Cardiovascular Physical Assessment - Exam 1 Flashcards Preview

SEMESTER FOUR!! Nursing 214 > Cardiovascular Physical Assessment - Exam 1 > Flashcards

Flashcards in Cardiovascular Physical Assessment - Exam 1 Deck (48):
1

Bradycardia

Slow resting heart rate. Less than 60 BPM

2

Tachycardia

Fast resting heart rate. Above 100 BPM

3

Normal PR interval

0.12-0.20 seconds

4

Normal QRS interval

Less than or equal to 0.12 seconds

5

Normal jugular vein distention (JVD)

Less than 3cm at 30 degrees head elevation

6

Order of assessment

Insepction, Palpation, Percussion, Auscultation

7

Normal PR Interval

0.12-0.20 seconds which is 3-5 small boxes

8

Normal QRS Interval

Less than or equal to 0.12 seconds which is 3 boxes or less

9

S1

First heart sound. Soft "Lubb"

Occurs at the end of the QRS interval. The ventricles depolarize, causing them to contract and the M & T valves to snap shut. Happens during Systole.

10

S2

Second heart sound. Sharp "Dubb"

Occurs during the T wave when the ventricles relax and the A & P valves snap shut. Happens during diastole

11

Normal characteristics for pulses

Normally 2+, equal bilaterally, with 0 meaning absent and 4+ being strong and bounding

12

Apical Pulse

Pulse counted for 1 minute at the 5th intercostal mid clavicular line

 

13

Normal Characteristics of the Carotid Arteries

Pulses equal in rate, rhythm, and strength bilaterally; unchanged by inspiration, expiration, or rotation of the neck

14

Normal characteristics of heart sounds

Regular intervals between each sequence of beats with a distinct pause between the two sounds. AKA lub dub, each lub dub counting as one heart beat.

15

Normal characteristics of jugular veins

3cm or less above the sternal angle is considered normal (angle of Louis)

16

Point of Maximum Impulse (PMI)

Point where apex of the heart is closest to the surface in the thorax (usually 5th intercostal mid clavicular line)

17

Heaves

Sustained lifts of chest wall that can be seen or palpated

18

Cardiac cell makeup

Cell is normally negative and more potassium is inside while sodium is outside. When the cell depolarizes, the cell becomes more positive and sodium rapidly enters the cell. Repolarization is the cell slowly going back to it's normal state.

19

Exercise/Stress Testing

Used to evaluate the cardiovascular response to physical stress (not used with pacemakers)

20

What can be a cause of juglar vein distention?

Right sided heart failure

21

Orthostatic BP normal results

Normal reduction from supine - standing is 20mm Hg and the HR should not increase more than 20 BPM

22

What is the difference between BP taken in the lower extremities VS upper extremities?

BP taken in the lower extremities can be expected to be 10 mm Hg higher than in the upper extremities

23

Normal Capillary Refill time

Less than 2 seconds

24

Resting ECG

Used for: conduction abnormalities, cardiac dysrhythmias, cardiac hypertrophy, pericarditis, myocardial ischemia, site and extent of MI, pacemaker performance, effectiveness of drug therapy

25

Ambulatory ECG Monitoring

Diagnostic info over greater amount of time than resting ECG

26

Event Monitor/Loop Recorder

Patient starts it when they experience symptoms

27

Systole

Ejection of blood from ventricles when ventricles contract.

Represented by QRS on ECG tracing

Sound S1

28

Diastole

Relaxation of ventricles and refilling of chambers

Represented by T wave on ECG

S2

29

Where is S1 best heard at?

Apex

30

Where is S2 best heard at?

Base

31

How many seconds does each small horizontal box represent (ECG)?

0.04 seconds

32

How many seconds does each large box represent (ECG)?

0.2 second

33

Cardiovascular Inspection

Use tangent light

Look for apical impulse - 5th intercoastals mid-clavicular

Alternate position - sit up, lean forward

34

Cardiovascular Palpation

Light touch

Point of maximal impulse (apical)

Base of heart (thrills)

Match PMI with carotid pulse

35

Cardiovascular Auscultation

  1. Sites: aortic, pulmonic, 2nd pulmoic (3rd intercostal), tricuspid (4th intercostals), mitral (5th intercostal)
  2. Patient may lean forward
  3. Check rhythm and rate
  4. Listen S1 while palpating carotid - begins systole
  5. Listen S2 - begins diastole
  6. Sound at apex S1>S2
  7. Sound at base S2>S1
  8. Neck Auscultation (listen for bruit)

36

Sinoatrial (SA) Node

Located in the upper right atrium

Initiates atrial depolarization and thus contraction

The natural pacemaker

Inherent rate of 60-100

37

Atrioventricular (AV) Node

Slows the electrical impulse to give ventricles time to fill

Considered the 2nd pacemaker

Inherent rate of 40-60

Begins conduction of the impulse to the ventricles

38

Bundle Branches and the Purkinje Fibers

Inherent rate of 20-40 if the SA and AV node stop

Ventricular depolarization and contraction

Any alteration in this conduction system is called a dysrhythmia/arrhythmia

39

Isoelectric Line

Area on a normal ECG strip that is electrically neutral

Nothing is happening in the heart at this time (electrically)

40

Normal characteristics of P Waves

Small

Rounded

Upright position in Lead II

One for every QRS

All same shape and size

Normal P waves indicate that the electrical impulse originated in the SA node and atrial depolarization occurred

41

Normal characteristics of PR Interval

The time it takes for the electrical impulse to leave the SA node and travel through to the Bundle of His

Measured from the beginning of the P wave to the beginning of the QRS complex

A normal PR interval measures 0.12-0.2 seconds or 3-5 small boxes

42

Normal characteristics of QRS complex

Represents the time it takes for the electrical impulse to depolarize the ventricles

The QRS is measured as the first wave leaves the baseline to where the last wave of the complex begins to flatten out

A normal QRS measures 0.12 (3 boxes or less)

43

Normal characteristics of T wave

The final phase of ventricular repolarization

Normal T waves are round, upright in lead II, smaller than QRS

44

How to measure heart rate from ECG

Refers to the ventricular rate. Count the number of R waves in a 6 second strip and multiply by 10

45

How to measure rhythm using an ECG

Measure from P to P and R to R - is it regular or irregular? use calipers or a peice of paper

46

Analyzing P waves ECG

Look at the P waves- is there one for each QRS, are they nearly identical?

47

Analyzing PR interval ECG

Measure the PR interval - is it normal, between 0.12-0.2 seconds?

48

Analyzing the QRS complex

Is each QRS preceded by a P wave? Do they all look nearly identical and is the complex less than or equal to 0.12 seconds?

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