Lecture 11: Cardiovascular Evaluation Flashcards
What is tachycardia considered to be?
Over 100 bpm
What is the normal heart rate range?
60-80 bpm
What is bradycardia considered to be and who can it normally occur in?
Less than 60bpm and it can be a normal occurrence for athletes
How long should you take heart rate for (in determining bpm) for a normal heart? How about in arrhythmias? Exercise?
15 or 30 seconds for a normal heart
60 seconds for a irregular heart
10 seconds during exercise
What are the grading scales for arterial pulses?
0 - absent 1 - trace 2 - normal 3 - greater than normal 4 - bounding
You note that your patient’s pulse is weak. What are the possible reasons for this?
(1) peripheral occlusion
(2) dehydration
(3) low BP
(4) arrhythmia
What different locations can arterial pulses be taken on the body?
- carotid, brachial, radial, femoral, popliteal, posterior tibial, dorsalis pedis , aortic (above umbilicus)
What is JVD a measurement for?
Jugular venous distribution measures right heart failure.
What distance is considered normal when measuring JVD vertically above the sternal angle? Abnormal?
Normal: less than 3-5 cm
Abnormal: greater than 5 cm
How far can one measure JVD?
Up to the angle of the jaw
How is BP indirectly measured?
With a sphygmomanometer at the arm or thigh
What % of the circumference of the arm/thigh is the bladder of the sphygmomanometer at the correct length and width?
Width - 40%
Length - 80%
If you use a BP cuff that is too small, how will this alter the reading?
BP will be too high - inadequate compression of the arm.
What is the technique for taking BP?
-Limb is relaxed and at heart level
-Palpate artery
-Place midpoint of cuff over the brachial artery
-Wrap cuff snugly
-Inflate cuff 20-30 mmHg above point when radial artery disappears
Deflate cuff 2 to 3 mmHg per second
If you miss a reading and or need to retake BP what do you do?
deflate cuff fully and wait 1-2 minutes before next measurement.
If you miss the reading and/or need to retake BP can you take the BP in the other arm?
No, because you want to stay consistent with the limb BP.
When you note a BP measurement in the chart, what must you specify?
Which limb the measurement was taken
Position (ie. sitting/supine/standing)
SBP/DBP
What are the 2 normal heart sounds? Two abnormal?
Normal: S1-S2
adventitious: S3-S4
For listening for normal heart sounds, what part of the stethoscope should you use?
Diaphragm
For listening for adventitious heart sounds, what part of the stethoscope should you use?
The bell
What is the S1 heart sound signify? What does it sound like? Where is it best heard?
- AV valve closure
- lower pitch, softer, longer
- heard best at the apex
What is the S2 heart sound signify? What does it sound like? Where is it best heard?
Pulmonary and aortic valve closure
Higher pitch, louder, shorter
Heard best at base
What is S2 splitting? When can S2 splitting normally occur?
When the pulmonic valve closes a little after aortic
Can occur normally during inspiration as blood flows to right heart increases
What is S3 signify? Who can it occur in normally?
Ventricular gallop, like rumble
Is normal during diastole in children and young adults
