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Flashcards in Cardiovascular Assessment and Skills Deck (15)
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1

general considerations of cardiac assessment (patient and general surroundings)

-patient must be properly dressed in a gown
-good lighting to see pulsations and slight movements
-quiet environment
-warm stethoscope and room

2

sequence of cardiac exam`

-inspection
-palpation
-auscultation
(percussion not routinely performed)

3

where are the different point of ausculation?

- aortic area: pt right side 2 ICS space
-pulmonic area: pt left side 2 ICS space
-erbs points: pt left side 3 ICS space
-tricupid: pt left side 4 ICS spance
-mitral/apical: pt left side 5th ICS midcalvicular line

4

inspection of the precordium

-apical impulse (may not be seen due to breast, obesity, muscle)
-apical impulse may be visible in children and adults with thin chest wall
-abnormal: strong pulsation like heaves/lifts in adult

5

inspection of the neck: carotid arteries

-medical to sternocleidomastoid muscle
-at 45 degree angle pulsation can be visible bilaterally and equal
-normal: mild pulsations at carotid

6

inspection of the neck: jugular vein

-distention reflects right sided heart failure
-normal: not visible at 30-25 degree angle
-if visible documentL degree, height: sign of worsening CHF
-located above clavicle and next to SCM
-

7

technique for heart palpation

-what to document

-postion at 30 degress, use 4 fingers
- note: locations, size of pulsations, quality of pulsation(sustained vs brief), at the apical pulse
-note: thrills, heaves, lifts at the aortic, pulmonic, tricuspid, erbs)

8

what can make palpating the apical pulse easier?

turning the patient to the left lateral position: this must the heart closer to the chest wall

9

palpation of the carotid arteries

-only do 1 at a time
-note quality

10

what to auscultate

-heart rate and rhythm
-sounds
-listen for 1 minute to determine pulse rate and regularity

11

what to listen for when ausclautign the heart?

-rate
-rhythm: regular/irregular
-S1: lub (mitral and tricuspid valve close)
-S2: dub (pulmonic and aortic valves close)
- S3 and S4 are abnormal
extra heart sounds

12

what is the diaphragm used for

-high pitch sounds
S1 and S2

13

what is the bell used for

Lowe pitched sounds
S3 and S4

14

heart murmurs

-caused by disruption of flow through the heart
-sound depends on: functions fo the valve, size of the valve opening, rate of blood flow

15

palpating the peripheral pulses

what to look for?

- assess for amplitude and symmetry
-capillary refill: less than 3 seconds