaces between the ribs that are largely occupied by muscles

32

What are some things to assess for during inspection?

Scars, lifts and heaves, pulsations, skin discoloration, chest wall deformities

33

What are thrills?

These are vibratory sensations felt on the skin overlying the heart, which indicates turbulence; this can be felt in loud murmurs.

34

Where does one palpate for the point of maximal impulse?

Mid-clavicular line, 5th intercostal space, palpate PMI with one finger (located under breast tissue in women)

35

What are some things to assess for during cardiac palpation?

Note any thrills, palpate the Point of Maximal Impulse

36

Can you feel the PMI in everyone?

No, about 50% of people

37

What are two things that will help you if you are trying to palpate the PMI?

Have the patient hold their breath or lay on their left side. These both push heart closer to the surface.

38

What is the mailing address of the heart?

2245 APT. M
Heart Blvd

39

What the eff does the 2245 stand for?

second ICS R of sternum
second ICS L of sternum
fourth ICS L of sternum
fifth ICS mid clavicular

40

What does APT M stand for?

Aortic area, pulmonary area, tricuspid area, mitral area

41

When we are auscultating heart sounds, where do we begin?

Start at the supra-sternal notch to the Angle of Louis, 2nd intercostal space

42

The third intercostal space, left sternal border is called what?

Erb's point

43

What is the name for a high-pitched, scratchy sound caused by pericardial inflammation?

Cardiac rub (two pieces of oily salami is normal)

44

Where is a cardiac rub best heard?

Along the lower left sternal border using the diaphragm of the stethoscope with the patient sitting up, leaning forward, and briefly holding the breath.

45

How do you listen for murmurs?

Listen for murmurs in the same auscultatory sites: APTM.

46

What is the murmur grading system?

I - VI

47

What are two types of murmurs?

Regurgitation murmur - mitral valve insufficiency (bubbly murmur, a leak)
Ejection murmur – aortic stenosis

48

What are we checking in a peripheral vascular assessment?

• Skin temp
• Color
• Pulses
• Capillary refill
• Edema

49

What are the big kahuna vessels of the neck?

Carotid arteries and jugular veins

50

What is a bruit?

Blowing or swishing sound

51

What do we do when assessing the carotid arteries?

• Inspection (identify them)
• Palpate (pulse symmetry)—one at a time
• Auscultate for bruit (blowing or swishing sound)

52

What do we do when assessing the jugular veins?

Inspect bilaterally for distention

53

What is generally the most difficult pulse to find?

Popliteal

54

What is the name of the pulse point on the top of the foot?

Dorsalis pedis

55

What is the name of the pulse point on the back of the ankle, near the medial malleus?

Posterior tibeal

56

How do we grade pulses?

0-3+, 4+ in some places.

57

What does a 0 mean in pulse grading?

Absent

58

What does a 1+ mean in pulse grading?

Weak/thready

59

What does a 2+ mean in pulse grading?

Normal

60

What does a 3+ mean in pulse grading?

Increased, strong. Bounding.

61

If you are taking a CRT using a finger, where should the hand be?

Level with the heart

62

What is the edema grading system?

Grade if pitting present (1+ to 4+)

63

What is another way to assess edema?

Weight the patient

64

What is 1+ edema?

Disappears rapidly, "slight" (2mm)

65

What is 2+ edema?

Increased, disappears within 10-15 seconds (4mm)

66

What is 3+ edema?

Deeper, more obvious in extremetis, looks swollen, lasts 1 min (6mm)

67

What is 4+ edema?

Severe, looks edemous, can look deformed, lasts 2-3 minutes (8mm)

68

What is erythema?

Redness

69

Four things to assess for with a DVT

➢ Unilateral edema
➢ Pain or achiness
➢ Erythema
➢ Warmth

70

Should you move a patient with a suspected DVT or keep them still?

Do not move, could dislodge clot

71

Name whether this is a symptom related to a possible arterial vs. venous disorder: Pain after exercise.

Arterial

72

Name whether this is a symptom related to a possible arterial vs. venous disorder: Sharp, stabbing pain.

Arterial

73

Name whether this is a symptom related to a possible arterial vs. venous disorder: Pain with prolonged sitting or standing.

Venous

74

Name whether this is a symptom related to a possible arterial vs. venous disorder: Pain that is reduced with activity.

Venous

75

Name whether this is a symptom related to a possible arterial vs. venous disorder: Pain is described as aching, heavy.

Venous

76

Name whether this is a symptom related to a possible arterial vs. venous disorder: Lowering feet reduces pain.

Arterial

77

Which disorder is described by oxygenated blood being unable to get where it needs to be, type of atherosclerosis, affects legs more than arms, "can't get the stuff out." Arterial or venous disorder?

Arterial

78

Which disorder is described as a pump issue, "can't get the stuff in." Arterial or venous disorder?

Venous

79

Arterial or venous disorder?
Skin is:
Cool or cold
Hairless
Shiny

Arterial

80

Arterial or venous disorder?
Skin is:
Warm Thickened Mottled
Brown pigmented areas

Venous

81

Arterial or venous disorder?
Skin shows pallor on elevation and
rubor on dangling

Arterial
*Rubor is flushed

82

Arterial or venous disorder?
Pulses are often absent

Arterial

83

Arterial or venous disorder?
Pulses are usually present

Venous

84

Arterial or venous disorder?
Edema is frequent

Venous

85

Arterial or venous disorder?
Edema is infrequent

Arterial

86

What are the 6 P's of acute arterial occlusion?

• Pain
• Poikilothermia (“coldness”)
• Parasthesia (burning or prickling sensation)
• Paralysis
• Pallor
• Pulselessness

87

What is poikilothermia?

Coldness