exam 2 Flashcards
(162 cards)
1
Q
apical heart rate can be auscultated where
A
Erb point
2
Q
what helps determine how much pressure in the right atrium
A
neck veins
3
Q
locations where to auscultate heart sounds
A
aortic area, pulmonic area, Erb point, tricuspid area, mitral area
4
Q
what causes variations in heart sounds
A
timing of heart valve closure
structure of heart valves
how quickly pressure rises in vessels
5
Q
a third heart sound is a indication of
A
congestive heart failure, myocardial failure, valvular disease
6
Q
degree of bed when looking at patient neck vessels
A
30-45
7
Q
high pitched noise that increases with inhalation in third intercostal space on left sternal border
A
pericardial friction rub
8
Q
what system has more pressure: arterial or venous
A
arterial
9
Q
picks up all extra interstitial fluid
A
lymphatic capillaries
10
Q
what disease is known to cause muscle atrophy
A
peripheral vascular disease
11
Q
signs of arterial disease
A
decreased capillary refill, delayed wound healing
12
Q
signs of DVT or thrombophlebitis
A
erythema, edema, tenderness
13
Q
finding that is most suggestive of skin cancer
A
8-mm diameter
14
Q
fluid filled lesion on skin
A
vesicle
15
Q
turgor
A
speed with which skin returns into place
16
Q
the sound made from air passing through narrowed bronchioles
A
wheezing
17
Q
high pitched, soft, brief sounds on inspiration
A
fine crackles
18
Q
low pitched, moist, lung sounds on inspiration
A
coarse crackles
19
Q
continuous, high pitched sounds caused by narrowing of small airways
A
wheezing
20
Q
load, coarse, low pitched grating or creaking sound
A
pleural friction rub
21
Q
low pitched snoring or gurgling sound that may clear with coughing
A
rhonchi noise
22
Q
high, harsh sounds with short inspiration and long expiration while ausculating trachea
A
bronchial breath sounds
23
Q
when does wheezing occur
A
when air passes thru a constricted passageway
24
Q
what causes crackles in breath sounds
A
moisture in airways
25
normal lung sound for most of lung for normal adult
vesicular
26
turbulence in blood flow
murmur
27
when does s4 happen
immediately before s1
28
what happens at start of systole
mitral and tricuspid valve need to close
29
what happens during P wave
depolarization of atria. atrial pressure increases, ventricular volume increases
30
what happens during QRS complex
depolarization of ventricles. increase in ventricular pressure
31
what happens during T wave
ventricular repolarization. ventricular pressure goes down
32
what does phonocardiograms do
shows sound of heart beat
33
S1
Tricuspid and mitral valve close
34
S1
Tricuspid and mitral valve close
35
S2
aortic and pulmonary valve close
36
split s2
heard only during inspiration. pulmonary valve was delayed in closing
37
split S1
mitral closes before tricuspid. this can be heard the best on apex. does not vary with respiration
38
usually closes after birth. if it doesn't close, oxygenated blood mixes with deoxygenated blood
Atrial septal defect (ASD)
ventricular septal defect (VSD)
39
Jugular venous distention
backup of blood flow. right atria has high pressures
40
JVP
high pressure that reflects right atrial pressure.
would be seen on right internal jugular vein over the left, but could be both
41
what should bed be at to detect JVP
30-45 degrees
42
dyspnea
SOB
43
orthopnea
SOB when patient is laying down but improves when standing
44
paroxysmal nocturnal dyspnea
sudden SOB that wakes someone up from sleep. makes a person physically stand to breathe
45
what could cause chest pain
angina pectoris, CAD, MI, acute coronary syndrome
46
swelling on lower part of body. legs, sacrum, feet
dependant edema
46
swelling on lower part of body. legs, sacrum, feet
dependant edema
47
poor oxygenated of body
cyanosis or pallor
48
fatigue in cardio patients
signals heart is not adequately supplying oxygen
49
what could rheumatic fever cause
cardiac dysfunction
50
assessing carotids
one at a time. do not massage them. Patients need to be laying down
51
All Patients Eventually Take Meds acronym
aortic
pulmonic
ERBs point
Tricuspid
Mitral
5 areas of listening to heart
52
where to listen to aortic
right 2nd intercostal space
53
where to listen to pulmonic
left 2nd intercostal space
54
where to listen to ERBs point
left 3rd intercostal space
55
where to listen to tricuspid
lower left sternal border/4th intercostal
56
where to listen to mitral
left 5th intercostal
medial to midclavicular line
57
high rate of blood flow thru normal valves
murmer
58
normal blood flow thru abnormal valves
murmer
59
grade 1 murmer
very faint. may not be heard in all positions
60
grade 2 murmer
quiet, but heard immediately after placing stethoscope on chest
61
grade 3 murmer
moderately loud
62
grade 4 murmur
loud with palpable thrill (vibration)
63
grade 5 murmur
very loud with thrill. may be heard when stethoscope is partly off chest
64
grade 6 murmur
very loud with thrill. can be heard with stethoscope entirely off chest
65
risk factors in coronary heart disease
diabetes, hypertension, increased cholesterol, smoking, obesity, inactivity
66
risk factors of hypertension
alc consumption, obesity, excess sodium intake, smoking, inactivity, not enough K+
67
healthy fats
foods high in monounsaturated fats, polyunsaturated fats, and omega 3 fatty acids
68
lymphatic system
takes fluid out of capillary beds, if fails, edema occurs
69
should you be able to palpate lymph nodes in healthy normal adults
no
70
brawny edema
nonpitting
71
scale 1 edema
2 mm depression - pitting
72
scale 2 pitting edema
4 mm depression
73
scale 3 pitting edema
6 mm depression
74
scale 4 pitting edema
8 mm depression
75
intermittent cladication
pain in legs during activity caused by insufficient arterial blood flow
76
symptoms/signs of PAD
sharp pain that's worse at night
intermittent claudication
weak pulse in extremities
cool temp
pale
hairless, dry, scaly skin
gangrene- tissue death from lack of blood
round, punched out wounds
77
signs/symptoms of PVD
dull,achy pain
edema
warm legs
stasis dermatitis- brownish/yellow skin
irregular shaped wounds
78
what causes swollen lymph nodes
infection, tumor, malignancy
79
0 grading for pulse
absent pulse. try doppler before writing this
80
1+ grading pulse
diminshed, weak pulse
81
2+ grading pulse
brisk, expected (normal)
82
3+ grading pulse
bounding pulse
83
when inspecting edema
measure difference, note color and texture of skin, note wounds
84
when assessing hair
access color, condition of shaft, if hair shafts are shiny, cleanliness, parasites, lesions
85
A high-pitched crowing sound from the upper airway results from tracheal or laryngeal spasm and is called what?
stridor
86
sound to suspect client has chronic lung disease
hyperresonance
87
When assessing posteriorly, where would the trachea bifurcate into its mainstem bronchi?
T4 spinous process
88
What replaces resonance when fluid or solid tissue replaces air-containing lung or occupies the pleural space?
dullness
89
what causes jaundice
liver issues.
Too much Bilirubin.
you can tell if someone has jaundice by the sclera of the eye
90
what causes cyanosis
lack of oxygen or bloodflow
91
ecchymosis
bruising
92
what is erythema and what causes it
reddening of the skin
caused by increased blood flow
93
carotenemia
comes from a diet high in beta carotene. yellow/orangish skin
94
vitiligo
absence of melanin pigment
95
mobility
ease at which skin lifts
96
turgor
speed at which skin returns to place
97
characteristics of psoriasis
red and angry looking
on extensor surfaces
98
linear skin pattern
in line
99
geographic skin pattern
map like appearence
100
clustered skin lesion
several lesions that are grouped together
101
serpiginous lesion
wavy border
102
annular lesion
ring shaped
103
acriform lesion
arc shaped
104
plaque
elevated lesion. 1cm or larger
105
patch
larger than cm. flat, nonpalpable
106
macule
less than cm. flat, non palpable
107
wheals
localized, palpable skin edema
108
cyst
nodule with accessible material like pus
109
vesicle
clear appearance with fluid
110
bulla
vesicles that are a cm or larger with fluid
111
pustule
palpable lesion filled with pus
112
what causes secondary skin lesions
over treating other skin issues or continuous scratching
113
lichenification
chronic rubbing or scratching
114
keloid
over scarring
115
erosion
loss of superficial epidermis
116
fissure
skin cracks due to dry skin
117
spider angioma
bright red, up to 2 cm. has middle with leg like appearance. throb or pulse feeling present
118
spider vein
could be several inches, common in legs or anterior chest. from increased pressure in veins
119
cherry angioma
bright red. no pulse feeling
120
petechiae / purpura
blood accumulated outside blood vessel. fades to look like bruise overtime
121
nevus
mole
122
stage 1 ulcer
reddend slin
123
stage 2 ulcer
skin is broken. superficial
124
stage 3 ulcer
wound near to reaching muscle
125
stage 4 ulcer
wound is down to bone
126
characteristics of alopecia
skin looks healthy, clear borders
127
trichotilomania
broken hair loss is seen. from plucking or pulling
128
clubbing nails
rounded. means chronic hypoxia
129
basal cell carcinoma
basal level of epidermis
most common and rarely metastasize
130
squamous cell carcinoma
upper layer of epidermis
can metastasize
ulcerated and scaly looking
131
melanoma
arise from melanocytes in epidermis
dangerous- metastasizes easy
dark with irregular looking border
132
how many lobes in lung
left-2
right-3
133
accessory muscles breathing
can see if there is trouble with respiration
134
hemoptysis
bloody sputum
135
purulent sputum
pus in sputum
136
sudden onset dyspnea examples
anaphylaxis, pulmonary embolism, spontaneous pneumothorax, anxiety
137
progressive onset wheezes
pneumonia, bronchitis, copd, interstitial lung disease, left sided heart failure
138
wheezing
from airway obstruction or inflammation
139
pleuritic pain
very painful with inspiration, coughing, or movement
-inflammation of pluera
140
funnel chest
chest indents. could lead to lung or cardiac issues
141
barrel chested
from air trapping
142
pigeon chest
from cartilage displacement. effects breathing
143
pigeon chest
from cartilage displacement. effects breathing
143
pigeon chest
from cartilage displacement. effects breathing
144
spine issues not allowing good expansion
thoracic kyphoscoliosis
145
tactile fremitus
patient say 99
If vibration heard in all location, normal finding
use hand
146
bronchoscopy
patient say 99
Sound becomes less distinct as moving down
Use stethoscope
If same throughout- abnormal
147
egophony
patient say E
Use stethoscope
Normal if E is more distinct
If it sounds more like AAA then abnormal finding
148
whispered pectoriloquy
Whisper 99
Use stethoscope
It should sound faint, if distinct as you keep going down, abnormal
149
low pitch, loud sound
resonance
sound of a healthy lung
150
high pitch soft sound
flatness
ex-thigh
151
medium pitch and sound
dullness
ex-liver
152
very loud, low pitch
hyperresonance
153
loud, high pitch
tymphany
154
crackles
fluid in lungs
could be fine or course
155
friction rub
could be from pleura or pericardium
156
rhonchi sounds
from thick mucus
157
measures how fast you can push air out the lungs when you blow as hard as you can
peak flow measure
158
Hair follicles, sebaceous glands, and sweat glands originate from the
dermis
159
ABCDE melanoma
Asymmetry
border
color
diameter
evolving
160
The nurse should carefully inspect which part of the body in an effort to differentiate central cyanosis from peripheral cyanosis?
oral mucosa
