RLE: Heart & Central Vessels Flashcards
(108 cards)
1
Q
???, the area of the chest overlying the heart, is inspected and palpated for the presence of ???
A
precordium;
abnormal pulsations or lifts or heaves.
2
Q
refer to a rising along the sternal border with each heartbeat. It occurs when cardiac action is very forceful
A
lift and heave
3
Q
lifts are confirmed by
A
palpation with the palm of hand
4
Q
Enlargement or overactivity of the ??? produces a heave lateral to the apex
A
left ventricle
5
Q
enlargement of the ??? produces a heave at or near the sternum
A
right ventricle
6
Q
Anatomic sites of the precordium.
A
aortic,
pulmonic,
tricuspid,
mitral,
epigastric area
7
Q
S1, occurs when the ??? valves close
A
atrioventricular (AV)
8
Q
the ??? valves close, producing the second heart sound, S2
A
semilunar
9
Q
AV valves
A
mitral, tricuspid
10
Q
semilunar valves
A
aortic, pulmonic
11
Q
s1 description
A
Dull, low pitched,
and longer than S2
12
Q
s2 description
A
Higher pitch than s1
13
Q
is the period in which the ventricles contract
A
Systole
14
Q
Systole is normally ??? than diastole
A
shorter
15
Q
the period in which the ventricles relax
A
Diastole
16
Q
S3 is normal in ???
A
children and young adults
17
Q
S3 often disappears when ??
A
the client sits up
18
Q
S3 in older adults, it may indicate ???
A
heart failure
19
Q
ventricular gallop
A
S4
20
Q
may be heard in older clients and can be a sign of hypertension.
A
S4
21
Q
only source of blood to the brain, prolonged occlusion of these arteries can result in serious brain damage.
A
carotid arteries
22
Q
The carotid is also auscultated for a ?
A
bruit
23
Q
A bruit (a blowing or swishing sound) is created by turbulence of blood flow due either to a narrowed ??? (a common development in older people) or to a condition, such as ??? or ???, that elevates cardiac output
A
arterial lumen;
anemia or hyperthyroidism
24
Q
If a bruit is found, the carotid artery is then palpated for ?
A
a thrill
25
frequently accompanies a bruit, is a vibrating sensation like the purring of a cat or water running through a hose. It, too, indicates turbulent blood flow due to arterial obstruction.
thrill
26
Normally, external neck veins are distended and visible when
a person lies down
27
external neck veins are flat
and not as visible when a person stands up, because ?
gravity encourages venous drainage.
28
By inspecting the jugular veins for pulsations and distention, the nurse can assess the ???
adequacy of function of the right side of the heart and venous pressure.
29
may indicate right-sided heart failure.
Bilateral jugular venous distention (JVD)
30
It is felt as a prominence on the sternum.
the angle of Louis
31
Diffuse lift or heave at the tricuspid area, indicates?
enlarged or overactive right ventricle
32
PMI displaced laterally or lower indicates ???
enlarged heart
33
Diffuse lift or heave lateral to apex
indicates ??
enlargement or
overactivity of left ventricle
34
Avoid exerting too much pressure or massaging the area. Rationale:
Pressure can occlude the artery, and carotid sinus massage can precipitate bradycardia
35
is a small dilation at the beginning of the internal carotid artery just above the bifurcation of the common carotid artery, in the upper third of the neck
carotid sinus
36
Presence of bruit in one or both arteries suggests
occlusive artery disease
37
Although either the internal or the
external jugular vein can be used, the internal jugular vein is more reliable.
Rationale:
The external jugular vein is more easily affected by obstruction or kinking at the base of the neck.
38
JVP: Bilateral measurements above ??? are considered elevated
3 to 4 cm (1.2 to 1.6 in.)
39
Infants: Physiological splitting of the second heart sound (S2) may be heard when the child takes a deep breath and the ?
aortic valve closes a split second before the pulmonic valve
40
Infants: . If splitting of S2 is heard
during normal respirations, it is abnormal and may indicate an ???, ???, or ???
atrial-septal defect, pulmonary stenosis, or another heart problem
41
Infants may normally have ??? that is related to respiration. The heart rate slows during ??? and ??? when the child breathes in.
sinus arrhythmia;
expiration;
increases
42
??? may be heard in newborns as the structures of fetal circulation, especially the ductus arteriosus, close.
Murmurs
43
In ???, Heart sounds may be louder because of the thinner chest wall
children
44
The PMI is higher and more medial in children under ? years old.
8
45
If no ??? is present, heart size remains the same size throughout life.
disease
46
??? and ??? decrease, thus lessening the older person’s activity tolerance.
Cardiac output and strength of contraction
47
In older adults, extra ??? commonly occur.
[how many] of this per minute are considered abnormal?
systoles,
Ten or more
48
For older adults, sudden emotional and physical stresses may result in ??? and ???
cardiac arrhythmias and heart failure
49
The heart is a hollow, muscular, four-chambered organ located in the middle of the thoracic cavity between the lungs in the space called the ???
mediastinum
50
The anterior chest area that overlies the heart and great vessels is called the ???
precordium
51
The ??? side of the heart pumps blood to the lungs for gas exchange (pulmonary circulation) by removing CO2 from blood and replenishing oxygen supply.
right
52
the ??? side of the heart pumps blood to all other parts of the body (systemic circulation).
left
53
occurs when blood flows to tissues and organs promoting the diffusion of oxygen and carbon dioxide.
Perfusion
54
The ??? is thicker than the other ventricle because the this side of the heart has a greater workload
left ventricle
55
The ??? is a tough, inextensible, loose-fitting, fibroserous sac that attaches to the great vessels and surrounds the heart.
pericardium
56
A serous membrane lining, the ???, secretes a small amount of pericardial fluid that allows for smooth, friction-free movement of the heart.
parietal pericardium
57
covers the outer surface of the heart
epicardium
58
The ??? is the thickest layer of the heart, made up of contractile cardiac muscle cells.
myocardium
59
The ??? is a thin layer of endothelial tissue that forms the innermost layer of the heart and is continuous with the endothelial lining of blood vessels
endocardium
60
The generation and conduction of electrical impulses by specialized sections of the myocardium regulate the events associated with the filling and emptying of the cardiac chambers. The process is called the ???
cardiac cycle
61
is located on the posterior wall of the right atrium near the junction of the superior and inferior vena cava. With inherent rhythmicity, generates impulses (at a rate of 60–100/min) that are conducted over both atria, causing them to contract simultaneously and send blood into the ventricles.
sinoatrial (SA) node (or sinus node)
62
node located in the lower interatrial septum. This node slightly delays incoming electrical impulses from the atria and then relays the impulse to the ??? in the upper interventricular septum.
AV node;
AV bundle (bundle of His)
63
The electrical impulse then travels down the right and left bundle branches and the ??? in the myocardium of both ventricles, causing them to contract almost simultaneously
Purkinje fibers
64
Although the ??? functions as the “pacemaker of the heart,” this activity shifts to other areas of the conduction system, such as the Bundle of His (with an inherent discharge of 40–60/min), if the this cannot function.
SA node
65
Electrical impulses, which are generated by the SA node and travel throughout the cardiac conduction circuit, can be detected on the surface of the skin. This electrical activity can be measured and recorded by ???
electrocardiography
66
Atrial depolarization; conduction of the impulse throughout the atria
P wave
67
Time from the beginning of the atrial depolarization to the beginning of ventricular depolarization, that is, from the beginning of the P wave to the beginning of the QRS complex
PR interval
68
Ventricular depolarization (also atrial repolarization); conduction
of the impulse throughout the ventricles, which then triggers contraction of the ventricles; measured from the beginning of the Q wave to the end of the S wave
QRS complex
69
Period between ventricular depolarization and the beginning of ventricular repolarization
ST segment
70
Ventricular repolarization; the ventricles return to a resting state.
T wave
71
Total time for ventricular depolarization and repolarization, that is,
from the beginning of the Q wave to the end of the T wave; this varies with heart rate (HR).
QT interval
72
May or may not be present; if present, it follows the T wave and represents the final phase of ventricular repolarization
U wave
73
This refers to the filling and emptying of the heart’s chambers.
cardiac cycle
74
The cardiac cycle has two phases:
diastole
systole
75
(relaxation of the ventricles, known as filling)
diastole
76
(contraction of the ventricles, known as emptying)
systole
77
Heart sounds are produced by ?
valve closure
78
are referred to as diastolic filling sounds, or extra heart sounds, which result from ventricular vibration secondary to rapid ventricular filling.
S3 and S4
79
The four valve areas do not reflect the anatomic location of the valves. Rather,
they reflect the way in which heart sounds radiate to the chest wall.
80
Second ICS at the right sternal border—the base of the heart
Aortic area
81
Second or third ICS at the left sternal border—the base of the heart
Pulmonic area
82
Fifth ICS near the left MCL—the apex of the heart
Mitral (apical)
82
Third ICS at the left sternal border
Erb point
83
Fourth or fifth ICS at the left lower sternal border
Tricuspid area
84
How to Auscultate:
Position yourself on the client’s ??? side. The client should be ???, with the upper trunk elevated ? degrees.
right;
supine;
30
85
Use the ??? of the stethoscope to auscultate all areas of the precordium for high-pitched sounds.
diaphragm
86
Use the ??? of the stethoscope to detect (differentiate) low-pitched sounds or gallops.
bell
87
Auscultating: Apply the ??? firmly to the chest, but apply the ??? lightly.
diaphragm;
bell
88
Blood normally flows silently through the heart. There are conditions, however, that can create turbulent blood flow in which a swooshing or blowing sound may be auscultated over the precordium.
Murmurs
89
is the amount of blood pumped by the ventricles during a given period of time (usually 1 minute)
Cardiac output (CO)
90
The normal adult CO is
5 to 6
L/min
91
is the amount of blood pumped from the heart with each contraction
stroke volume (SV)
92
It should be assumed that the chest pain is due to ??? until determined otherwise through a thorough assessment. This may be life threatening due to lack of oxygen causing damage to cells in the heart muscle.
cardiac ischemia
93
??? presents the greatest risk for developing CAD.
Dyslipidemia
94
CAD
Coronary Artery Disease
95
Elevated cholesterol levels have been linked to the development of ???
atherosclerosis
96
Cardiovascular Pain: myocardial ischemia
Angina
97
Cardiovascular Pain: Irreversible heart damage due to myocardial ischemia
myocardial infarction
98
Cardiovascular Pain: tear in the wall lining the aorta
Aortic dissecting aneurysm
99
Cardiovascular Pain: inflammation of the parietal pleura next to the pericardium
pericarditis
100
In women with large breasts, it may be helpful to ask the client to pull their breast [direction] when you are auscultating for heart sounds
upward and to their side
101
Distention of jugular vein on one side may be caused by a ??? or ???
kink or aneurysm
102
Always ??? the carotid arteries before ??? because palpation may increase or slow the HR, changing the strength of the carotid impulse heard
auscultate;
palpating;
103
Be cautious with older clients because ??? may have caused obstruction and compression may easily block circulation.
atherosclerosis
104
If this apical pulsation cannot be
palpated, have the client assume a ???. This displaces the heart toward the left chest wall and relocates the apical impulse
farther to the left.
left lateral position
105
In older clients, the ??? may be difficult to palpate because of increased anteroposterior chest diameter
apical impulse
106
Do not ask the client to ???. This will cause any normal or abnormal split to subside.
hold their
breath
107
While auscultating, keep in mind that development of a ??? may be the earliest sign of heart failure.
pathologic S3
